Transcript The West Midlands LSA Team

The West Midlands
LSA ANNUAL
REPORT
2011-2012
The West Midlands LSA Team
The LSA Team
 Barbara Kuypers LSAMO
 Lisa Wilkes P.A. to LSAMO
Supported by Link Supervisors
 Ann Kingscott
 Toni Martin
 Carmel McCalmont
Role of the LSA & Midwifery Officer
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Implementing the legislation from
Nursing and Midwifery Order
Compliance with the Midwives rules and
standards (54)
Guidance for LSAs around Audit and
compliance with standards
Receiving the Annuals Reports (Rules 16)
Recognising excellence and sharing good
supervisory practice
Assessing risk and providing support and
guidance.
West Midlands LSA
15
17
12
3100+
230+
1/14
Midwife
Acute Trusts
providing
maternity
services
Acute
Hospital Sites
Midwifery
Led Units
Midwife ITPs
Supervisor of
Midwives
LSA SoM to
Ratio
West Midlands Clusters
Clusters and Trusts
West Mercia
Worcester & Redditch
Hereford
Shropshire & Telford
Staffordshire
North Staffordshire
Stafford
Burton
Arden
Nuneaton
Warwick
Coventry
Birmingham
Heart of England
City
Birmingham Women’s
Black Country
Dudley
Walsall
Wolverhampton
Communications
Annually:
4 combined meetings with:
 Link Supervisors
 Contacts
 Lead Midwives for Education
Annual meetings with new
Supervisors
6 Heads of Midwifery meetings
Student POSOMs throughout the
programme
Adhoc policy review work
Local Supervising Authority
based at the
Midlands and East National Commissioning
Board
Local Supervising Authority
Midwifery Officer
Supervisors of Midwives
Midwives
LSA Event Calendars
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Supervision workshops – NMC Standard of Investigation
Practice Forum – Case Reviews
Maternal Mortality and Morbidity study days
Bond Solon
Annual Academic Day at University
Annual LSA Conference
National LSAMO Bi-annual Conference
Mediation & reconciliation
Attitude & bullying
Child Safeguarding
Advocacy for Normal Birth
The ‘business’ of midwifery
Preparation of Supervisors of Midwives Programme
(POSOM)
 32 Places to take up annually at
Birmingham Universities
 Ballot and selection process reviewed
 Peer & Panel discussions as part of
selection
 LSAMO as part of the curricula & planning
 Looking to host spring and autumn
programmes at Birmingham
 Degree and Master’s Programmes
 Support and reflection at 6 months post
appointment for new SoMs
Audit Themes
 2007/8 – Benchmark against 5 LSA
Standards
 2008/9 – NMC Standards of
Investigation & Supervised Practice
 2009/10 – Web based questionnaires
 Electronic collation of activity and
trends.
 2010-2011 – Audit of impact of
Supervision on:
 Women’s Choice
 Student Learning
 Pre-ceptorship (1st three years of
registration
 Review of Incident Investigation
and Supervisory Practice
Supervision continues to support extra-ordinary
births at home
Supporting choices for women and their families.
 Twins at home
 VBAC at Home
 Home births without monitoring or intervention
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(No FH & no VE’s)
Lotus births
Women with previous history of post partum
haemorrhage
Women with prescriptive requirements
Complex social family environments with
involvement of LA
Women with dominant partners and isolated
proposed place of birth
Women with history of living with domestic violence
Women with previous history of sexual assault
Previous poor experience of obstetric or midwifery
care
Families new to the area reluctant to register with GP
Request for attendance but obstructing in provision
of care.
Pre-ceptorship
 For the Trust to consider for the Maternity
Pre-ceptorship Packs to integrate pages for
supervisory communications or to provide a
separate booklet. These can be noted with
the LSA Logo for all discussions held between
the registrant and their Supervisor of
Midwives and also on the pages used for the
Reflective Diary.
 For the Supervisors to provide guidance at
Supervisory Annual Reviews with regard to
ensuring all midwives understand and take
on their full role as teachers of the profession
as described in The code (2008) so that
student midwives received excellent clinical
support and assessment whilst undertaking
their training in the clinical placement.
Table to demonstrate the ratio of Midwives per Supervisor with each Trust, and the ratio for the whole LSA. In
addition provides numbers of midwives with Universities and the West Midlands Perinatal Institute.
