Midwifery coc

[scissorss]

Midwives, the time is almost upon us where we are expected to work “ flexible” to provide continuity of car( work 37.5 hours a week and be on call an additional 48 - 60 hrs per week and have our phones on to work when the women need us) .

I am having sleepless nights about the way our hospital plans to implement this. We cannot afford to do it the way that is the dream model ( 35 women each per year). Our caseloads will be bigger at any given time. Our full time midwives will need to do upto 4 on calls a week to cover annual leave, study leave and sickness. And when you do a weekend it will be a 60 hour on call!!! Payment for call ins is a pitiful amount.

They will force through 35% in the next few months 🙁

Are there any hospitals out there who have decided to rebel and not implement this model and pay the fine, if your hospital is pushing it through what are your models like and is everyone onboard?

Our hospital is taking a much less extreme approach. Setting up teams slowly. We have a high elective section rate so they started there, our homebirth team was already well established, they’ve moved on to expanding the mental health/safeguarding team, and creating a birthing unit team. No one is doing an individual caseload, but sharing clinics/doing introductory sessions so that their women have met everyone or most people from a team. No mad on calls (homebirth team a bit different but still fairly reasonable) as there will be midwives from each team allocated to delivery suite on any given shift.

We do 5000-ish births per year I think? Meeting our current target of 20% I believe.

We are doing team midwifery. Teams of about 8 where some are part time. No on calls. There are about 10 teams for the hospital if I remember right and every day each team is expected to provide one midwife for community work, one midwife for the day inpatient team and one midwife for the night inpatient team. There are also some core midwives. Then when the inpatient midwives come in for their shift, if one of the women from their team is in labour they will care for her, otherwise she will do postnatal or antenatal ward.

Personally I am on board, I would like to provide some continuity and although I think the teams are too big to provide proper continuity, the odds of a woman knowing her midwife in labour have increased and we don't have to do any on calls. I personally wouldn't mind doing some, but agree four a week would be too many. I also enjoy doing a mix of community, postnatal ward and labour ward / birth centre.