5 Glossary

Acuity

Refers to the seriousness of a woman or baby's condition, the risk of clinical deterioration and their specific care needs.

Antenatal

The period of time after conception and before birth.

Contact time

The balance between time spent providing direct care and indirect care such as attendance at multidisciplinary team meetings, ward rounds and discharge planning. See the NHS England website for further details.

Dependency

The level to which a woman or baby is dependent on direct care to support their physical and psychological needs and activities of daily living, such as eating and drinking, personal care and hygiene, and mobilisation.

Endogeneity

A statistical problem that can occur when analysing data. It occurs when an outcome is partly determined by an explanatory factor. For example, when adverse outcomes are expected to be more likely to happen in a particular area of care, more qualified staff might be allocated to that area of care. This means that the techniques used in research to analyse the data can over- or under- estimate the impact of a factor (such as staffing) on an outcome (such as adverse effects).

Established labour

Established labour is when there are regular and painful contractions, and there is progressive cervical dilatation from 4 cm.

Establishment

In the context of this guideline establishment refers to the number of registered midwives funded to work in an organisation providing maternity care. This includes all midwives in post, as well as unfilled vacancies or vacancies being covered by temporary staff. Midwife establishments are usually expressed in number of whole-time equivalents.

Indicator

Positive or negative signs that can be monitored and used to inform future midwifery staff requirements or prevent negative events related to midwifery staffing levels happening in the future.

Intrapartum

The period of time from the start of labour to birth of the baby and delivery of the placenta and membranes.

Maternity care

Care and treatment provided in relation to pregnancy and delivery of a baby. It is influenced by the physical and psychosocial needs of the woman, the woman's entire family, and the baby. Maternity care is provided by a range of healthcare professionals.

Midwife/Midwifery

Qualified midwives who are registered with the Nursing and Midwifery Council.

Midwifery red flag events

Red flag events are negative events that are immediate signs that something is wrong and action is needed now to stop the situation getting worse. Action includes escalation to the senior midwife in charge of the service and the response may include allocating additional staff to the ward or unit.

Midwifery staffing requirements

Used to describe the number of registered midwives that are needed for the establishment and on each day.

NICE endorsement programme

A new programme that formally endorses guidance support resources produced by external organisations. The programme will assess resources such as toolkits that aim to estimate nursing or midwifery staffing requirements. NICE awards an endorsement statement to toolkits that meet the endorsement criteria.

Non-registered nursing staff

Non-registered staff working in hospital or community settings under the guidance and supervision of a registered healthcare professional. Their titles may include healthcare assistant, healthcare support worker, maternity support worker, nursing auxiliary, nursing assistants and assistant practitioners. Their responsibilities vary, depending on the healthcare setting and their level of training and competence.

On-call staff

Staff who are available to work at short notice during the period of time that they are not rostered to work or off duty. The on-call arrangements should be locally agreed and should not deplete other areas of care.

One-to-one care

Care provided for the woman throughout labour exclusively by a midwife solely dedicated to her care (not necessarily the same midwife for the whole of labour).

Postnatal

The first 6 weeks after birth.

Pre-conception

In the context of this guideline, pre-conception refers to care provided by midwives to women before they are pregnant.

Preceptorship

A period of time when newly qualified midwives are supported by a clinical instructor or preceptor.

Roster

The daily staffing schedule for each maternity service.

Safe midwifery care

When reliable systems, processes and practices are in place to meet required care needs and protect people from missed care and avoidable harm.

Skill mix

The composition of the midwifery team in terms of qualification and experience.

Staffing requirement

The number and skill mix of staff needed in a service.

Supervision

Aims to safeguard and enhance the quality of care for childbearing women and their families. Its primary purpose is to protect women and babies by actively promoting safe standards through ensuring that midwives are fit to practice autonomously and by initiating action when a midwife's fitness to practice is impaired.

Temporary staff

Local bank or agency staff.

Toolkit

A practical resource to facilitate the process of calculating midwifery staffing requirements for maternity services. It may be electronic or paper-based.

Uplift

Uplift is likely to be set at an organisational level and takes account of annual leave, maternity leave, paternity leave, study leave (including time to give and receive supervision) and sickness absence.