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Only 51 full-time midwives have been hired in the NHS within the past year

These figures are equivalent to only one additional midwife per week.

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The figures suggest it will take the Government 50 years to honor a pledge on midwifery recruitment figures.

The Royal College of Midwives (RCM) has called on the new Prime Minister to follow through on a promise to boost midwife numbers after a report revealed the NHS has only recruited 51 midwives in the past year.

Appointed only last week, the new Prime Minister recently vowed that additional funding for the NHS will go to directly to the frontline where it is needed most.

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New figures, published in the April 2019 NHS Workforce Statistics, show that only 51 full-time equivalent midwives have been hired within the past year in England; despite the 2018 Government committed to hiring 3000 more midwives to the NHS.

Just one per week.

These figures are equivalent to only one additional midwife per week for England’s NHS and a third of one midwife per maternity unit.

Commenting on the figures, Sean O’Sullivan, Head of Health and Social Policy at the Royal College of Midwives, stated: “Last year the Conservatives committed to deliver 3,000 more midwives for the NHS frontline.

“Today’s official workforce figures reveal however that the NHS is adding midwives at a rate of just one per week, and that’s across the whole of England. At that rate, the Conservatives will take over half a century to deliver on their pledge, until we’re well into the 2070s. That’s not good enough.”

The same publication also shows that in the past month 92 full-time equivalent midwife vacancies have opened.

Action is needed.

The NHS Vacancy Statistics England – February 2015 to March 2019 Provisional Experimental Statistics show, in the final quarter of 2018, the amount of Nursing and Midwifery Registered shortlist applicants receiving the job has decreased from 69% the previous quarter to 59%. This is also 5% fewer than the overall NHS job positions achieved, up from 1% fewer the previous quarter.

“Money must reach the NHS frontline,” O’Sullivan explained. “That’s what our new Prime Minister committed to when he spoke in Downing Street yesterday and he’s absolutely right.

Adding; “We need action. We need it now. We need more midwives on the frontline of NHS care.”

Clinical Care

Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

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Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

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Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

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Clinical Updates

Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

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Observations

A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

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Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

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