Proposed NHS pension contribution changes could see staff leaving the NHS says RCM

By Colin Beesley on 12 January 2022 Midwifery Midwives RCM Member MSWs - Maternity Support Workers Pensions Pay and Agenda For Change Midwife Shortage NHS Unions

Proposed changes to NHS pension contributions for midwives, maternity support workers (MSW) and other staff could see people leaving the NHS, says the Royal College of Midwives (RCM).

The warning comes in the RCM’s response to the Government’s NHS pensions consultation on a proposed new member contribution structure in England and Wales, with contributions for many set to increase from 1 April this year. The changes will see higher earners paying less in contributions, and middle and lower earners paying more.

“We have real concerns about the proposed changes and how it will affect RCM members. Midwife numbers have been falling over the past year or so and, with a pre-existing shortfall of around 2,000, the NHS can ill-afford to lose any more. There are many, particularly those with more experience, who may be unhappy with these pension changes and choose to leave,” said Alice Sorby, the RCM Employment Relations Advisor and author of its consultation response. “Our members are also facing rising prices, rising inflation, and a National Insurance increase, on the back of an inadequate pay award. We have real fears that increases in pension contributions will tip many over the edge into the leaving the NHS.”

There are some changes in the proposed structure that the RCM says it can support. These include proposals to base contributions on actual salaries, not the whole time equivalent. There are also plans to align the contribution tiers in the proposed system to Agenda for Change pay rises so that any annual pay awards do not move people into a higher contribution tier.

Introducing these changes at the same time as embedding the McCloud remedy may further exacerbate confusion and distrust in the scheme. You can read more about the McCloud judgement and remedy here.

There are also concerns that the proposed changes could impact women more because 99% of midwives and the majority of MSWs are women - and high earners in the NHS are more likely to be men.

The RCM says that increased pension contributions will affect staff that are already exhausted, and demoralised by years of pay freezes, pay stagnation, understaffing and under-investment. An RCM survey in 2021 showed real discontent from midwives and MSWs with 92% of respondents saying they do not fee valued by the Government. Over half (57%) of those who told us they were considering leaving the NHS said they would do so in the next year.

“There are some positives in the proposals, but overall these proposed changes mean hardworking midwives and MSWs are going to be seeing a fall in their take home pay at a time when living costs are rising sharply. It will also have a disproportionate impact on women and affect the lowest earners the hardest. That simply is not fair or reasonable,” said Alice Sorby. “That is why, in our consultation response, we are challenging many of the changes the Government wants to make and will continue to campaign for an increase not a decrease in our member’s take home pay.”

To read the RCM's pensions consultation response in full visit rcm-response-to-nhs-pensions-contribution-consultation-converted.pdf.

For more information about NHS pensions see the pensions section of the RCM website at