Cluster and Trusts
Supervisor
Midwives
RATIO
RATIO
RATIO
Head Count
Head Count
2010
2011
2012
18
7
13
305
80
277
16.5
13.1
17.5
16.9
13.1
21.3
16.7
11.2
21.3
19
8
13
242
107
155
16.4
15.4
12.8
12.7
14.2
12
13
13.3
11.9
9
9
20
88
120
224
12.7
13.1
11.1
9.7
13.3
11.2
8.1
13.5
12.3
Heart of England
City
Birmingham Women’s
Black Country
Dudley
Walsall
Wolverhampton
33
20
26
463
241
334
17.5
12.3
20
14.4
12.
14.
14.0
14.2
12.8
17
11
16
179
157
150
12.6
14.7
13
10.2
14.2
9.4
10.5
14.7
7.7
Total
238
3120
13.6
13.2
13.1
West Mercia
Worcester & Redditch
Wye Valley
Shropshire & Telford
Staffordshire
North Staffordshire
Stafford
Burton
Arden
Nuneaton
Warwick
Coventry
Birmingham
Table to demonstrates the numbers of midwives working in managerial or specialist roles at Band 7 to 9.
SMP
W.T.E.
8D
W.T.E.
8C
W.T.E.
8B
W.T.E.
8A
W.T.E.
7
W.T.E.
TOTAL
FUNDED
WTE
0.00
0.00
1.00
0.00
5.00
0.00
6.00
HEREFORD
0.00
0.00
0.00
1.00
2.00
0.00
3.00
SHROPSHIRE
0.00
0.00
0.00
1.00
2.00
3.00
6.00
NORTH STAFFORDSHIRE
0.00
0.00
0.00
1.00
3.00
0.00
4.00
STAFFORD
0.00
0.00
0.00
1.00
1.00
6.00
8.00
BURTON
0.00
0.00
1.00
0.00
2.00
0.00
3.00
NUNEATON
0.00
0.00
0.00
1.00
0.00
0.00
1.00
WARWICK
0.00
0.00
1.00
0.00
1.00
0.00
2.00
COVENTRY
0.00
0.00
1.00
0.00
4.00
3.50
8.50
HEART OF ENGLAND
0.00
1.00
0.00
4.00
5.00
0.00
10.00
Sutton Coldfield
0.00
0.00
0.00
0.00
0.00
0.00
0.00
W.BIRMINGHAM – City
0.00
1.00
0.00
1.00
3.00
0.00
5.00
BWH
0.00
0.00
0.00
4.00
0.00
4.82
8.82
DUDLEY
1.00
0.00
0.00
0.00
1.00
0.00
2.00
WALSALL
0.00
0.00
0.00
1.00
7.27
4.00
12.27
WOLVERHAMPTON
0.00
0.00
0.00
1.00
3.00
0.00
4.00
TOTAL
1.00
2.00
4.00
16.00
39.27
21.32
83.59
TRUSTS & SITES
WORCESTERSHIRE
(INC REDDITCH
ACUTE
Table to demonstrates the total staff of midwives, nurses and non-qualified staff working in maternity services giving
direct care to mothers and babies. Non-qualified staff, includes maternity support workers, auxiliary staff and nursery
nurses.
MIDWIVES
W.T.E.
NURSES
W.T.E.
HCA/MCA
W.T.E.
TOTAL
W.T.E.
