Overcoming staff shortages


03 / 02 / 2009

  • SHA region
  • The organisation
  • What we did and why
  • How we did it
  • The results and next steps
  • Contact details and further information
  • SHA region

    NHS London

    The organisation

    The maternity services department and Guy's and St Thomas' in London has plenty going for it: newly-built, state-of-the-art facilities, good collaborative team working between midwives, doctors and other staff, and a varied, interesting caseload generated by some 6,000 births every year. However, in common with many other London services, it also had a major problem: staff shortages, which had reached almost chronic condition.

    What we did and why

    High vacancy numbers were putting even greater pressure on midwives, undermining morale, and increasing staff turnover still more.

    When Lesley Page and Marie McDonald were appointed joint Heads of Midwifery and Nursing Women's Services as a job share in mid-2003, they decided to prioritise recruitment and retention.

    How we did it

    Their first step was to share with staff the recognition of the pressures they were all working under, express the determination to improve matters, and to make senior managers in the department more visible by resuming more clinical activity.

    One of the management team was delegated to focus on recruitment. This has resulted in more effective advertising, a series of well-organised open days, and a regular presence at recruitment fairs and midwifery conferences. Enquiries have been followed up more vigorously, with a swift response to all job applications and minimum delay in moving to interview stage. There was a good orientation programme in place, and this was a major factor in retaining staff.

    To keep staff informed of what was happening; minutes of management meetings where recruitment and retention was discussed were posted in the wards and departments. The department newsletter reported on activity and included news of new staff as well as those who were leaving. As the first list got longer than the latter, vacancy rates fell from 25.1% to 9.2% in little more than a year.

    With a total workforce of 271.10 whole time equivalent midwives working in a range of flexible patterns, effort is made to nurture good working relationships across the department. Open departmental meetings every 2 months are always well attended. The annual summer BBQ and Christmas Party are treated as important events. Staff are clearly happier, and the atmosphere is good.

    The results and next steps

    'The point is that Guy's and St Thomas' is a very good place to practice midwifery,' says Lesley. 'Marie and I are both passionate about developing sound midwifery practice and supporting midwives. The model of midwife-led care is strong; over 40% of our women will only see a midwife throughout their care. There are 3 consultant midwives and 3 practice development midwives whose professional contribution is very important. Our managers are also clinical leaders. Working here is seen as a team effort and if we manage to get the staffing numbers right, it's better for everyone.'

    Contact details and further information

    For more information, contact Lesley Page or Marie McDonald, Heads of Midwifery and Nursing Women's Services.

    Email: lesley.page@gstt.nhs.uk or marie.mcdonald@gstt.nhs.uk

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