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NHS on verge of midwife ‘exodus’ - New survey shows midwives leaving due to workload, poor staffing levels and not able to give the best care

17 October, 2016

NHS on verge of midwife ‘exodus’ - New survey shows midwives leaving due to workload, poor staffing levels and not able to give the best care

Midwives are leaving the profession and are being driven out by excessive workloads and poor staffing levels according to a new report from the Royal College of Midwives (RCM). The report - ‘Why Midwives Leave’ - details a survey of over two-thousand midwives across the UK who have left the profession in the last two years or are intending to leave in the next two years. It also makes recommendations to prevent this flow of midwives out of the profession and the NHS.

The report’s publication comes as the RCM starts it Annual Conference in Harrogate on the 19th and 20th of October 2016.

The survey paints a picture of midwives working ever harder to provide safe and high quality care, and being unable to do this, they leave. It asked midwives that have left the profession why they decided to leave. Over half (52%) said they were not happy with staffing levels. A similar number (48%) said they were unhappy with the quality of care they were able to give.

A similar picture emerges in responses from midwives intending to leave. Nearly two-thirds (62%) said they are not happy about the staffing levels where they work. Over half (52%) said they are not satisfied with the quality of care they are able to give. Just under half (46%) said the excessive workload was one of the key reasons they were planning to leave.

Midwives were also asked what would encourage them to stay in the profession or return. Their responses reflected their reasons for leaving or intending to leave. Over four-fifths (88%) said they would very or quite likely return if staffing levels improved. Almost the same number (83%) said they would very likely or quite likely return if the workload was eased.

The morale of midwives is reflected in questions about how the profession is valued. Just a third (35%) said they felt midwifery was valued by their employer. The Government fare badly in the eyes of midwives. Only a tenth (9%) said they feel midwifery is valued by the Government.  

The report does though lay out solutions to stem this flood of leavers, and makes five recommendations to change the situation around.

These include:

  • NHS organisations should review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.
  • NHS organisations should review their midwifery turnover and vacancies and address recruitment and retention issues. They should make use of recruitment and retention premia to counter existing shortages
  • NHS organisations should sign up to the RCM’s Caring for You Charter (part of the RCM’s Caring for You Campaign) to take action on flexible working, breaks and workplace culture.
  • Government should end public sector pay restraint allowing the NHS Pay Review Body to make unfettered pay recommendations for NHS midwives and other staff, and break the 1% pay cap to ensure that midwives are fairly rewarded for the job they do.
  • The Government should re-think its plans to abolish the bursary for midwifery students and not introduce tuition fees. Both of these actions will have consequences for the numbers of new students training to be midwives.

Commenting on the report, Cathy Warwick, Chief Executive of the Royal College of Midwives, said: “That so many midwives have left or intend to leave is saddening, dispiriting and worrying. I read the comments of the midwives in the report with increasing distress and concern, for them and for mothers and babies.

“Maternity services are performing as well as they are on the backs of the selfless dedication of midwives and other maternity staff, and their capacity to go that extra mile for mothers and babies, day after day.  However, this shows that many cannot fight that battle any longer.

“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 quality of care that women deserve.

“We are asking for employers and Government to take action to keep midwives in  midwifery. In particular we are asking employers to sign up to the RCM’s Caring for You Charter to try and improve midwives health, safety and wellbeing at work. The Caring for You Charter asks organisations to work locally with the RCM to take action on improving the working environment, ensuring that midwives get their breaks, have access to flexible working so they can balance work and family life and create a positive workplace culture.  

“I urge the Government and employers to look at our recommendations . Let us all work together to keep the midwives we have and encourage those who have left to return.”

The report ‘Why Midwives Leave’ can be read here via: https://www.rcm.org.uk/sites/default/files/Why%20Midwives%20Leave%20Revisted%20-%20October%202016.pdf from 22.30 Tuesday, 18th October 2016.

To contact the RCM Press Office and for a copy of the report call 020 7312 3456 or email pressofficer@rcm.org.uk.


Notes to editors

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/.

Comments from Midwives

“I am tired and worn out and am concerned that if this continues that I might make a tragic mistake”.
Midwife, England, intending to leave midwifery in the next 12-18 months

“…My unit was struggling with employing enough midwives - we had a shortage of thirty full time midwives... I was not able to deliver the care I wanted as decisions were often made about women’s birth without her full involvement. It was not safe to look after fifteen mums and babies on a postnatal ward by one midwife. We were not listened to when we raised issues over staffing and safety”.
Midwife, England, left midwifery in the last 6 months

“Although it was primarily for health reasons, I can honestly say those health concerns were in a large part caused by the stress of trying to provide good as well as safe midwifery care despite ridiculously low staffing levels and having to complete endless paperwork…”.
Midwife, England, left midwifery 18-24 months ago

“…the workload is far above what is safe for me and the women and babies we care for. I am constantly exhausted both mentally and physically. I hate the fact that I am not able to give high quality care due to lack of staff”.
Midwife, England, intending to leave midwifery in the next 18-24 months


“I felt scared with the care I was able to deliver. I was left in a dangerous position on many occasions due to a lack of staff and a lack of support from managers when escalating concerns. The care was not patient-friendly as the level of staff did not allow for this…”.
Midwife, England, left midwifery 6-12 months ago

“…The importance placed on documentation and covering yourself and the trust have overtaken the importance placed on care, and the staffing levels and workload make it really unsafe sometimes”
Midwife, England, intending to leave midwifery in the next 6 months

“I was happy working with postnatal women and families but the ‘system’ I worked left me constantly feeling dissatisfied, unfulfilled, afraid of making a mistake when caring for really unwell women with increasingly complicated needs. Higher management …only appeared to take any notice of midwives’ opinions after a serious incident had occurred”.
Midwife, England, left midwifery 12-18 months ago

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