THE government is responsible for maternity services being overworked, understaffed and struggling to cope, warned the Royal College of Midwives (RCM) yesterday.
Maternity unit closures, budget and training cuts and reduced services are among the issues highlighted by a survey of UK senior midwives by the RCM. The RCM believes that maternity units are facing unprecedented challenges as a historically high birth-rate, increasingly complex births, and a serious shortage of midwives in England piles pressure on services.
According to the survey of Heads of Midwifery (HoMs) over two-fifths of maternity units had to close during the last year because they couldn’t cope with the demand – 32.8% in 2014 and 41.5% in 2015. Units closed their doors on average on 6.6 separate occasions in 2014 and 4.8 separate occasions in 2015. The most times a single unit closed in a year was 33 times (2014) and 23 times (2015).
The number of closures is a reflection of the rising demands on services from increasingly complex births and staffing levels. Most senior midwives surveyed, 96.9% in 2014 and 91.3% in 2015, said their unit is dealing with more complex cases than the previous year. On staffing levels well over a quarter of HoMs, 29.5% in 2014 and 29.6% in 2015, said that they simply did not have enough midwives. The shortage of midwives in England remains critical with the country still short of 2600 full-time midwives.
Services are also being reduced as inadequate funding and staffing shortages bite. A tenth of HoMs, 10.9% in 2014 and 11.0% 2015, reported that they had to reduce services in the last year. This included reductions in specialist midwives, fewer parent classes and less bereavement and breast feeding support.
Services such as home births and postnatal care are also suffering. Around two-thirds, 65.6% in 2014 and 64.6% in 2015, of HoMs said that on-call community staff have to be called in to cover the labour and delivery suites. Many HoMs responding to the 2015 survey also had concerns about how well they were able to do their job given the pressures and demands of the role.
Some HoMs also reported having to provide additional midwifery services but without any extra budget. The RCM of course welcomes additional services but they must be adequately funded. It is a concern then that two-fifths, 21.9% in 2014 and 20.3% in 2015, of HoMs had to reduce training for their staff. Training and continuing professional development are critical to ensure staff can deliver safe and high quality care.
Commenting on the survey, Cathy Warwick, chief executive of the Royal College of Midwives, said: ‘Midwives and maternity support workers are too often keeping services afloat by working long hours, often doing unpaid overtime and missing breaks. This is not a situation that leads to safe and high quality care for women and babies.
‘All of this shows a system that is creaking at the seams and only able to deliver high quality care through the efforts and dedication of its staff. When services are operating at or beyond their capacity, safety is compromised and mistakes can, and almost certainly will be made, through no fault of the dedicated staff delivering the service.
‘The government is responsible for this and it is they who are letting down women, babies and their families, as well as the staff they purport to value. This is simply not acceptable.’
