NHS Improvement has urged trusts to follow maternity guidelines that have been drawn up by NICE previously.
Advice relating to staffing in maternity services has been recently published by the regulator, and those that were previously outlined by the National Institute for Health and Care Excellence, published in 2015, should be followed and was “based on the best available evidence”.
The maternity advice is one of seven initiatives currently being developed by NHS Improvement, having been asked to produce guidance when the Department of Health and NHS England suspended the work of NICE.
Yet the new organisation has concluded that the NICE programme was ultimately commendable.
NICE’s programme, which cost more than £1m, had been a key recommendation of Sir Robert Francis QC following the public inquiry into poor care at the Mid Staffordshire Foundation Trust.
There had been widespread criticism of the suspension at the time, and it indeed seems that this may have been a mistake.
The decision to suspend NICE’s work sparked widespread criticism of the government and NHS England, leading to health secretary Jeremy Hunt asking NHS Improvement to take the lead.
“You should follow NICE guideline NG4 (2015) for midwives. This guideline makes recommendations on safe midwifery staffing requirements for maternity settings, based on the best available evidence,” the new document advises trust.
NICE had included actions for trust boards, senior managers, commissioners and senior midwives in charge of departments and shifts in its guidance that was ceased two years ago.
NHS Improvement says responsible managers should “take NICE’s guidance fully into account”, although it emphasises that professional judgement should also be taken into consideration.
The NHS Improvement guidance states: “NHS provider boards are accountable for ensuring their organisation has the right culture, leadership and skills for safe, sustainable and productive staffing. They hold individual and collective responsibility for making judgements about staffing and the delivery of safe, effective, compassionate and responsive care within available resources.”
This guidance also acknowledges that the situation in the NHS at present is particularly taxing.
“The current climate is challenging in many ways. Increasing acuity of births and the lack of availability of maternity staff reported by the Royal Colleges are significant issues for many units. Maternity leaders recognise that modernising maternity services will require new ways of working to support midwives and obstetricians, anaesthetists and neonatologists, as well as ensuring that staffing numbers are adequate and appropriate.”
The guidance concludes by advocating a collaborative approach going forward.
“Commissioners, providers and higher education institutions need to work together in designing and redesigning the current and future workforce.”