The latest Agency, bank and overtime spending in UK maternity units in 2016 report was unveiled at this year’s RCM conference, making it the third year in a row that research has looked into the amount of money spent on temporary staffing in maternity units, and the third year in a row it has revealed spending is increasing and out of control.
The report reveals that in total, NHS organisations spent more than £97m on agency, bank and overtime in maternity services in the UK in 2016 – that’s enough to pay 2731 full-time Band 6 midwives or 4391 full-time newly qualified midwives (NQMs). Some 26 organisations spent more than £1m on agency, bank and overtime in maternity – 24 in England, one in Scotland and one in Northern Ireland. Nine of them spent more than £2m. In England, NHS organisations spent more than £87m – a rise of 20% on 2015 (almost £73m). In Wales, NHS organisations spent more than £1.2m, in Scotland more than £5m, and in Northern Ireland more than £3m.
This is a staggering amount of money. While there will always be a place for temporary cover, it is clear that some units are using temporary staff to cover permanent staffing shortages. This raises two questions: why isn’t this money being spent on recruiting permanent staff and why isn’t money being spent on a fair pay rise to retain experienced midwives?
There are six recommendations made in the report. One is that NHS organisations should review maternity staffing levels using a recognised workforce-planning tool, such as Birthrate Plus, to ensure they have appropriate numbers for their workload. Any resulting vacancies should be filled urgently. NHS organisations should also use recruitment and retention premia, an allowance within Agenda for Change that can pay to attract midwives to units with a shortfall. The report also calls for the government to reintroduce the bursary and abolish fees for student midwives to ensure there are enough NQMs.
Recruitment is just one side of the story. The NHS also needs to retain experienced midwives. The place to start is a fair pay rise. The government must end its policy of public sector pay restraint and allow the NHS Pay Review Body to make unfettered recommendation for the pay of NHS staff, including midwives. It also needs to make sure the funds are available for a fair pay rise. RCM research in 2016 found that 80% of midwives intending to leave midwifery would stay if they had a pay increase.
NHS organisations should also sign up to the RCM’s Caring for You campaign. Too often we hear of members being denied requests to work flexibly (ironically because of staffing pressures), which forces them to leave permanent employment to work for an agency. This is a false economy – maternity units need to accommodate flexible working requests so they can retain existing staff.
While temporary workers will always be needed, it is clear that organisations are far too reliant on them. They need to develop a total workforce strategy that ensures they are retaining existing staff and recruiting enough new staff to deal with the increased demand.