Low staff leads to maternity care delays

• Published date: 27 May 2023
• Author: Nicholas Jones
• Publication title: Weekend Herald

Hospital managers say most of the incidents were minor “or were identified early and mitigated”, and “staffing pressures may have contributed to many”. An example of a common incident includes a delay to care, or poor communication

Some of the increase happened in a period when nearly half of midwifery positions were vacant.

The situation is revealed in an internal briefing from January, obtained by the Weekend Herald under the Official Information Act.

“Service resilience (ie the reliability of the safety and quality) is negatively impacted by the level of staff vacancy, as is evidenced by patient complaints and adverse events due to recruitment and retention challenges in midwifery and the medical subspecialties,” the document says.

“We’re not meeting our targets for waiting times except in abortion services; disruptions in planned care related to Covid, holiday service reduction, staffing shortages and inefficiencies continue to drive waitlist growth.”

In response to Herald questions, Te Toka Tumai Auckland (formerly Auckland DHB) confirmed there were 133 incidents recorded into its Incident Management System for the women’s health service between January and April 30.

“This number is more than we would typically expect over a four-month period,” interim lead for hospital and specialist services Dr Mark Edwards said.

“Most of these were minor incidents that did not result in patient harm or were identified early and mitigated. We know from analysing these incidents that staffing pressures may have contributed to many of them.”

Of the 133, five were categorised as category 1 or 2 “adverse events”, meaning an unexpected outcome could have affected the patient. Examples in these cases included an unexpected need for specialist neonatal treatment for a baby and unexpected blood loss requiring a patient to return to theatre.

“Initial findings suggest staffing levels were not a factor in [these] adverse events. However, we will continue with our process to review all of the cases,” Edwards said.

Overall vacancy rates in the January briefing included 65per cent in midwifery. Edwards said that “took into account broader midwifery roles in the service such as leadership or midwife educator positions”.

“The actual midwifery vacancy rate for our maternity wards was 45per cent in January, and this has since reduced to 32per cent...