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'Temporary staffing costs in maternity units rise to almost £100 million in 2016'

27 October, 2017

'Temporary staffing costs in maternity units rise to almost £100 million in 2016'


NHS spending on midwifery agency, bank staff and overtime in the UK has reached over £97 million in 2016 says a report published today by the Royal College of Midwives (RCM).

The RCM report details spending in maternity units in 98% of NHS organisations in the UK. It shows that 26 NHS organisations spent over £1 million on agency, bank or overtime on midwives in 2016. Twenty four of these are in England with one each in Scotland and Northern Ireland. Nine organisations spent over £2 million.

The findings come from a freedom of Information request (FOI)* investigating the costs of temporary staffing through agency, overtime and bank use and are published as the RCM starts its annual conference in Manchester.**

A total of just over £97 million was spent on midwifery agency, bank and overtime payments in 2016 throughout the UK. This is enough to pay for 2,731 full time and experienced midwives or 4,391 newly qualified midwives.

The FOI found that the average hourly spend for an agency midwife was £43.65. This is compared to a permanently employed midwife with ten years’ experience working full time in the NHS, for which the average hourly rate across the UK is around £18.30. The revelation comes as England struggles to maintain its maternity services with a shortage of 3500 full time midwives.

In the autumn 2015 the Government placed a cap on agency spending in NHS trusts in England. Maternity units in England spent £20,635,047.30 on agency midwives in 2016 which is down slightly from spending on agency midwives in 2015 which was £24,950,157. However, bank spending has leapt from £43,225,603 in 2015 to £58,646,085.50 in 2016 showing that the agency cap has not tackled the underlying problem and maternity units’ reliance on temporary staffing is still growing year-on-year.

The problems are also serious in other UK countries. In Northern Ireland NHS organisations spent £3.2 million on agency, bank and overtime in maternity in 2016. In Scotland NHS organisations spent £5.3 million on agency, bank and overtime in maternity in 2016. The NHS in Wales spent £1,286,234.82 on agency, bank and overtime in maternity in 2016.

The RCM believes that the current shortage of 3,500 midwives and seven years of pay restraint are the two most significant factors that are contributing to the rising spending on temporary staffing. The RCM has concerns the shortage of midwives could grow even further across the UK because of the introduction of tuition fees and removal of the bursary for student midwives this year; the continuing uncertainty around midwives from other EU countries right to remain following Brexit; and retention of existing midwives in an increasingly pressured service.

In 2016 the RCM conducted research*** of the reasons why midwives leave, or are considering leaving, midwifery and found that 80% of midwives said they would stay in midwifery if their pay increased.

Commenting Jon Skewes, Director for Policy, Employment Relations and Communications at the Royal College of Midwives, said:  “This report shows quite clearly that our maternity services are under-staffed and under-resourced. The use of temporary midwives to staff permanent shortages is counter-productive and smacks of short-termism when there needs to be sensible and strategic long term planning in midwifery and across the NHS.  It is costing more in the long run to pay agency, bank and overtime than it would if services employed the right numbers of midwives in the first place.

“The first positive step the Government could take is to end public sector pay restraint and fully fund a pay rise for midwives, maternity support workers and other NHS staff. This would retain our hard-working, experienced midwives in the service so that when new midwives are trained they are reducing the shortage rather than replacing the midwives who’ve had enough of seeing their pay packet dwindle while they’re working harder and harder.

“The average midwife has seen their salary decrease in value by over £6,000 since 2010 so it is little wonder why midwives are looking for opportunities elsewhere. This report shows that the vast amounts of money spent on temporary staffing can and should be used to recruit and retain permanent staff and is proof that fair pay for midwives is overdue.

“We have a NHS and maternity service that is heading for a crisis and the Government’s policies are clearly failing. This Government must ensure NHS maternity services have the staffing and resources they need to meet the demands they are facing, so that they can deliver the safest and best possible care for women and their families. A fundamental part of the necessary resources for running the service is funding for a fair pay award for midwives and other NHS staff.”

To contact the RCM Press Office call 020 7312 3456, or email pressofficer@rcm.org.uk.


Notes to editors

Agency, Bank and Overtime Spending in UK Maternity Units 2016: https://www.rcm.org.uk/sites/default/files/Agency%20Bank%20and%20Overtime%20Spending%202017%20A4%2016pp_2%20%282%29%20FINAL.pdf




*About the Freedom of Information request - In January 2017 the Royal College of Midwives (RCM) sent a freedom of information request (FOI) to all the NHS organisations in the UK that have maternity units to ask them how much they have spent on agency and bank staff and overtime for every month in 2016. The FOI also asked about the numbers of hours of staff time this equated to. 159 trusts responded to the FOI giving a response rate of 98.8%.


**The Royal College of Midwives Annual Conference runs on Tuesday 31st and Wednesday 1st November 2017. For more information visit https://www.rcm.org.uk/rcm-annual-conference-2017.

***See the RCM report ‘Why Midwives Leave - revisited’ - https://www.rcm.org.uk/sites/default/files/Why%20Midwives%20Leave%20Revisted%20-%20October%202016.pdf.


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/.





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