More midwives needed at James Paget

Fears have been raised that the county's health service will not be able to afford the number of midwives which are needed for the rising number of births in Norfolk.

It is estimated that the Norfolk and Norwich University Hospital needs at least 35 more midwives, the James Paget University Hospital in Gorleston needs 10 more and about 15 more midwives are required at the Queen Elizabeth Hospital in Kings Lynn.

These posts are funded by NHS Norfolk but the primary care trust has recently revealed they are struggling to deal with an overspend of �2.8m this year.

It is believed an increased volume of patients, a growing elderly population and the management of long term and chronic conditions has contributed to the financial burden.

Now health campaigners are concerned the money that is needed to fund additional midwives will not be made available in the current financial climate.

At a meeting of the Health Overview and Scrutiny Committee (HOSC) next week NHS Norfolk will be quizzed about its ability fund more midwives and bosses saying they are investing in this service.

North Norfolk MP Norman Lamb said: “The service is under enormous pressure, midwives are working harder than ever and delivering more babies than ever before.

“The impact on hospitals such as the N&N is massive and investment in this needs to be a priority. I have spoken in parliament about the need for at least 3,000 more midwives across the country.

“We have to meet this shortfall because the situation is becoming critical. We can't let this go on any longer.”

Patrick Thompson, from watchdog Local Involvement Network (LINk), said: “It is a concern how NHS Norfolk will pay for services such as midwifery.

“We have a growing number of births and it is worrying if we can cope with this. NHS Norfolk needs to let people know how they are spending their money and where cuts and investments are being made.”

The number of deliveries has steadily risen in Norfolk, which last year led to the delivery suite at the N&N being closed 18 times. In 2008 5,712 babies were delivered by the hospital's midwives, a rise from 2002 when there were 4,681 births and this number is expected to continue to rise. In 2007 there were 145 midwives and there are currently 164.

While patient experience at the hospital is reported to be “good” with 98pc of mums confident in midwives, health bosses have to try and continue to the high level of service.

A spokeswoman for the N&N said: “We have been recruiting for more midwives all year and will have 13 more in post by the end of October and anticipate another 15 between now and April.

“We are also increasing the number of students on the student training programme as well as promoting return to practice to bring back those who previously used to be midwives.

“All this will greatly improve our midwife to birth ratio and progression toward recommended levels.”

At the QEH bosses have been told that NHS Norfolk have committed to four additional midwifery posts and it is also actively recruiting to fill all vacant posts.

If NHS Norfolk does not take action now the deficit could rise to �17m by the end of the financial year, with the risk it could slide into the black hole it faced three years ago.

NHS Norfolk, then called Norfolk primary care trust, inherited a �50m debt in 2006 after the amalgamation of six primary care trusts in the county. All primary care trusts were told by the government to make major cutbacks to claw back their debts and health bosses were forced to make cuts in community hospital provision, mental health, minor surgery and GP practices - causing longer waits and greater inconvenience for patients.

The estimated figure of midwives needed came from a HOSC meeting earlier this year when representatives from the three trusts were asked to estimate the extra staffing needed.

Clive Rennie, NHS Norfolk's Assistant Director of Women and Children's Services Commissioning, confirmed he would be attending the meeting of the Norfolk HOSC.

He said: “Maternity services are funded in two ways. Firstly the acute hospitals are paid based on their activity levels, through a tariff system. Consequently, there is an expectation that the Norfolk and Norwich University Hospital and the Queen Elizabeth Hospital will re-invest this money into recruitment to boost their midwifery teams and NHS Norfolk is working closely with the hospitals to ensure that this happens.

“The second way maternity services are funded is through a block contract which specifies a set amount of funding the hospitals receive for their community maternity services per year. NHS Norfolk is encouraging the recruitment of additional community-based midwives to work across Norfolk which will improve on access and patient choice.

“To achieve this, NHS Norfolk is increasing the amount of money invested as part of this block contract by �650,000, which will be shared across the Norfolk and Norwich University Hospital and the Queen Elizabeth Hospital's midwifery teams.”

A spokesman for James Paget Hospital said: “Additional investment for our midwifery service has been agreed with our commissioners at NHS Great Yarmouth and Waveney.”

The HOSC meeting will be held in the Edwards Room, County Hall, Norwich at 10am on Thursday October 15.