Day: October 4, 2021

RCM warn of midwife exodus as maternity staffing crisis grows

Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM).  

The College is warning of a ‘midwife exodus’ as it publishes the results of its annual member experiences of work survey. Over half of midwives surveyed said they were considering leaving their job as a midwife with 57% saying they would leave the NHS in the next year. 

Of those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.  

Alarmingly, the highest level of dissatisfaction among those surveyed came from midwives who had only worked for five years or less in the NHS. This will have a significantly detrimental impact on workforce planning and, says the RCM, the ability of maternity services across the country to provide acceptable levels of safe, quality care. 

The RCM’s General Secretary and Chief Executive, Gill Walton, said: “Every midwife and maternity support worker goes to work to provide safe, quality care. That so many feel that understaffing means they are unable to do so is deeply worrying.

“What these numbers suggest is a midwife exodus, which will leave already-struggling services on their knees. Quite rightly, there is a strong focus on improving maternity safety, but there is a risk that the Government is ignoring the essential ingredient to that: having the right staff, in the right place.  

“Investment and programmes to improve safety in maternity services hang in the balance here, because without adequate numbers of staff with are fighting a losing battle. Every safety report cites understaffing as an issue that is comprising the delivery of safe care, but when are the Government going to take note?

“We are calling on the Government to listen to those best advised and work with us to improve retention and recruitment. All NHS organisations must urgently review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.” 

A report published by NHS Digital in July revealed the number of NHS midwives working in England in May had fallen by almost 300 in just two months. This is the fastest fall for these two months for any of the years listed in the NHS report, which goes back to 20 years say the RCM.  

Burnout among midwives and all maternity staff is higher than ever, particularly after COVID-19 which saw an increase in sickness absence adding to a pre-existing shortage of 2,000 midwives in England alone.

Last week leaked results of an NHS national staff survey showed a sharp drop in those who believe their health and wellbeing is being supported by their employer. This is echoed in the RCM survey, with over half of respondents saying that they did not feel valued by their employer.

Almost all (92%) of midwives and maternity support workers (MSW) said that they did not feel their work was valued by the current Government.

 

Gill added: “Not a day goes by that we don’t hear of a maternity service having to close temporarily, suspend services or divert women to other maternity units just because there simply aren’t enough midwives. This can’t continue because we know it compromises safety and means women don’t always get the safe positive pregnancy and birth experience that they should.  

“It’s also having a shocking impact on maternity staff themselves. A shortage of midwives has undoubtedly worsened rates of physical and mental burnout among our members. Morale among staff is low and has been worsened by the recent pay award in England.  

“Sadly, this survey shows that many midwives and MSWs have had enough. They are feeling very fragile and are simply at breaking point. 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 safe, high-quality care that women deserve.

“We have previously advised the Government on what can be done to begin to address this situation which hasn’t happened overnight. Prior to the pandemic the RCM has voiced concerns and solutions to the recruitment and retention issues faced by UK maternity services, and we are happy to do that again, but we are now sadly at crisis point.

“That is today we are again calling on the Government and NHS Employers to take action immediate to keep midwives in midwifery before it’s too late.” 

JRF issues stark warning on child poverty targets in key state of the nation report

“It is time for the Scottish Government to stop walking and start running”

The Scottish Government must take urgent action to avoid missing its own child poverty targets by a significant margin, leaving families across the country locked in poverty. The cut to Universal Credit by the UK Government in just two days’ time makes the task more urgent. 

Kicking off Challenge Poverty Week with its annual state of the nation report, Poverty in Scotland 2021, the Joseph Rowntree Foundation (JRF) paints a picture of poverty levels in Scotland just before the Covid-19 pandemic.

It highlights a failure to make inroads into the significant levels of poverty among the priority groups for action as identified by the Scottish Government, including families from an ethnic minority background, families where someone is disabled, those with a child under the age of one and single parent households.

Key findings for these groups include: 

  • More than 80% of children in poverty are in one of these groups.  
  • 100,000 children in poverty in live in a household where someone is disabled – a shocking 40% of all children in poverty 
  • Children from minority ethnic backgrounds make up 7% of the population yet make up 16% of all children in poverty 
  • Children in two or more priority groups have a much higher poverty rate (36%) than those in one priority group (25%) and nearly three times that of those in no priority group (13%). 

These figures are pre-Covid 19, and much evidence has highlighted the unequal impact the pandemic has had on many of these groups, meaning their current situations could be much worse. This lays bare scale of the challenge facing the Scottish Government if it is to meet its targets and makes clear the need for targeted action to support these groups.  

The report was produced alongside the End Poverty Scotland Group, an advisory group of people from across Scotland with first-hand experience of living on a low income.  

Alex, a member of the advisory group said: ‘If over 80% of children in poverty are still in one of the priority groups, how much of a priority  are we, really?’ 

The findings also highlight the importance of full-time work in reducing poverty in Scotland. 54% of people who are in families where no one is working are in poverty. People in families where someone is working part-time have a poverty rate of 30% while the poverty rate for people in families where at least one person is in full-time work is 10%.  

The desire and need to work was a strong theme from the advisory group, but the inflexibility of childcare provision was highlighted as a consistent barrier. The group expressed deep frustration that in most cases people were trying to create a better life for them and their families, but success was often despite the system rather than because of it.  

The report urges both the Scottish and UK Governments to increase the adequacy of social security in order to drive down poverty levels. 

JRF recommends that the Scottish Child Payment is doubled as soon as possible and that the upcoming Tackling Child Poverty Delivery Plan must set out a clear and measurable course towards meeting those targets. It must include a far greater scale and pace of activity to support families in the priority groups who are most at risk of poverty. 

The UK Government’s cut to Universal Credit and Working Tax credit in just two days’ time will cut £1,040 per year from the incomes of 450,000 families in Scotland. This cut will increase poverty in Scotland across all groups, not just families with children.

The UK Government is responsible for 85% of social security spending in Scotland and the responsibility for the impact of this cut lies at their door. As well as reversing the cut, the report recommends reform of rules such as the five-week wait for the first payment of Universal Credit, and the two-child limit, which drive destitution and hardship in Scotland as they do in other parts of the UK. 

Chris Birt, Associate Director of JRF in Scotland said: “The Scottish Government has rightly set a national mission to end child poverty and has put in place steps to move us in the right direction. But we are on course to miss our targets by some distance. Such a political failure would have a profound human cost –  tens of thousands more children will experience childhoods blighted by hardship and anxiety. 

“It is time for the Scottish Government to stop walking and start running, by immediately doubling the Scottish Child Payment and by significantly increasing the scale and pace of its programme to support families in priority groups.  The forthcoming Budget and Tackling Child Poverty Delivery Plan will be crucial in putting us on a path to meeting our targets. 

“All tiers of government must look at the design and cultures that underpin public services. The group of people on low incomes who co-authored the report are clear in the need for a more constructive approach underpinned by kindness and ease of use as well as more accountability to the people who use the systems. 

“The responsibility for the cut to Universal Credit falls squarely at the UK Government’s door.  It is a failure of both compassion and of policy.  Its decision to impose the biggest overnight cut to social security in the history of our welfare state will cause immediate and widespread hardship in Scotland. With reserved powers, comes reserved responsibility.  

“Our social security system should protect people from poverty, but the UK Government is instead choosing to condemn them to it.” 

poverty_in_scotland_2021Download