NHS maternity services are “reaching crisis point” according to a new report published today by the Royal College of Midwives (RCM), with England short of 3,500 midwives.
The rising shortage is made worse by the fact that over a third of the UK’s NHS midwives are nearing retirement age. Two in five midwives in Scotland and Northern Ireland are in their fifties or sixties, and over 1,000 midwives in England are 60 or older.
“A vast proportion of our midwives are close to retirement,” said RCM chief executive Cathy Warwick. “We’re lucky to have them. They are doing great work every day. But it’s an inescapable fact that they will soon take their well-deserved retirement. That will challenge our maternity units and put the whole system potentially on the brink of collapse.”
The RCM’s State of Maternity Services report is the annual look at the UK’s maternity services, bringing together information about all four UK countries. The report will officially be launched in London at the House of Commons at 9am on Tuesday the 7th February.
The RCM has previously warned of a ‘retirement time-bomb’ and the situation has not got any better. In fact, the number of midwives in the NHS in England aged fewer than 50 has actually fallen since 2010, with the number aged 50 or over growing substantially.
Over a third (33%) of midwives working in the NHS in England are now in their fifties or sixties nearing retirement age. Between September 2010 and July last year (2016), the number of midwives aged under 50 working in the NHS in England fell, whereas the number in their fifties or sixties rose.
The ageing workforce and existing shortages are further compounded by the fact that only one extra midwife is being hired per maternity unit per year.
In the 12 months to September 2016, the number of midwives working in the NHS in England rose by 104. At that rate, the midwifery workforce of an average maternity unit is growing at the pitiful rate of around one extra midwife every two years.
For the last six academic years (2011/12-2016/17) more than 2,500 places for new student midwives have been commissioned each year. However, just last week figures released by UCAS revealed that the removal of the student midwifery and nursing bursary has already impacted on recruitment, with a dramatic drop in application numbers to courses.
Meanwhile, the number of babies born in England in 2015 was over 50,000 higher than ten years ago and over 100,000 more than in 2001.
Another long-term trend is the age profile of mothers. Across the UK, there are fewer births to younger women, more to older women. In every region of England since 2010 there are where babies born to women in their thirties or older and fewer to those aged below thirty. In addition there has also been an increase of over 12,000 in the number births per year to women aged 40 or older.
In Wales there were almost a thousand more babies born to women in their early thirties in 2014 compared with 2003.While Births to women aged forty or over rose by over 300 during the same period. Births to those aged under 25 fell by 1,400.
The age profile of midwives in Wales is a similar picture to that in England with over one in three (35%) of midwives working in the NHS in Wales in March 2016 were in their fifties of sixties, that compared with figures from 2011 where the most numerous group of midwives were those in their late forties; in 2016, it was those in their early fifties.
Births to women in their late thirties are up over 2,000 since the year 2000, and to women aged 40 or older the number is up by around 1,000. The number of women giving birth aged 30 or above in 2015/16 is now double the number of what is was 40 years ago (1975/76).
For women aged 45 or older, the number of births has jumped fourfold, from 29 to 143 between 2000 and 2015.
Midwives and maternity care assistants now make up 41% of the workforce in Scotland. The number of staff in the oldest age categories is up, but down in the younger age groups.
In Northern Ireland the age profile of women accessing maternity care is ageing too. In Northern Ireland, births to women in their thirties are up almost 3,000 since the start of the century. An added source of pressure is that due to its land border with Ireland a significant number of non-residents give birth in Northern Ireland. This puts further pressure on maternity services.
Births also remain historically high. Whilst the birth rate has flattened in the last few years the number of births in Northern Ireland was still 13% higher in 2015 than it was in 2000. It remains at a level of a few thousand up on what it was at the turn of the century.
The situation in Northern Ireland on the ageing workforce issue is similar to England. In terms of the ageing workforce, in Northern Ireland two midwives in every five (40%) are aged at least 50.
Commenting, Cathy Warwick chief executive at the Royal College of Midwives(RCM) said; “One of the benefits of publishing this RCM report annually is it allows us to look deeply into emerging issues and reoccurring trends that impact our maternity services, affecting women, their babies and the midwives who care for them.
Unfortunately, again this year one of the top reoccurring issues across the UK is our ageing midwifery workforce. One in three midwives in England are now in their fifties or sixties and the RCM remains most concerned that there are not enough newly qualified midwives coming into to staff an already understaffed maternity service.
Right across the UK we are not seeing enough midwives being taken on. Older midwives will be lost to retirement soon and with this we lose their experience and their ability to train and guide younger midwives. This situation cannot be ignored any longer, if we wait, there will not be enough time for us to train new midwives and get them into the service.
In England the removal of the student bursary is already having an impact on recruitment as we saw last week with the drastic fall in UCAS applications for both midwifery and nursing degrees.
Also, the working rights of EU nationals to remain working in the UK post-Brexit must be confirmed quickly. With 1,300 midwives working in the NHS in England alone, the national shortage of midwives could be well over 4,500, if not close to 5,000, without them.”
“Births to older mothers across the UK have increased and becoming a mother later in life is nothing new. However, older women who become pregnant may require more care throughout their pregnancy and we must ensure there are enough midwives in post so women get safe high quality care that they need and so deserve.
Rates of obesity highlighted in this report also contribute to additional demands being placed on maternity services. In England and Scotland over one in five pregnant women are now obese.”
“We hear from our member’s everyday that they are struggling to provide the best maternity care they can because of understaffing. We know if there were enough midwives their time could be spent helping new mothers to breastfeed or to stop smoking. The less time midwives have with women the more likely it is that signs of post natal depression for example could be missed.”
“The right amount of midwives to meet the demands of the ever growing birth rate will allow women and their babies to get the best possible start in life and will save the NHS money in the long run. The Government must listen to our calls, if we our to future proof are maternity services we must see action before its too late.”
To contact the RCM Press Office call 020 7312 3456 or email firstname.lastname@example.org.
The 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 at https://www.rcm.org.uk/.
Notes to editors
The RCMs State of Maternity Services Report (SoMs) 2016 will be LIVE on the RCM website from 22:00hrs Monday 6th February 2017 https://www.rcm.org.uk/sites/default/files/SoMS%20Report%202016_New%20Design_lowres.pdf