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Recommendations and activity to date

1. The maternity workforce should not be redeployed

The RCOG recognises that some trusts have had major challenges in staffing COVID-19 facing and intensive care services. However, maternity services cannot be paused and should be classified as a core service in the context of the current pandemic and any future waves. The RCOG is clear that the maternity workforce should not be redeployed in this, or any future, pandemic unless there are no other viable options to provide medical staffing.

2. The same standards should apply to the maternity workforce as the emergency department workforce

Our survey shows clearly that in some places redeployment has been indiscriminate, without consideration of the needs of different specialties. While this might be appropriate in extreme circumstances, we believe that maternity should be the last option for redeployment, alongside other essential front door services. It makes sense that medical staff of any grade working in services where elective activity has stopped should be redeployed before those from core services where activity levels have not been reduced. In simplistic terms, if organisations are not removing doctors from the emergency department they should not consider removing doctors providing maternity care until they have exhausted all other options

3. Non specialist doctors working in maternity services should be first to be redeployed if there is no alternative

Should future waves of COVID-19 require movement of staff, we recommend that any decision to move staff out of maternity services must come with a strong rationale, which must be clearly communicated to maternity staff, and a commitment to regularly reviewing staffing with a view to returning maternity staff as soon as possible. We would suggest that only when there is no alternative, GP trainees and foundation doctors are prioritised for redeployment, allowing specialty trainee doctors to remain with their service for as long as possible.

4. Senior and middle grade doctors in maternity should not be redeployed

Lastly, senior and middle grade obstetricians should only be removed from the maternity service as a last resort after all other possibilities have been exhausted.

RCOG activity so far

  • Dr Edward Morris, RCOG President, and Dr Jo Mountfield, RCOG Vice President for Workforce and Professionalism, have written to Professor Stephen Powis, National Medical Director for NHS England, highlighting the results of the survey and offering support and recommendations for future decision making should we have another surge of COVID-19.
  • The RCOG will shortly be publishing guidance for Consultants and SAS and locally employed doctors on acting up/acting down and guidance on the engagement of locums in maternity care, two areas which were significantly impacted by the changes in staffing across maternity units.
  • Findings from the COVID-19 workforce survey helped to shape the¬†RCOG Restoration and Recovery: Priorities for Obstetrics and Gynaecology¬†framework document.
  • The RCOG will be sharing the report findings with all UK trusts, highlighting the impact of changes on maternity services and on the individuals delivering those services.
  • A brief follow-up survey to our members is scheduled to find out if staff have been returned to their units and i working patterns have changed as a result of the pandemic.