Two years ago I was a senior charge midwife in a busy labour ward.
While labour wards can be joyful places, as parents welcome a new little one into the world, they can also be very intense, stressful places as staff try their very best to make sure birth is a positive, safe experience for both parents and child.
“When the Scottish Government published The Best Start report for maternity and neonatal services, I was excited, enthused and apprehensive.”
Maternity services in Scotland vary hugely not just in relation to geography, but also to the workforce, the location of care delivery and capacity of services. So when the Scottish Government published The Best Start report for maternity and neonatal services in 2017, I was excited and enthused but equally apprehensive.
The key recommendations of Best Start included continuity of carer, putting women and babies at the centre of care, multi-professional working and a new model of neonatal intensive care service.
While midwifery student numbers were receiving substantial investment, I was aware that the experience and expertise of the midwives I was working alongside would be lost just as these younger, less experienced staff were coming into the workplace: almost 40% of midwives were aged in the 50 and over bracket.
Therefore, Best Start was a BIG ask, and I had a LOT of questions.
How will such ambitious recommendations ever be achievable? How can we ensure the staff are confidently skilled in all areas of the pregnancy journey? How can I as a clinical leader support this in a busy, high risk obstetric unit?
When the Government announced in 2018 its intentions to enshrine safe staffing in law, I had even more questions.
What is safe staffing? What would this mean for the staff on the shop floor? How will this impact midwifery care and, wider than that, nursing care?
“The basic aim of the Bill was to provide high quality care by ensuring the right people were in the right place, with the right skills at the right time”
I became engrossed in the new Bill and its progress through parliament. The basic aim of the Bill was to provide high quality care by ensuring the right people were in the right place, with the right skills at the right time to ensure the best health and care outcomes. Throughout my work as a clinical midwife, research midwife and senior midwife, in a variety of boards I’ve come to see these factors as central to the work of not just midwives but to the wider workforce of the NHS. So when a secondment opportunity arose to work as part of the advisory team supporting NHSScotland Boards with the use of workload and workforce planning tools, I went for it.
Initially based in the Chief Nursing Officer’s Directorate before moving to Healthcare Improvement Scotland in 2019, being a programme advisor has allowed me to look closely at the workforce planning processes not just in midwifery, but across a range of healthcare professions. It’s allowed me to explore the wide variation in tools and resources that are used in clinical service. To really understand the basic fundamentals of budgets, planning and service redesign for the best service user experience. To appreciate the positives of good governance and risk assessment. All of these are areas I knew about as a midwife, but can I really say I understood them?
Now, in my role with Healthcare Improvement Scotland, I’m working to answer for others all the questions that I’ve had.
“Supporting boards to understand the demands of the new Safer Staffing legislation and prepare for meeting its requirements as we move towards final enactment, I have been on a rollercoaster of learning and overcoming challenges.”
Supporting boards to understand the demands of the new legislation and prepare for meeting its requirements as we move towards final enactment, I have been on a rollercoaster of learning and overcoming challenges. My role has evolved massively in a short period of time and I now find myself speaking at national events and presenting abstracts for improvement work in this field. I have forged networks and empowered so many wonderful professionals and like-minded individuals who all aspire to that safe, effective and high quality care goal.
How we will monitor and report on the compliance of the legislation is in its infancy, but it’s exciting and uplifting to be a part of something that is shaping healthcare for future generations.
Find out more about the Health and Care (Staffing) (Scotland) Act:
Contact the mailbox: HCIS.HSP@nhs.net
Laura Boyce is a Programme Advisor with the Healthcare Staffing Programme.