Our midwifery workforce

SARAH NICHOLSON 

Deputy Chief Midwife CHRIS MALLON

Chief Midwife

ANTONIA YELAVICH

Human Resources Business Partner WH

In July 2019, the Women’s Health division was established (separated from KidzFirst), and included a new midwifery leadership framework at Counties Manukau Health.

The move centralised two midwifery roles, the Maternity Service Development Manager and the Maternity Quality and Safety Coordinator which were previously based in the District Health Board’s Planning and Funding division, which now sit in the Division of Women’s Health. This has strengthened the links between our maternity quality and safety programme and our service development for maternity services.

A new Chief Midwife role was also introduced, enabling midwifery to work alongside other professional clinical groups at the executive leadership level of CM Health. This appointment is the first of its kind in New Zealand and illustrates CM Health’s commitment to its midwifery workforce. The Chief Midwife is supported by a deputy, indicating the size and scope for professional midwifery development at CM Health.

In 2020 a specialist research midwife was also appointed at CM Health. The purpose of this role is to strengthen the midwifery research focus that underpins the care we provide. This appointment will enable CM Health to lead the way in midwifery focused research, and support midwives to participate in postgraduate research and further professional development.

Recruitment – graduate midwives

The CM Health graduate midwifery programme continues to be well regarded as a strong foundation for new practitioners joining the CM Health workforce.

The 15-month programme offers supported clinical experience in inpatient and community-based primary and secondary midwifery settings. This includes three 5-month placements in the Maternity Ward/Ward 21 (inpatient high-risk antenatal and postnatal care), the Birthing and Assessment Unit, and either a primary birthing unit or with the District Health Board’s community midwives in Lambie Drive (antenatal and postnatal caseloads, excluding intrapartum). Feedback from midwives completing this programme continues to highlight its well-designed structure and support, which enable our graduate colleagues to develop a wide range of midwifery experiences.

Graduate midwives practising as community lead-maternitycarer midwives in Counties Manukau are also invited to join the midwifery graduate programme orientation and study days. These days enable graduate midwives to continue their pre-registration collegial relationships and foster a united workforce.

In 2020, we welcomed 22 employed and 12 community leadmaternity-carer graduate midwives.

“I felt so supported, welcomed and part of the team. I talked to many of the new graduates and they had the best things to say about their experiences in the graduate program Middlemore offers. Having a program that is highly regarded by the staff, and being 15 months vs. some districts of a 9 month graduate program, this greatly influences my choice to come here”

“I decided to work at Counties as I was treated well as a student and expected that to continue as an employee. The grant greatly helped as I had just finished a financially demanding 4 year degree. It helped me pay off my credit card; I bought some good shoes for work and then borrowed more for a reliable car!”

Recruitment – international midwives

International recruitment has continued during 2020 despite COVID-19, as midwifery is listed as an essential workforce. We have worked closely with international agencies who promote New Zealand midwifery careers across the world. We continue to interview and offer positions to midwives based in the UK and the US. Packages of support are individually tailored to assist with New Zealand practice requirements and relocation.

Recruitment – strategy 2021

In 2021, we will maintain a strong emphasis on midwifery recruitment and staff retention. Initiatives will focus on areas such as incentivising midwives to work full-time, and valuing those who are continuing to work long hours. We plan to develop opportunities to support midwives who travel to work from out of the Counties Manukau area. We also aim to facilitate structured career planning for permanent staff and student midwives, and are exploring the idea of a midwifery support worker role. Our intention is to phase these programmes in over the next 12 to 18 months.

Retention

Supporting midwives to stay in the profession involves a multifactorial approach. Working with midwives to enable sustainable working arrangements has been a key priority in 2020. The option of flexible rotations across various locations and wards has been a popular option for many midwives. Tailored shift patterns have enabled midwives who live outside of Auckland to continue to work at CM Health.

A wide variety of professional development opportunities at CM Health foster learning opportunities and career development for midwives. Our close links to AUT (Auckland University of Technology) and the established complex care course enable interconnected academic and clinical learning. The course is a postgraduate certificate programme, which encourages midwives to further their skills. We continue to support midwives on this postgraduate journey.

During 2020, a national career pathway framework for midwives has been developed and is near to completion. This Midwifery Employee Representation Advisory Service (MERAS) initiative will help midwives direct their career development to areas of interest. CM Health will continue to develop roles that fit within this framework to support and enhance career opportunities for midwives.

Employee engagement survey

CM Health undertook an employee engagement survey with all employees at the end of 2019 and into 2020. The survey’s purpose was to help managers understand how engaged their staff are in the workplace and work towards having a fully engaged workforce, and to inform workforce development, workplace culture and employee wellbeing initiatives. During 2020, managers worked with their teams to develop action plans for fostering a working environment where employees are welcomed and feel safe.

Safe Staffing

In 2020 the Care Capacity Demand Management Program was introduced to the Women’s Health division. This program aims to match a persons’ need for care with the right staffing. The national Care Capacity Demand Management Programme is led by the Safe Staffing, Healthy Workplace unit in partnership with New Zealand’s 20 DHBs, and health unions.

This program includes tools such as ‘TrendCare’. This tool will enable midwives, nurses and allied staff to be able to measure staffing levels against acuity and use the data for acuity-based staffing. This is a significant change from the way we have historically managed workloads and staffing. TrendCare data and the national Multi-Employer Collective Agreement (MECA) entitlements will be used to generate a recommended roster and staffing levels for each ward. This will help provide timely, appropriate and safe care for patients and a healthier work environment for staff.

International Midwives’ Day

Unfortunately, the COVID-19 lockdown in May 2020 interrupted planned celebrations for both the International Year of the Midwife and International Midwives ‘Day.

Planning for International Midwives’ Day 2021 is underway, and 4 May 2021 will see Ko Awatea filled with midwifery, as we showcase the fabulous midwifery care provided across Counties Manukau. Invitations to this event will be circulated nationally. The day will celebrate the amazing work our midwives are doing in hospitals and the community, and will provide a platform for recruitment, as we highlight to a national audience the midwifery opportunities here in CM Health.