This guideline covers safe midwifery staffing in all maternity settings, including at home, in the community, in day assessment units, in obstetric units, and in units led by midwives (both alongside hospitals and free-standing). It aims to improve maternity care by giving advice on monitoring staffing levels and actions to take if there are not enough midwives to meet the needs of women and babies in the service.
This guideline includes recommendations on:
- organisational requirements
- setting the midwifery establishment
- assessing differences in the number and skill mix of midwives needed and the number of midwives available
- monitoring and evaluating midwifery staffing requirements
Who is it for?
- Midwives and other healthcare professionals
- Hospital managers and service managers
- Heads and directors of nursing and midwifery
- Commissioners, trust boards and policy decision-makers
- Women and babies who use maternity services
Guideline development process
Other national documents
There are other national documents that are relevant to midwifery staffing for NHS services, including:
- Francis report on Mid Staffordshire (Francis 2013)
- Keogh review into the quality of care and treatment provided in 14 hospital trusts in England (Keogh 2013)
- Cavendish review, an independent enquiry into healthcare assistants and support workers in the NHS and social care setting (Cavendish 2013)
- Berwick report on improving the safety of patients in England (Berwick 2013)
- How to ensure the right people, with the right skills, are in the right place at the right time. A guide to nursing midwifery and care staffing capacity and capability (National Quality Board 2013)
- Hard truths. The journey to putting patients first (Department of Health 2013)
- Compassion in Practice (Department of Health 2012)
- Safer Childbirth – Minimum standards for the organisation and delivery of care in Labour (RCOG 2007)
- Maternity Matters (Department of Health 2007)
- Standards of Maternity Care (RCOG 2008)
- Midwifery 2020 (Department of Health 2010)
- Saving Mothers Lives: Maternity summary(Centre for Maternal and Child Enquiries 2011)
- Safe Staffing Levels (RCN 2013)
- Workforce risks and opportunities: midwives (Centre for Workforce Intelligence 2012)
- Staffing in Maternity Units: getting the right people in the right place at the right time (King’s Fund 2011)
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.