The decision means the community maternity unit (CMU) at CGH is to fall in line with the same working patterns as other midwife-led units run by NHS Highland from the end of this month.
In view of current midwifery staffing pressures brought about through vacant posts and retirements, the unit will implement this change sooner than planned and the midwives will commence on-call working overnight from 30th January 2017.
From that date, while there will be a 24/7 service at CGH, midwives will move to the standard 10-hour or 12-hour shift model used elsewhere.
During the day midwives will cover the service from 8am to 8pm and, like other CMUs, two midwives will be on-call from 8pm to 8am. The latter can be quickly called into the hospital if required.
The move is part of the transition work and workforce planning following the board’s decision on 29th November 2016 to set up a midwife-led CMU at CGH.
NHS Highland’s North & West Operational Unit lead midwife Mary Burnside, said: “The number of contacts for the maternity unit overnight is very small. By moving to on-call it provides a more sustainable model. It will free-up midwifery hours which will add to the staffing level during the day when activity is busiest and where the greatest need is in relation to antenatal care, postnatal care and collaborative working with colleagues in health visiting and child protection to support vulnerable women and families.”
The midwives at the Wick CMU work in collaboration with Highland Council Children’s service colleagues in supporting the fundamental principles of GIRFEC and the Early Years agenda to ensure all children get the best possible start in life.
She added: “Women currently on the CMU caseload will receive written information regarding the change to service and the contact details should they need to speak with a midwife overnight, between 8pm and 8am.
“Calls will be triaged by the Raigmore Midwifery Labour Suite Team, this is the system currently in place for all other areas of NHS Highland. If an expectant mother needs to be seen by a local midwife, the on-call midwife will be contacted and meet the woman at CGH to undertake an assessment.”
The current system of contacting the Caithness Midwifery team will remain in place until the 30th January 2017.
As part of the CMU transition, NHS Highland has set up a robust midwifery leadership structure. Overseen by the board’s Head of Midwifery, Dr Helen Bryers, the North & West Operational Unit is led by lead midwife Mary Burnside, with the Caithness Community Midwife Unit (CMU) led by midwifery team leader Laura Menzies.
Dr Lucy Caird, consultant obstetrician at Raigmore has also been appointed as clinical lead for the CMU transition to oversee joint working and clinical pathways across the Raigmore ‘Hub’ and CMU spokes.
During the transition period, expected to be around four months, the leadership will be able to call on support for the unit from the seven CMUs already operated by NHS Highland.
Two of these, like CGH, are located next to a Rural General Hospital (Oban and Fort William) with five CMUs located near a Community Hospital (Campbeltown, Isle of Bute, Dunoon, Lochgilphead and Broadford in Skye).
Jaki Lambert, the consultant midwife from Argyll and Bute has already made a number of visits to Wick and Sarah McLeod, lead midwife and NHSH practice development midwife is visiting on a regular basis to provide training for the midwifery team and wider nursing and medical hospital team.
In addition, the expertise of all seven of the other CMU’s Midwifery team leaders has been made available and a dedicated telecommunication / video conferencing link has been set up to help further facilitate and strengthen this support and also minimise unnecessary travel.
Following the board’s decision, a Caithness CMU Transformation Oversight Group was also set up. Chaired by Dr Roderick Harvey, NHS Highland’s medical director, the group has been specifically set up to oversee the transition and strengthen the maternity and neonatal services and networks across the North Highlands during the transition period.