Free labour to support those in labour no way to run maternity services says RCM

on 10 April 2024 Pay NHS Pay Review Body Pay and Agenda For Change NHS Staff Staffing Levels Midwifery Midwives Midwife Shortage MSWs - Maternity Support Workers Scottish Government Welsh Government Government NHS NHS Wales NHS England NHS Funding NHS Scotland

Findings published by the Royal College of Midwives (RCM) have revealed that during one week in March midwives and maternity support workers (MSWs) in England, Scotland and Wales worked 136,834 extra unpaid hours to keep services running safely.

A situation the College has described as ‘unsustainable’ and ‘grossly unfair’ as its members wait for a now overdue pay announcement from Government.

Alarmingly over three quarters (76%) RCM members said that their workplace was not safely staffed during those seven days in March. 

More than eight out of ten (85%) worked additional unpaid hours, while in some regions in England this increased to nine out of ten. Shockingly, 97% of respondents in the northeast of England said they had worked additional hours unpaid that week, while 93% of members in London worked extra unpaid hours.

In England alone RCM members worked an extra 118,181 hours during the week from Monday 4 to Sunday 10 March – which is an increase of almost 20 percent (18%) on the same poll undertaken last year, says the RCM.

Commenting, The RCM’s General Secretary, Gill Walton said:

Across the country, maternity services are only being kept running because midwives and maternity support workers are working beyond their hours. What’s even worse is that they aren’t getting paid for those hours. This is something the RCM has flagged before and the results of our latest poll are further proof of that. Staff are doing their upmost to plug the gaps, but this situation is unsustainable, and it is not the way we should be delivering maternity services. Services can’t continue to run on the goodwill of midwives. Aside from the toll that is taking on our members physical and mental health, they are being further, right demoralised by governments dragging their feet over giving them a pay rise, which is now overdue. The Government have disgracefully left hardworking midwives and MSWs in limbo once again about their pay in the midst of a cost-of-living crisis. We’ve told the Government time and time again that improving pay is one of the crucial levers in retaining staff and right now given the staff retention issues facing the NHS they should be doing all they can to ensure staff are paid fairly.”

Over half (51%) of respondents worked up to five additional hours and over a quarter (27%) worked between five and 10 hours unpaid across the week of the survey.

In its evidence to the NHS Pay Review Body (PRB) in addition to a real terms pay increase one of the RCM’s asks was for members who work additional hours to get paid fairly. Improving pay was also highlighted as a crucial factor in retaining midwives.

Meanwhile over two thirds (66%) of respondents to this poll considered leaving their role as midwife or MSW in the past year, something the RCM says is a worrying upward trend as intention to leave in a similar poll in 2021 was ten percentage points less (57%).

Gill added:

“Report after report has made a direct connection between staffing levels and safety. While there has been some progress it clearly is not happening at the pace needed. We are calling on the Westminster and Scottish Government to do their homework, review the NHS workforce plan, listen to what RCM members are saying, they don’t believe that staffing levels are always safe. The pressure that is putting on midwives and MSWs is profound, they are struggling to deliver the care they want and know they can and that is undoubtedly impacting the care women and their babies are receiving.”

Earlier this year the RCM said that ‘ending the midwifery staffing shortage was possible’ as it published a new guide which also included low cost solutions to improve working conditions for midwives, It was developed for current and future Members of Parliament, setting out solutions to the issues faced not only in England, but right across the UK.




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*Please see below for how the RCM calculated the estimate for the number of free hours worked by midwives during the week of the survey.



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 | A professional organisation and trade union dedicated to serving the whole midwifery team