There is growing concern from MERAS – the midwives union – over the failure of Health NZ to approve increases in staffing budgets as an outcome of CCDM (Care Capacity Demand Management) for the second year in a row, and the impact this is having on maternity services.

MERAS Co-Leader (Midwifery), Caroline Conroy, says that as part of CCDM there are annual calculations of staffing needs for hospital wards. Maternity services adopted the CCDM programme and the annual leave staffing calculations later than many nursing ward areas, and several of New Zealand’s largest maternity services have only been doing their first round of staffing calculations since 2022.

“It’s the first and second time that staffing (FTE) calculations are undertaken that you see the largest increase in staffing required”, explains Ms Conroy, “and this increase includes addressing historic understaffing on these wards areas.”

Maternity is unique in hospital inpatient services in that it has two patients occupying many of its beds – a mother and a baby. Older methods of calculating staffing needs for a ward were based on bed numbers or occupancy, and did not acknowledge the differing workload in maternity.

Ms Conroy says the increase in staffing numbers required as a result of the CCDM calculations were not approved in the 23/24 budget and have still not been approved in the 24/25 budget.

“This is very worrying. Maternity services, as the CCDM data clearly shows, requires appropriate staffing which is not happening. To have current staffing budgets based on 2022 figures is misleading at best and potentially affecting safe delivery of services, at worst,” she says.

With the growing number of new graduate midwives entering the workforce, MERAS says Health NZs failure to approve staffing budgets for two years in a row is also impacting on the ability for maternity services to offer positions to new graduate midwives or to provide them with appropriately staffed maternity services to work in.

“After so many years of a midwifery workforce shortage and midwives still badly needed, we do not want to see graduate midwives unable to find jobs within Health NZ,” says Ms Conroy.
MERAS and the Ministry of Health were signatories to the Midwifery Accord 2021, and part of that was agreement that CCDM would be fully implemented in maternity services.

“It’s reasonable to expect that ‘fully implemented’ also means actually funding the number of staff needed to deliver the service,” says Ms Conroy.