RCM warns of midwife exodus as maternity staffing crisis grows
Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM).
The College is warning of a ‘midwife exodus’ as it publishes the results of its annual member experiences of work survey. Over half of midwives surveyed said they were considering leaving their job as a midwife with 57% saying they would leave the NHS in the next year.
Of those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.
Alarmingly, the highest level of dissatisfaction among those surveyed came from midwives who had only worked for five years or less in the NHS. This will have a significantly detrimental impact on workforce planning and, says the RCM, the ability of maternity services across the country to provide acceptable levels of safe, quality care.
The RCM’s General Secretary and 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 with 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? We are calling on the Government to listen to those best advised and work with us to improve retention and recruitment. All NHS organisations must urgently review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.”
A report published by NHS Digital in July revealed the number of NHS midwives working in England in May had fallen by almost 300 in just two months. This is the fastest fall for these two months for any of the years listed in the NHS report, which goes back to 20 years say the RCM.
Burnout among midwives and all maternity staff is higher than ever, particularly after COVID-19 which saw an increase in sickness absence adding to a pre-existing shortage of 2,000 midwives in England alone. Last week leaked results of an NHS national staff survey showed a sharp drop in those who believe their health and wellbeing is being supported by their employer. This is echoed in the RCM survey, with over half of respondents saying that they did not feel valued by their employer. Almost all (92%) of midwives and maternity support workers (MSW) said that they did not feel their work was valued by the current Government.
“Not a day goes by that we don’t hear of a maternity service having to close temporarily, suspend services or divert women to other maternity units just because there simply aren’t enough midwives. This can’t continue because we know it compromises safety and means women don’t always get the safe positive pregnancy and birth experience that they should.
“It’s also having a shocking impact on maternity staff themselves. A shortage of midwives has undoubtedly worsened rates of physical and mental burnout among our members. Morale among staff is low and has been worsened by the recent pay award in England.
“Sadly, this survey shows that many midwives and MSWs have had enough. They are feeling very fragile and are simply at breaking point. Enormous demands are being made on midwives and the services they work for, yet investment in these services from the Government remains inadequate to provide the safe, high-quality care that women deserve. We have previously advised the Government on what can be done to begin to address this situation which hasn’t happened overnight. Prior to the pandemic the RCM has voiced concerns and solutions to the recruitment and retention issues faced by UK maternity services, and we are happy to do that again, but we are now sadly at crisis point. That is today we are again calling on the Government and NHS Employers to take action immediate to keep midwives in midwifery before it’s too late.”
Case studies for publication – please note, these have been anonymised
“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 and following a breakdown of a full-scale attempt at a midwifery continuity model”
“Staffing is in a tragic state, begging, borrowing, and pleading for more staff, more help, more for tonight’s shift, cover for the weekend where 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.”
To contact the RCM media office call 020 7312 3456 or email [email protected].
Notes to Editors
About the ‘RCM members experience survey’ – This survey was conducted by the RCM during August 2021. In total there where 1,588 of which 1,273 responses from members in England. Both midwives and maternity support workers responded to this survey.
- Over half of midwives surveyed said they were considering leaving their job as a midwife
- 57% are considering leaving their role as a midwife or MSW
- Of those considering leaving 57% are planning to do so within the next year.
- 5% of respondents had already left
- Staffing levels and concerns about delivering safe care top reasons midwives are leaving or have considered leaving profession
- 84% not happy with staffing levels.
- 67% not satisfied with the quality of care able to deliver
- 54% ‘not happy with pay (54%)
- Almost all surveyed said that being a midwife or MSW is not valued by the government or ‘said they did not feel valued by the current Government’
- 92% said they do not feel valued by Government.
- 54% don’t feel valued by their employer.
- But 82% do feel valued by the women and families they care for, and 47% do feel valued by the general public
- Of members surveyed highest dissatisfaction among midwives who have spent five years or less working in NHS
- 96% of those working in the NHS for five years or less do not feel valued by the Government
- 50% of these midwives are considering leaving
- 46% of those considering leaving plan to do so in the next year.
Related RCM content and media releases
- Midwives warn NHS underinvestment ‘brutally exposed’ by pandemic (rcm.org.uk)
- Structural weaknesses in maternity funding exposed by COVID, say maternity Royal Colleges (rcm.org.uk)
- Midwife numbers drop in latest NHS report (rcm.org.uk)
- COVID unlocking will create ‘perfect storm’ for pregnant women, say maternity Colleges (rcm.org.uk)
The Royal College of Midwives (RCM) is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit the RCM website www.rcm.org.