Midwife Work Done By Unqualified Support Staff
Maternity support workers in NHS hospitals are being given tasks that only qualified midwives should be doing.This could be putting mothers and their babies at risk according to researchers at Kings College London. Maternity Support Staff, sometimes known as maternity care assistants, were first introduced into the NHS in 2005 in response to growing concerns over staffing on maternity wards. The support staff could be doing anything from clerical work and answering the telephone, to helping out in ante-natal clinics and accompanying midwives on community visits.
The Royal College of Midwives has warned that the workload faced by midwives is intense, and morale is low. 20% of all midwives are over 50 and although the the number of midwives in training is growing, there are fears that many will opt to leave the NHS. At the moment, more than half of all midwives choose to work only part-time.
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If properly trained, support workers could even support women in early labour, carry out blood and urine tests, and make sure women got proper support when learning to breastfeed after having their baby. Some trusts have given maternity care assistants roles where they help midwives during waterbirths. The duties given to the support workers varies from trust to trust, as does the length of training.
According to the report, in some cases, midwives released up to 64% of their time each week by handing over simple duties to maternity support workers.
However the reasearchers found that maternity support staff have often been told to go further than this as a result of busy periods on hard-pressed labour wards. They have carried out tests such as ultrasounds or foetal heart monitors, vaginal examinations or one-to-one care later in labour. The report says that in some cases, maternity support staff have even acted as the sole 'night cover' member of staff at a midwife-led birthing centre.
The report suggested that some trusts, in order to save money, were closing vacancies for midwives and replacing them with a vacancy for a maternity support worker.
Mervi Jokinen, Practice and Standards Development Adviser for the Royal College of Midwives, said there were certain tasks that midwives were legally required to carry out.
She said: "You can understand how, when a trust is pushed, and short of midwives, that this boundary could be crossed - but that doesn't make it right. There is no excuse for doing this when someone's safety is at risk. At a very basic level a maternity care assistant helps carry out all non-clinical tasks on the ward, perhaps helping to feed and clean the women, do paperwork, but we would not expect clinical maternity care to be carried out by them. What would be the point of a maternity care assistant carrying out a foetal heart trace if they don't have the skills to interpret it?"
Belinda Phipps, from the National Childbirth Trust, said
"What women want is a one-to-one relationship with a skilled midwife while they give birth. The last thing they need is to have a room like Piccadilly Circus with lots of people popping in and out to do different things."
The Department of Health has now issued clear guidance on what maternity support workers are not allowed to do. And Chief Nursing Officer Christine Beasley has written to all NHS chief executives reminding them that they have a legal responsibility for all babies to be delivered either by a midwife or a doctor.
May 2007
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