In our series of blogs, we share stories from a selection of trusts who presented at the recent Connected Health & Care Summit 2024.
Summary
The Belfast Health and Social Care Trust (BHSCT) serves the Belfast region in Northern Ireland. It was formed on 1 April 2007 by the Department of Health, Social Services and Public Safety (DHSSPS) as part of a reorganisation that established five new trusts. With a workforce of 22,000 staff members, BHSCT is tasked with providing care to over 340,000 patients across several key hospitals, including Belfast City Hospital, the Royal Victoria Hospital, the Mater Hospital, and Musgrave Park Hospital. The Belfast Health and Social Care Trust faced the task of implementing the Continuity of Midwifery Carer (CoMC) model, which aimed to provide women with consistent care from the same midwife or team throughout pregnancy, childbirth, and early parenthood.
A more flexible, patient-centred approach
This model required a fundamental shift from the traditional shift-based roster system to a more flexible, patient-centred approach. The challenge was to enable midwives to follow women through their care journey while maintaining work-life balance and making sure the right care was provided at the right time. Achieving this transformation demanded the redesign of staff scheduling, improved team coordination, and the alignment of staff availability with patient needs.
Implementing the CoMC model
To address this challenge, the Belfast Trust, working closely with its e-Roster team, implemented the CoMC model, using RLDatix’s Optima to manage the new flexible rosters. This model allowed midwives to work collaboratively with women to plan and manage their care, moving away from the shift-based system. By using color-coded shifts and clearly identifying work patterns, the trust was able to create schedules that matched the unique needs of both midwives and their patients.
Midwives were empowered to plan their caseloads while balancing personal and professional responsibilities. The system also factored in protected time off, ensuring team members adhered to their contracted hours while still delivering personalised care. The collaboration with other trusts, including the Southern Health and Social Care Trust, further supported the effective rollout of this model.
Allen Jamison, Deputy E-Roster Manager at Belfast Health and Social Care Trust, explains: “Implementing the Continuity of Midwifery Carer model transformed our scheduling approach, allowing midwives to work more flexibly while ensuring patients received consistent, personalised care throughout their journey.”
“The collaboration between midwives and the e-Roster team was key to our success,” says Allen. “By using RLDatix’s Optima, we were able to design rosters that balanced patient care needs with midwives’ personal commitments, creating a win-win for both.”
Benefits for both patients and midwives
The CoMC model brought significant benefits for both patients and midwives. For patients, it increased the likelihood of being attended by a midwife they knew at birth by seven times. The model also led to a 16% reduction in neonatal loss and a 24% decrease in pre-term births, demonstrating the clinical and emotional value of consistent care. For midwives, the model resulted in higher job satisfaction, improved work-life balance, and greater autonomy.
They experienced more flexibility in managing their caseloads and enjoyed a stronger sense of professional pride. The trust successfully implemented a standardised process for CoMC, which offered flexibility in rostering and allowed for adaptation to the needs of both midwives and patients. This led to enhanced staff morale, greater continuity of care for patients, and a positive shift in how midwifery services were delivered.
Reflecting on the results, Allen says: “The CoMC model not only improved patient outcomes, like reducing neonatal loss and pre-term births, but also boosted staff morale by offering midwives more control over their caseloads and work-life balance.”
Top tips
- Empower staff to plan caseloads: Giving midwives autonomy over their caseloads promotes job satisfaction and better work-life balance, while ensuring patients receive consistent care.
- Harness the power of technology for adaptability: Optima can help manage non-traditional work patterns, allowing staff to work more flexibly and ensuring patient care is uninterrupted.
- Collaborate across teams: Engage with e-Roster teams and collaborate with other trusts or organisations to share insights, improve processes, and ensure smooth implementation of new care models.
- Measure success through patient and staff outcomes: Monitor the impact of care continuity on both patient outcomes (e.g., reduced neonatal loss) and staff satisfaction to gauge the success of the model and make necessary adjustments.
- Focus on protected time off: Ensure that rosters account for team members’ contracted hours and provide protected time off to promote a sustainable work-life balance and prevent burnout.
To watch a recording of the session, please visit our ‘OnDemand Hub’ here.
