26.04.2024

Poor staffing and safety fears is driving midwives out of the NHS

The Royal College of Midwives (RCM) said fears over poor staffing levels were making midwives worried they cannot deliver safe care. It said there was now a real risk of a midwife exodus following the results of its annual survey of members.

From the 1,273 midwives and maternity support workers who responded, 57 per cent told the union they were planning to leave within the next 12 months with five per cent having already done so.

More than half of NHS midwives and maternity support staff say they are planning to leave the health service in the next year.

Concerns over staffing levels, at 84 per cent, was the top reason for staff wanting to leave alongside two thirds not being satisfied with the quality of care they could deliver.

Just over half cited pay as a reason they wanted to leave the NHS.

One midwife said: “I feel that the maternity system is completely broken. In the unit I work in from the labour ward to antenatal and postnatal ward and community services, it’s broken.”

The RCM said the highest level of dissatisfaction was among younger midwives who had only worked for five years or less in the NHS.

Chief executive, Gill Walton, said: “Every midwife and maternity support worker goes to work to provide safe, quality care. That so many feel that understaffing means they are unable to do so is deeply worrying. What these numbers suggest is a midwife exodus, which will leave already-struggling services on their knees. Quite rightly, there is a strong focus on improving maternity safety, but there is a risk that the government is ignoring the essential ingredient to that: having the right staff, in the right place.

“Investment and programmes to improve safety in maternity services hang in the balance here, because without adequate numbers of staff we are fighting a losing battle. Every safety report cites understaffing as an issue that is comprising the delivery of safe care, but when are the government going to take note?”

Concerns over the safety of maternity services in England have been rising following repeated maternity scandals involving hundreds of families and costing the NHS more than £8 billion in negligence payments over the past 15 years.

In the wake of poor care at the Shrewsbury and Telford Hospitals Trust, the largest maternity scandal in NHS history, NHS England has invested £95 million this year to fund an extra 1,000 midwives and improve safety training.

The Care Quality Commission has called for action and said more than 40 per cent of maternity units in England need to improve on safety.

The first signs of a possible exodus came in a report from NHS Digital in July showing the number of midwives working in England in May was down 300 in just two months. The RCM said this was one of the fastest falls in the past 20 years.

Numbers of nursing and midwifery staff do tend to fall in the summer as older staff retire before being replaced by newly qualified students in the autumn.

The RCM also warned about the burnout of midwives following the pandemic which it said could exacerbate what it estimates is a current shortfall of 2,000 midwives.

A midwife called Anna, told the RCM: “I see tired, burntout midwives everywhere I go. I see women receiving poor care by an overstretched service and we are all too tired to fight for what we believe in. I realise this is a national picture, but more reason to take action. The time has passed for us just ‘making do’ with the situation or ‘just getting through the summer’. This standard of care and staffing shortages have become a way of life for us and its unsustainable. More and more midwives are leaving, and our physical health is suffering.”

Julia, also a midwife, added: “Staffing is in a tragic state, begging, borrowing, and pleading for more staff, more help, more for tonight’s shift, cover for the weekend when we’re four midwives short, two just called in sick. The government have added more hurdles to make it impossible to get people into university, taken away bursaries, childcare is astronomical, bills too high to allow someone to train without them struggling to pay their rent.

“We’re reducing the time we give to women, having to close facilities, reduce antenatal education, postnatal visits cut to a minimum. Stretched physically is one thing, you can rest your body eventually when home, but the mind, the mind does not have an easy off switch. The constant unrealistic expectations on maternity staff is damaging their mental health, it’s impacting on the wider service and it’s putting women, babies and families hopes and dreams in danger.”

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