Time for the Government to stop ducking its responsibility on staffing

By Sean O'Sullivan Head of Health and Social Policy Midwives NHS Pregnancy Maternity Safety

For over a decade, the RCM has been telling successive Health Secretaries that there is a midwifery staffing crisis. The Ockenden Review has drawn a direct correlation between staff shortages and safety shortcomings. Sean O’Sullivan, the RCM’s Head of Health & Social Policy, explains why warm words from the current Health Secretary are meaningless without swift action.

The publication this week of the Ockenden Review into the failings in maternity care at Shrewsbury and Telford NHS Trust has given all of us cause for sober reflection. The testimony of the families, whose suffering and loss was compounded by a refusal to listen to them, makes for particularly grim reading.

What is clear is that underfunding and chronic staffing shortages contributed to sub-standard care and a toxic workplace culture. The Review identified midwifery staffing shortages across the service, resulting in unmanageable workloads, a lack of support for junior midwives and doctors and delays in the appropriate review and management of care for women and babies. The report has rightly called on the Government to ensure there is sufficient funding to deliver safe staffing levels, so enable staff to deliver safe care. We welcome this demand, which echoes the call in our safe staffing position statement for the Boards of NHS maternity providers to ensure that they employ, at all times, sufficient midwives to provide women and babies with safe, compassionate and high-quality care.

It was encouraging to hear Sajid Javid, the Secretary of State for Health for England, tell the House of Commons that the Government accepts all the Immediate and Essential Actions contained in the Ockenden Review, including implementing the action to expand the maternity workforce further.

We were therefore more than a little perplexed when, only a few hours after making these pledges, the very same Mr Javid led the Government’s opposition to an amendment to the Health and Care Bill, which would have required him to publish independently verified forecasts of the workforce numbers needed across the NHS to ensure that services are safely staffed. The amendment, which the RCM supported, along with more than 100 other Royal Colleges, health unions, charities and think tanks, also enjoyed the support of politicians from all parties and in both Houses of Parliament.

So why does this matter? Well, as Jeremy Hunt, former Secretary of State for Health and current chair of the Commons Health & Social Care Select Committee, observed, the Ockenden Review calls for the implementation of the same measures around workforce planning that are set out in the amendment to the Health and Care Bill. In his words, “It beggars belief that, despite this urgent need for more doctors and midwives to deliver safe maternity care, … the Government is set to reject an amendment to the Health and Care Bill that would permanently end the ongoing crisis in workforce numbers.”

Indeed, had there been regular reports on staffing (as the amendment called for) alarm bells would have been sounding about midwife numbers throughout the period looked at by Donna Ockenden and her team.

According to the latest workforce figures, there were 400 fewer midwives working in the NHS in January, than had been in post 12 months previously. At a time when the NHS is losing midwives faster than it can recruit them, it is hugely disappointing that the Government is ducking responsibility for workforce planning.

Sajid Javid said all the right things about Ockenden, but what is really important is that the Government backs up its warm words with actions. Had the Government supported the amendment to the Health and Care Bill, it could have signalled the seriousness of its intent to implement Donna Ockenden’s actions on workforce planning. That it chose not to, must give us all cause for concern.