University Hospitals Coventry and Warwickshire NHS Trust
Section 1
Introduction
Purpose of document
The women of Coventry & Warwickshire are able to access maternity services that are able to deliver the choice agenda, set out in Maternity
Matters, by end 2009. Specifically: Choice of how to access maternity care; Choice of type of antenatal care; Choice of place of birth; Choic e of
postnatal care.
The access and quality of these services is not dictated by locality or the diversity of the pregnant women.
Quality outcome for pregnant women & the newborn is high as evidenced by compliance to NICE guidance, evidence based practice, Health
Commission standards and achievement of PSA targets.
The workforce delivering the care to pregnant women and the newborn are skilled, competent and confident to deliver that care in all care settings
in a flexible manor. This will reflect in improved sickness & retention rates and staff survey results.
Maternity Care features positively in the Organisational Plans of provider services and Local Delivery Plans of commissioning organisations
Description of geographical area
The Health Economy of Coventry & Warwickshire is a mixed urban and rural community. See appendix 1 for map
Demographics
Warwickshire Demographics
The total population of Warwickshire is just over 500,000 (ONS mid year estimates 2006) of which just over 101,000 are women aged 15 – 44
years. The table below show the numbers of women aged 15-44 years for Warwickshire and by district council.
Locality Females aged 15-44yrs (Thousands)
North Warwickshire 11.9
Nuneaton and Bedworth 24.1
Rugby 17.4
Stratford-on-Avon 20.0
Warwick 28.0
Warwickshire 101.4
Recent projections of ethnicity suggest the following, which will impact on maternity services:
Nationally, the White British population declined between 2001 and 2005, yet across Warwickshire over the same period this population group
is estimated to have increased slightly by 1,700.
The non-„White British‟ group is estimated to have risen by 10,100 between 2001 and 2005, increasing its proportion of Warwickshire‟s total
resident population from 7.3% to 9.2%.
The proportion of the total non-„White British‟ population is highest in Warwick (14.0%), and lowest in North Warwickshire, with 5.1% of the
total population.
The „Asian Indian‟ group is estimated to be the largest non-„White British‟ BME group in Nuneaton & Bedworth, Rugby, Warwick, and
Warwickshire as a whole.
Source: Warwickshire Observatory 2007
Deprivation at SOA level: Income Deprivation Affecting Children Index:
The percentage of children aged 0-15 living in income deprived
householdsChase
Cannock
Cannock Chase
Lichfield
Lichfield
The map highlights the key areas of deprivation in Warwickshire based on income deprivation
and lone parents from the 2007 Index IMD 2007 of Multiple deprivation (IMD) scores.
Walsall
Walsall
Warwickshire has low income Wolverhampton
Wolverhampton
deprivation and child poverty, with 8% of residents living
in low-income households. These North Warwickshire
areas are centred around Nuneaton, Bedworth & North
Warwickshire Sandwell
Sandwell
Dudley
Dudley Birmingham
Birmingham Nuneaton and Bedworth
% living in income deprived households
The teenage pregnancy rate is low in >=40% and =30% and =20% and =10% and =5% and 10 >5 <5
years Years years
104 98 20
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Pay Bands
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST
MIDWIFERY SERVICES MANPOWER FIGURES AT 31 MARCH 2007 (Excluding Neonatal Unit Staff)
IN POST (WTE) TOTAL
STAFF FUNDED ESTAB. FULL TIME PART TIME TOTAL IN POST
(WTE) IN POST (WTE) (HEAD COUNT)
1 2 3 4 5
MIDWIVES – BAND 9
MANAGERS AND NON-
CLINICAL MIDWIVES: MIDWIVES – BAND 8D
MIDWIVES – BAND 8C 1.0 1.0 1.0 1
MIDWIVES – BAND 8B
MIDWIVES – BAND 8A 3.0 3.0 3.0 3
MIDWIVES – BAND 7 0.80 0.80 1
CONSULTANT MIDWIFE
MIDWIVES:
BAND 7 58 37 19.40 56.40 65
BAND 6 80 22 52.67 74.67 108
BAND 5 10 11 3.20 14.20 15
BAND 7
NON MIDWIVES:
BAND 6 1.0 1.0 1.0 1
BAND 5
NURSERY NURSES ALL GRADES
MATERNITY CARE ALL GRADES 28 7 15.74 22.74 35
ASSISTANTS
TOTAL MIDWIVES
ALLOCATED TO
COMMUNITY (WTE) 32.70
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Section 4
Delivering the vision.
