In the past month five major midwifery units in England have hit the headlines over midwifery staffing levels.
Liverpool Women’s hospital (LWH), Jessop Wing in Sheffield, Sandwell and West Birmingham, with Ipswich and Colchester in the same trust, have responsibility for around 28000 births a year and are all having challenges due to a lack of midwives.
In recent weeks LWH has regularly closed its midwifery led unit temporarily as well as well as sending out changes in appointments, due to staff lack and sickness. A visit by the CQC to Sandwell and Birmingham noted low morale due to poor staffing. The Jessop Wing has been found with inadequate staffing on an inspection visit by the Care Quality Commission (CQC), and the units in Ipswich and Colchester have also been downgraded following reporting to the CQC from whistleblowers. A subsequent news report hints at 30 midwives being recruited (are these re-recruited following Brexit?) from Europe to plug the gaps. This is in the same month of reporting of candidate for the new head of the NHS, Baroness Harding, vowing to stop relying on NHS staff from other countries.
It is evident these maternity services will not be the only ones struggling. There is no doubt this past year of the pandemic has increased the pressure on units who have already had numerous vacancies. Over the last year the CQC have reported concerns on safety of around two fifths of units due to staffing and culture.
The Royal College of Midwives survey of staff last year showed 83% of respondents believe their maternity services do not have enough staff to operate safely. Recently the State of the World’s Midwifery report shows this is a global problem.
The high levels of stress and burnout of staff being reported are sure to be related to these issues, as discussed on this forum last week. Though NHS England has promised around 95million to support increasing staff and training , the impact of this may be compounded by midwives leaving. It was highlighted in an RCM report from 2016 the high levels of midwives aged over 50.
The stress increase in the recent year may lead to increased earlier exits. The Nursing and Midwifery council report on the register of numbers of nurses and midwives for the past year shows and increase of midwives on the permanent register of 1152, yet there are also 174 less midwives who have joint registration. 2221 midwives have joined the register for the first time, yet 1335 midwives, and 215 dual-qualified have left- the increase in numbers overall has not been enough to deal with the shortfall. The NHS money is only to fund 1000 midwives; though this will help a great deal it may not be enough to stem the tide.
We will all watch this development carefully. What staff and students need at the present time is support to do their job well and for their wellbeing following a very challenging year and recognition of the difficulties they have faced. What women and birthing people need is the assurance they can give birth in the place they want to and that there are enough staff available to provide them safe care.
Is this too much to ask?
Get in touch about what is happening where you are working.
Dr Jenny Hall