The Good Practice paper, Reconfiguration of women’s services in the UK, is based around recommendations made in several RCOG reports and guidance from other relevant organisations. It focuses on workforce planning including obstetric staffing, size of unit, geographical access to units, education and training, and discusses the NHS reforms and changes.
A key consideration for reconfiguration includes staffing of units and rigorous assessment of a woman’s risk profile. In any birth setting the role of the midwife remains central as the main supporter of the labouring woman but in the obstetric unit there needs to be immediate access to senior medical obstetric staff, says the paper.
Providing 24-hour consultant presence on the delivery suite for women requiring obstetric care is important and improves patient safety and overall experience; however, this may not be necessary for smaller units, says the paper. The RCOG report Safer Childbirth suggested 60 hours per week presence as a minimum standard for units between 2500 and 4000 births per year.
In addition, as births are increasingly complex, there is a need for enhanced multidisciplinary team working, states the paper, including the availability of obstetric physicians and perinatal psychiatrists to deal with co-morbidities.
In response to the NHS reforms the paper says that any non-NHS providers of healthcare must adhere to NHS standards and pathways including the use of national clinical guidelines from NICE and the RCOG. Moreover, patient-centred care needs to be a priority and the new Healthwatch groups and Health and Wellbeing Boards should advise CCGs using Patient Reported Outcome Measures (PROMs).
The paper refers to the RCOG’s Working Party report High Quality Women’s Health Care which made the case for the reorganisation of reproductive health services and recommended that health care be provided through women’s health networks, offering better care throughout the life course.
Professor Alan Cameron, RCOG Vice President Clinical Quality, says:
“The RCOG has a responsibility to define standards of care for maternity and gynaecological services.
“As the demands on services are increasing due to a rising birth rate, more complex cases and more women with existing co-morbidities, there is an urgent need to invest in more consultants and midwives in order to provide high quality care.”
The new paper can be found here.
For more information please contact Naomi Courtenay-Luck on 020 77726357 or firstname.lastname@example.org