In order to deliver the vision for maternity matters Coventry and Warwickshire have set up a
Maternity Matters Network in order that all areas can deliver the vision across the healt h economy
and share good practice.
The Coventry maternity service has been reviewing skill mix, roles and responsibilities and
developing a flexible workforce over the last three years. There has been excellent partnership
working with Coventry university in order to commission an appropriate number of student midwives
in order to fill the expected shortfall of qualified midwives in the future. The UHCW midwifery team
have been actively involved in curriculum planning with the university in order that midwives have the
appropriate skills to implement and continue the maternity matters agenda for the future.
The midwifery team have committed to enabling midwives to practice the art of midwifery by
removing non-midwifery roles from midwives and this will be further developed over the next year.
Midwives are being supported to normalise birth and there is a plan to develop a midwifery led unit in
the West Wing.
Choice.
In order to deliver the choice agenda several areas are currently under exploration:
Increasing the choice of place of birth including home birth by reviewing on call systems
and developing the night midwifery practitioner.
Developing postnatal clinics in children‟s centres in order that women have a wider
choice about postnatal care and sign posting to the multi-professional team.
Ensuring that midwifery led care is fully implemented
The community midwifery team delivers continuity of midwife in both the ante and
postnatal period, this needs to continue with the integration of rotational midwifery
posts.
Access
The midwifery team are committed to ensuring that women can access local care. It is vital
that both midwifery and obstetric care is available in both Coventry and Rugby. There are 19
children‟s centres in Coventry and midwifery supports the children‟s centres parent education is also
available in locality centres.
Currently there are 87 antenatal clinics in GP surgeries and health centres across Coventry
and Rugby each week. There are 7 parent education sessions held in a variety of s ettings including
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children‟s centres. The vision is to review the timings of services in the community and to make
access easier for hard to reach communities.
Action Plan
Continue to recruit as posts become available
Retention of staff remains robust
Work with the Trust to implement the recommendations of the birth rate plus assessment
Continue to review student commissions annually
Expand on the normal birth commitment and develop the midwifery led area.
Continue the robust mandatory training programme which is in place and constantly review the
training needs of midwives and support staff
Develop the maternity care support worker particularly in community
Implementation and review.
Staff consultation and focus groups for midwifery led unit.
Ensure risk manager is involved in implementation
Work with local communities and centres to enable more access to flexible antenatal and
postnatal clinics
Continue negotiation with Trust to increase staffing establishments as recommended by birth
rate plus
Continue to review skill mix and roles
Review training needs and programmes
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Appendix 5 – Local Choice Agenda
Current Position across Coventry & Warwickshire for Place of Births (figures are for annual total births in each
unit)
Home Births – 4%
Midwifery Lead
Unit Births – 0%
Hospital Births – 96%
Position in 1 year Across Coventry Position in 2 years Across Coventry
& Warwickshire for Place of Births & Warwickshire for Place of Births
Home Births – 4% Home Births – 5%
Midwifery Lead Unit Midwifery Lead Unit
Births – 20% Births – 40%
Hospital Births – 50% Hospital Births – 50%
Position in 5 years Across Coventry & Warwickshire for Place of Births
Home Births – 10%
Midwifery Lead Unit
Births – 50%
Hospital Births – 40%
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