Dear Di,
we are in the same process of redesigning our postnatal service. We had an integrated m/w approach running where the community team midwives came to assess their inpatients and transfer care back to community. A major issue with this was that the integrated teams were often so stretched with delivery duties and community work, that these women did not get seen until late in the day, if at all. The wards had reduced staffing in anticipation increased input from the integrated units. (As stated this did not always occur). Also midwifery assistants were utilised to do less skilled tasks.
My advice would be to ensure a high level of trained staff as core to the wards with the added bonus of integrated help. Or ensure the needs of the postnatal care are built into the staffing of the integrated teams. Our teams were only 6 midwives per team, and for a unit that has approx 6,500 deliveries a year you can imagine the problems. Good luck with it all!
Maggie Prain
Midwife
Birmingham
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