PERFORMANCE: One of England’s two specialist women’s hospitals has admitted failing to meet recommended minimum staffing levels.

Birmingham Women’s Foundation Trust, which describes itself as “a centre of excellence” for the “full range of gynaecological, maternity and neonatal care”, has highlighted the problem in published board papers.

The papers say the trust missed a Royal College of Obstetricians and Gynaecologists safety recommendation to have, as a minimum, one midwife for every 26 patients.

The matter was red rated and classed as an “extreme” risk in the trust’s 26 May board meeting, despite the issue already having been discussed in February and March.

The papers said: “Although the trust had adequate controls in place it would be unable to meet the national standard.”

This also put the trust at risk of missing an NHS Litigation Authority standard, they said.

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A “bottom-up staffing review to gain assurance of correct midwifery establishment” was planned.

The trust was also falling significantly short of a second recommendation by the college to employ consultants for 168 hours a week in units with 5,000 births or more annually, according to the minutes. The trust was only managing 78 hours, an issue which was also flagged up as an “extreme” red risk.

The minutes drew attention to the Safer Childbirth Report, which includes both recommendations and had been peer reviewed by the royal colleges of midwives, obstetricians and gynaecologists, anaesthetists and paediatricians.

But a trust spokeswoman said the recommendations for the 1:26 midwife to patients ratio required a “level of funding which we do not receive”. 

HSJ has previously reported how the trust, along with Liverpool Women’s Foundation Trust, planned to lobby against losses of around 4 per cent to maternity income in 2011-12 due to tariff changes.

Birmingham’s 1:31 midwife to patient ratio compared favourably with the regional average for last year of 1:32, the spokeswoman said. She added: “We are confident our overall staffing levels are safe and appropriate for our case mix. The trust continuously monitors midwifery staffing levels to ensure ongoing quality and safe care.”

The trust is expanding its facilities and aims to increase birth numbers from 7,300 to 8,000 per year, which would be accompanied by additional midwives and a consultant.