WORCESTER
199.02
0.60
54.15
253.77
HEREFORD
57.94
0.00
16.55
74.49
SHROPSHIRE
174.69
0.00
55.74
230.43
NORTH STAFFORDSHIRE
187.89
0.00
50.26
238.15
STAFFORD
77.55
0.00
14.46
92.01
BURTON
117.86
0.00
31.38
149.24
NUNEATON
65.04
0.00
15.94
80.98
WARWICK
80.60
0.00
18.84
99.44
COVENTRY
179.50
0.00
58.08
237.58
HEART OF ENGLAND
230.47
0.00
75.07
305.54
Sutton Coldfield
117.92
0.00
34.29
152.21
W.BIRMINGHAM - City
201.69
0.00
57.66
259.35
BWH
245.63
0.00
59.22
304.85
DUDLEY
138.10
0.00
37.98
176.08
WALSALL
117.29
21.41
37.17
175.87
WOLVERHAMPTON
113.57
0.00
39.82
153.39
WEST MIDLANDS TOTAL
2272.31
22.01
656.61
2983.38
TRUSTS & SITES
Table to demonstrates midwives working in community settings
TRUSTS
WORCESTERSHIRE
Worcester
Redditch
WTE
Community
% of WTE
Establishment
54.93
26.4%
n/a
HEREFORDSHIRE
19.68
35.6 %
SHROPSHIRE
49.89
28.3 %
Stoke
52.50
28.0 %
Stafford
34.30
44.5 %
Burton
31.88
27.8 %
Nuneaton
14.80
24.3 %
Warwick
19.00
23.7 %
Coventry
39.00
27.1 %
Heartlands/Sol
55.57
23.9 %
Good Hope
24.37
20.6 %
BIRMINGHAM
City
67.30
34.4 %
BIRMINGHAM
Women’s
59.70
24.4 %
DUDLEY
28.00
22.0 %
WALSALL
34.78
33.0 %
WOLVERHAMPTON
28.00
24.0 %
WEST MIDLANDS TOTAL
613.70
27%
NORTH STAFFS
SOUTH STAFFS
WARWICKSHIRE
HEART OF ENGLAND
Table to demonstrate birth to midwife ratio over 3 year trend
TRUSTS
Risk
2009-2010
29.5
2010-2011
Redditch
25.3
28.4
HEREFORD
30.8
37.1
31.30
SHROPSHIRE
29.6
27.1
30.00
NORTH STAFFORDSHIRE
28.9
31.6
32.21
28
24.5
22.80
BURTON
34.5
32.4
32.34
NUNEATON
35.6
35.6
34.94
WARWICK
33.4
33.7
33.29
COVENTRY
35.8
36.6
34.0
HEART OF ENGLAND
38.5
30.6
30.88
Sutton Coldfield
34.9
32.7
31.26
W.BIRMINGHAM - City
33.4
30.8
28.40
BWH
28.7
29.8
31.24
DUDLEY
38.7
37.5
38.90
WALSALL
36.1
34.4
32.3
WOLVERHAMPTON
31.3
33.4
33.83
32.0
33.0
31.7
WORCESTER
STAFFORD
West Midlands Total
2011-2012
27.9
29.89
Falls within 1:30 Ratio
Meeting appropriate ratios
Falls within 1:30.1 to 1:34.9
Should consider Workforce Review
Falls outside of 1:35 Ratio
Workforce Review should be in progress
Risk
Table to demonstrate Births over a 3 year trend 2008 - 2012
TRUSTS
2009-2010
2010-2011
2011-2012
WORCESTER
3827
3985
3969
Redditch
1768
2054
2085
HEREFORD
1937
2047
1888
SHROPSHIRE
5260
5114
5241
5648
5881
STAFFORD
2167
1998
1865
BURTON
3854
3831
3812
NUNEATON
2295
2447
2368
WARWICK
2612
2843
2873
COVENTRY
5806
6006
6088
7554
7096
3737
3828
6307
6148
BWH
7104
7342
7449
DUDLEY
4718
4842
5222
WALSALL
3719
3995
4502
WOLVERHAMPTON
3846
4099
4112
72159
73556
74057
NORTH STAFFORDSHIRE
HEART OF ENGLAND
Sutton Coldfield
W.BIRMINGHAM - City
West Midlands Total
6052
7160
3681
5690
Table to demonstrate the Confinements by place of birth during 2010 -2012
TRUSTS AND SITES
TOTAL
HOSPITAL
MLU
BBAS
HOME
WORCESTER
3969
3890
0
23
56
Redditch
2085
2048
0
11
26
HEREFORD
1888
1816
0
12
60
SHROPSHIRE
5241
3897
1153
105
86
NORTH STAFFORDSHIRE
6052
4594
1348
52
58
STAFFORD
1865
1573
271
4
17
BURTON
3812
3481
317
5
9
NUNEATON
2368
2282
0
47
39
WARWICK
2873
2873
0
19
48
COVENTRY
6088
5983
0
55
50
HEART OF ENGLAND
7160
6003
1069
64
24
Sutton Coldfield
3681
3610
0
28
43
W.BIRMINGHAM - City
5690
4393
1202
50
45
BWH
7449
6074
1375
66
26
DUDLEY
5222
4406
750
14
52
WALSALL
4502
4467
0
0
14
WOLVERHAMPTON
4112
4043
0
34
35
WEST MIDLANDS TOTAL
74057
65433
7485
589
688
Table to demonstrate Elective and Emergency Caesarean Section Rates
