Author Mark Richards

Maternity units in the NHS are under increasing pressure, with the number of closures increasing. Could something as simple as an iPhone app be the answer to carers problem?

There are two things that people keep doing – they keep having babies, and they keep getting older. Both of these simple facts present expensive problems for the NHS: but maybe one entrepreneur in the much-maligned gig economy has come up with a solution. It is already working for older people: could it do the same for mothers and their babies?

Let us deal with the bad news first. Anyone who has picked up a paper recently or seen a news bulletin will know the NHS is under real financial pressure. We have written previously about the huge – and ever-increasing – costs of the diabetes epidemic and the ageing population. One of the areas where the lack of resources is most keenly felt is in midwifery services.

Help! I need a midwife

You could argue that there is nothing more fundamental to the NHS than midwifery services: that nothing is more important than a safe delivery into the world. And yet new figures, obtained under the Freedom of Information Act, show that more than 40% of NHS Trusts in England closed the doors of their maternity unit to expectant mothers in 2016. 42 out of 96 trusts (40 did not respond to the request for information) said they had shut maternity wards temporarily on a total of 382 occasions. As you might expect, the main reasons given for the closures were a lack of staff and/or a shortage of beds.

The Royal College of Midwives (RCM) conceded that it might sometimes be right to close a ward – if, for example, the safety of mothers and babies might be at risk – but did say that continuing to do so would “show underlying problems with the number of expert staff.”

Is the problem getting worse?

Sadly, the answer appears to be ‘yes.’ The 382 closures in 2016 compared to 375 in 2015 and just 225 in 2014. The does not necessarily mean that the staff shortages are increasing – hospital managers might simply be more ready to close maternity units on safety grounds – but if your waters have just broken the end result is the same…

Naturally, the figures were immediately seized on by Her Majesty’s Opposition – “devastating Tory cuts for mothers and children across the country” – whilst the Government said the closures were “well-rehearsed” and it was “misleading” to say that the closures were due to staff shortages. The RCM muttered darkly about a shortage of 3,500 full-time midwives – and certainly, their latest report makes grim reading, painting a picture of midwives leaving the NHS due to an increasing workload, low staffing levels and a feeling that they are not able to give the best possible care.

Whatever the rights and wrongs, whatever political standpoint you are arguing from, one fact is clear. Pregnant women need midwives and when they are about to deliver they need them urgently.

Maybe the gig economy has the answer?

The gig economy for carers

I can hear you snorting in derision from here. The gig economy? That is Uber and Deliveroo. It is Sports Direct and zero hours contracts: how on earth can the gig economy help the medical profession?

But what’s a nurse hurriedly hired from an agency but the gig economy? What about a locum doctor? Just because someone wears a suit it doesn’t make them any less a member of the gig economy than the guy on a bike with a pizza on his back.

Especially when that essential of the gig economy – the iPhone app – is being used to improve the lives of patients…

Meet Dr Jamie Wilson and his company, HomeTouch.

Dr Wilson previously specialised in dementia, but in 2015 he founded HomeTouch, a platform based on the same principles as the gig economy which matches up carers with elderly patients.

It is slightly different to the traditional gig economy model in that it allows carers – some of whom offer very specialised services – to set their own price. “They are some patients with very high care needs,” explained Dr Wilson,

“And they are willing to pay a premium for the best, most experienced carers.”

Does this model work?

It certainly seems to, for both carers and patients. According to Dr Wilson some of the 25,000 carers HomeTouch has vetted and registered earn 75% more than they would through an agency, whilst patients are getting reliable and experienced carers, delivering exactly the care they need.

…And would it work for the NHS?

‘If you always do what you have always done then you will always get what you have always got,’ is a well-worn maxim in business – except that these days ‘if you always do what you have always done’ you will very quickly find that someone with an app is doing it quicker, faster, more efficiently and cheaper – and that your customers have noticed.

Clearly, maternity wards cannot continue as they are. The ageing population and the diabetes epidemic will continue to use up ever-increasing proportions of the NHS budget. All services – not just midwifery – are going to be under strain and ‘doing what you have always done’ is simply not going to be an option.

So could a midwife app be the answer? Maybe one of those 96 NHS trusts which have closed maternity units needs to start thinking outside the box: clearly, what they are doing now is not working.

It is easy to demonise the gig economy – all too often the phrases ‘irregular hours’ and ‘uncertain pay’ are uttered automatically. But increasingly, people want to work more flexibly. For more and more people – both workers and customers – the gig economy meets a need. And right now, the gig economy and the application of technology present a possible solution to one very pressing problem in the NHS.

The population is increasing, it is getting older and we are suffering from type 2 diabetes in ever greater numbers: the NHS will not be able to deal with these problems unless someone, somewhere thinks outside the box labelled ‘what we have always done.’