Staff shortages threaten care of mums at ERI
July 26th, 2007
NEW mothers at Edinburgh Royal Infirmary could miss out on vital post-natal care because staff levels are repeatedly falling below the minimum required level, campaigners warned today.
Wards at the Simpson Centre were left short on 30 occasions in the first three months of the year, according to new figures.
The news has prompted calls for more midwives to be employed and for more expectant mothers from the Lothians to give birth at St John’s Hospital in Livingston to ease pressure on staff at Little France.
The worst affected departments at the Simpson Centre were post-natal wards, where new mothers receive key support in the hours and days after giving birth, such as learning about breastfeeding.
Edinburgh-based Cynthia Clarkson, maternity services convener with the National Childbirth Trust, said: “It is very difficult to work out exactly how many women are going to be present at the Simpson’s because of the unit’s size. It is the biggest in Scotland and dealing with 6000 births a year is the root of the problem.
“If wards are under-staffed it is sad for the women who need the support of a good midwife to ensure the best outcome for their birth.
“They need to be encouraged through the process, taught how to cope with the pain, and receive proper post-natal care.
“In the Lothians, I would like to see things evened up, with more women going to St John’s, although I appreciate some women may not choose this option.
“NHS Lothian could probably also do with a small increase in the number of midwives.”
At the ERI, ante-natal and post-natal care is provided in ward 119, where there are 25 beds. National guidelines dictate there should be a daytime minimum of six trained workers, such as midwives or nurses, and two untrained workers, such as auxiliaries.
Between January and March, there were five occasions when staffing dropped below the required levels, including times when the ward was nearly full.
Ward 211, which handles post-natal care and has 20 beds, requires five trained staff and three untrained staff during the day. There were 13 occasions when levels fell below operational requirements, including times when the ward was at capacity.
In the ERI’s labour suite, where women give birth, the minimum level is 14 midwives or nurses and three untrained workers.
During a dozen night shifts - when it is harder to find staff from the “nurse bank” of staff who work flexible hours - there were just 12 or 13 trained workers. However, in each instance the labour suite was less than half-full.
An NHS Lothian spokeswoman said it tries to bring in workers from elsewhere to ensure new mothers and babies at the ERI are not affected by staff absences.
Heather Tierney-Moore, nurse director with NHS Lothian, said: “Where staffing levels have dropped below operational requirements, personnel are deployed from neighbouring wards, the nurse bank or, in exceptional circumstances, nursing agencies. In many cases, a change in skill mix can also achieve the appropriate level of cover.
“This ensures that the mothers and babies in the Simpson’s are not affected by staff absences.
“NHS Lothian has one of the lowest rates of absence for health boards in Scotland and our promoting attendance policy is supporting this position.
“We have seen substantial improvements in staff sickness rates in recent years, with the average monthly rate dropping to five per cent compared to 5.4 per cent in the previous year.”
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