TRUSTS & SITES
CAESAREAN SECTIONS
TOTAL
BIRTHS
Emergency
Elective
Total
% of births
WORCESTER
3969
633
344
977
24.62
Redditch
2085
280
231
511
24.51
HEREFORD
1888
333
213
546
28.92
SHROPSHIRE
5241
427
304
731
13.95
NORTH STAFFORDSHIRE
6052
898
680
1578
26.07
STAFFORD
1865
188
103
291
15.60
BURTON
3812
571
383
954
25.03
NUNEATON
2368
330
223
553
23.35
WARWICK
2873
402
358
760
26.45
COVENTRY
6088
1017
742
1759
28.89
HEART OF ENGLAND
7160
1044
759
1803
25.18
Sutton Coldfield
3681
521
427
948
25.75
W.BIRMINGHAM - City
5690
717
563
1280
22.50
BWH
7449
1036
654
1690
22.69
DUDLEY
5222
774
576
1350
25.85
WALSALL
4502
716
500
1216
27.01
WOLVERHAMPTON
4112
650
406
1056
25.68
74057
10537
7466
18003
24.31
WESTMIDLANDS TOTAL
Table to demonstrate rates of Instrumental Delivery
TRUSTS & SITES
TOTAL BIRTHS
FORCEPS
VENTOUSE
VG BREECH
WORCESTER
3969
221
143
20
Redditch
2085
154
94
5
HEREFORD
1888
83
150
2
SHROPSHIRE
5241
205
328
39
NORTH STAFFORDSHIRE
6052
203
435
49
STAFFORD
1865
62
156
16
BURTON
3812
188
470
35
NUNEATON
2368
113
137
16
WARWICK
2873
186
210
9
COVENTRY
6088
360
259
26
HEART OF ENGLAND
7160
341
349
50
Sutton Coldfield
3681
163
168
18
W.BIRMINGHAM - City
5690
310
178
72
BWH
7449
572
558
41
DUDLEY
5222
435
131
23
WALSALL
4502
265
163
12
WOLVERHAMPTON
4112
190
238
20
74057
4051
4167
453
WEST MIDLANDS TOTAL
Tables to show 3 Year Clinical Trends
Other Modes of Delivery
TOTAL 09-10
TOTAL 10-11
TOTAL 11-12
Other Modes of Delivery
Total Births
Forceps
Ventouse
Vg Breech
72159
3312
3675
495
73556
3551
3918
425
4051
4167
453
74057
Total Births
Water Births
VBAC Births
TOTAL 09-10
72159
1440
1879
TOTAL 10-11
73556
1651
1735
TOTAL 11-12
74057
2280
1859
Year
Total
Hospital
MLU
BBA
Home
2009-2010
72159
67043
4914
554
925
65084
7110
489
873
65433
7485
589
688
2010-2011
2011-2012
73556
74057
Table to demonstrate the outcomes for babies born in West Midlands
TOTAL BIRTHS
(WOMEN
DELIVERED)
TOTAL
BABIES BORN
BABIES
BORN
ALIVE
STILL
BIRTHS
INTRA-PARTRUM
STILLBIRTHS
(DURING LABOUR)
WORCESTER
3969
4069
4054
15
4
Redditch
2085
2155
2149
6
0
HEREFORD
1888
1938
1935
3
0
SHROPSHIRE
5241
5241
5225
18
2
NORTH STAFFORDSHIRE
6052
6095
6069
25
STAFFORD
1865
1870
1856
10
4
BURTON
3812
3830
3812
18
0
NUNEATON
2368
2306
2283
7
0
WARWICK
2873
2961
2955
6
0
COVENTRY
6088
6153
6120
33
3
HEART OF ENGLAND
7160
7253
7205
45
5
SUTTON COLDFIELD
3681
3736
3724
11
0
W.BIRMINGHAM - City
5690
5774
5661
113
0
BWH
7449
7781
7625
51
0
DUDLEY
5222
5275
5255
20
1
WALSALL
4502
4502
4481
21
2
WOLVERHAMPTON
4112
4179
4151
27
1
74057
75118
74560
429
23
TRUSTS & SITES
WEST MIDLANDS TOTAL
1
Analysis of Supervisory Investigations
108 Supervisory Investigations. 123
44
25
0
Local Action
Developmental Support
Supervised Practice
Referrals to the NMC
Issues:
Regulation:
Failure to comply with PREP requirements
Operating and working out side of usual sphere of practice
and competency
Clinical:
Failure to recognise abnormal progression of labour
Failure to recognise abnormal CTG or signs of fetal distress
Failure to act
Failure to refer to appropriate physician
Failure to document and record appropriately
Failure to administrate correctly and record medicines
Colleagues
Failure to provide a safe environment for practice
Failure to check equipment required for safe and effective care
Failure to support students or newly qualified colleagues