Assignment evaluation of measures taken to maintain maternity care at three hospitals within Region Västerbotten and suggestions for more possible measures.
Background and current situation
The operations within the Center for Obstetrics and Gynecology (CFOG) have a mission to conduct patient-safe maternity care at three units within the region; in Lycksele, Skellefteå and Umeå. In 2022, approximately 260, 790 and 1,700 births will take place at the three units. Over the years, the difficulties in staffing maternity care with both midwives and gynecologists have increased, resulting in a constant and increasing need for temporary staff. In the last year, the situation has worsened further, with great difficulty in being able to call on rental staff. Extraordinary measures have been taken, such as rotating duty for relatively high remuneration, call-offs outside of contracts and intensive recruitment efforts. An action plan with several activities has been activated since May 2022 and parts are being implemented. Some measures that require extended financial frameworks have not yet been decided. Discussions are ongoing about organizing the work within CFOG to facilitate rotational duty between maternal health care and childbirth and create increased attractiveness in midwifery services. The action plan also includes a proposed model for the unit in Lycksele that is based on midwife-led births.
Emerging risks
1 As a result of the staffing situation, there is a risk that we cannot provide patient-safe maternity care in three locations in the county.
2 Further rotation of personnel between the units may entail a risk of more midwives and gynecologists leaving their positions and seriously hinder the ability to fulfill CFOG’s mission in the county.
Mission
Based on the staffing situation we are in today, we would like an external assessment of:
– whether the identified risks are relevant
– if further possible measures that can prevent a reduction in operations are identified and investigated
– if the developed action plan and the measures in it that can be implemented in the near term change the position on the need for reduced operations
Anders Sylvan (external consultant) and Sofie Jakobsson (chief physician) are given the task of investigating the questions raised. The assignment must be carried out quickly and reported to the regional director and director of health and medical care no later than 230 109
Tommy Svensson, Regional Director
Brita Winsa, Director of Health and Medical Services