National survey of staffing on obstetric units: are we meeting standards?
•The 2013 OAA/AAGBI guidelines made several recommendations regarding staffing on the delivery suite.
•These include a nominated consultant to cover delivery suite, separate consultant cover for scheduled care, and resources to allow emergency and elective care to run independently.
•We wanted to investigate how many units in England are currently meeting these standards.
•We conducted a telephone survey of the 163 obstetric led delivery suites in England
•Details of the units were obtained from the BirthChoiceUK Professional website
•The on-call obstetric anaesthetist was contacted via switchboard and asked the following questions:
1.Whether their unit ran an elective caesarean section list
2.If so, whether this list was staffed separately from delivery suite
3.What grade of anaesthetist was responsible for the elective list
4.If the anaesthetist on call for delivery suite had additional responsibilities out of hours
5.If so, which area they were responsible for covering
•We gained responses from a total of 144 of the 163 obstetric units in England
•This constitutes a response rate of 88%
•All but one unit ran an elective caesarean section list, of varying frequency from Monday-Friday
•92% of the scheduled lists were routinely run by a consultant anaesthetist
•97% of delivery suites had an anaesthetic consultant on site Monday- Friday between 0800-1800
Conclusions and discussion
•This survey has provided an up-to-date picture of anaesthetic staffing levels of labour wards in England.
•We were able to contact a high proportion of the units in England
•The majority of units are run by a consultant anaesthetist.
•A high proportion are unable to provide separate anaesthetic cover for emergency and elective care.
•This is more common in units with less than 4500 deliveries per year.
•As the number of operative deliveries increases, the number of anaesthetic interventions is likely to increase1.
•In order to be compliant with the OAA/AAGBI guidelines1, extra staffing and resources will be required.
•This survey does have a number of limitations. Firstly, our information was obtained from the on-call anaesthetist who may not have been aware of staffing levels. We may have generated more accurate data by asking the specific number of consultant sessions.