A new service and workforce planning tool designed specifically for maternity services is being developed which aims to support local organisations in planning future service delivery and take into account the impact of changes such as WTD 2009.

Research and consultancy group Matrix RCL is working with the Care Services Improvement Partnership (CSIP) to develop the tool. It will provide strategic health authorities and managed clinical networks with a method of comparing alternative approaches to providing maternity services across a health economy – allowing evaluation of the various approaches and potential scenarios that may affect service provision.

Initiatives and directives such as the Children’s National Service Framework, Shifting the Balance of Power, Agenda for Change, the Clinical Negligence Scheme for Trusts and the European Working Time Directive are transforming the way that healthcare generally, and maternity services specifically, are commissioned and delivered. New models of care are emerging – partly as a result of the explicit emphasis on reconfiguring healthcare around the needs of the patient. A number of local and national drivers affect service and workforce planning for maternity services. These drivers often shape strategic plans and service and capital investments. The tool has been developed from this approach – helping the NHS take these many factors into account.

“The tool provides key service and workforce information in a format that enables and informs local discussions,” explains David Wells, CSIP’s Working Time Directive lead for maternity and paediatrics, “It allows local knowledge and expertise to design services that meet local demand and retain local choice. This has proved vitally important in initial testing. Whilst population predictions are driven by the Office of National Statistics data, local choice influences are more difficult to map. They flow across health economy boundaries and various factors greatly influence demand. Using the tool it would be possible to ask questions such as just what is the future impact on a service if it is successful and demand increases by 2% or what the impact would be if an additional 10,000 new homes are built in the local area? This means that long-term planning can be improved and flexibility built into decision making.”

The project is based on the modelling tool developed by the Department of Health to support modernisation of neonatal services, which was utilised widely across the NHS. Notice has been taken in the design of the maternity tool of many of the comments received as a result of an evaluation of the neonatal tool.

The original vision has been shaped by working with groups of stakeholders – not only at SHA level but with doctors and midwives delivering frontline services. The model utilises national planning norms from Royal College guidance and data from existing tools such as Birthrate Plus, yet provides flexibility to allow health economies to model local norms and compare those with the national figures.

“We’ve tried to make the tool as practically useful as possible,” says David Wells, “Although it is possible, it was recognised there was little benefit in modelling the ideal locations for maternity units as few health economies would have the capital resources to move existing units. However, it was critical to understand the capacity, case mix and staffing requirements in units both now and for the future. The model allows for comparison of various combinations of delivery units, changes to skill mix, change in clinical practice and ultimately comparison of affordability.”

The tool is presently being tested in two health economies and will be available during March or April free of charge to SHAs and managed clinical networks. A series of training sessions and local support to health economies will be made available through CSIP (www.csip.org.uk).

For further information contact:
david.wells@dh.gsi.gov.uk

“It allows local knowledge and expertise to design services that meet local demand and retain local choice.”