82% of midwives work unpaid overtime – ‘We desperately need 5,000 more midwives’ says RCM leader

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Midwives banner on the North East London Council of Action demonstration in Enfield to keep open Chase Farm Hospital
Midwives banner on the North East London Council of Action demonstration in Enfield to keep open Chase Farm Hospital

MIDWIVES have commented on the NHS Staff Survey and the impact of staff shortages and inadequate staffing levels on the health of midwives and the mothers and babies they look after.

Analysis of midwives’ responses of the 2012 NHS staff survey released on Tuesday by The Royal College of Midwives (RCM) found that 82 per cent of midwives work additional unpaid hours and 47 per cent said that they had been unwell due to stress in the last 12 months.

The 2012 NHS staff survey involved 259 NHS organisations in England. 203,000 NHS staff were invited to participate using a self-completion postal questionnaire survey method. Responses were received from 101,169 NHS staff, a response rate of 50% (54% in 2011).

Royal College of Midwives’ Chief Executive Cathy Warwick said: ‘These results are deeply disappointing and it’s worrying that so many midwives are working considerable additional unpaid hours.

‘Midwives love their job and want to be with women and serve mothers, babies and families, but they are not given the time they need to deliver high quality care.

‘We need to have enough staff so that midwives can get breaks and feel valued and appreciated.

‘We desperately need 5,000 more midwives in the NHS in England.’

Overall, the survey results highlight worrying trends and on a number of indicators midwives remain in a worse position compared to other NHS staff.

•82% of midwives on average worked at least some additional unpaid hours, over and above their contracted hours compared to 58% of all staff. This is an increase from 78% of midwives in 2010.

•71% of midwives disagreed that there were enough staff at their organisation for them to do their job properly, compared to 48% of all NHS staff.

This is fairly consistent with previous years, and makes midwives the most likely of all staff groups to disagree that they have adequate in their organisation. Health Visitors and Paramedics are close seconds.

•45% of midwives worked at least some additional paid hours. This is an increase from 40% of midwives in 2010 and 2011.

•Midwives are more likely to think that they lack the time, resources and support staff needed to do their jobs properly.

Midwives remain the most likely of all NHS staff groups to disagree with the assertion that they have enough staff in their organisation.

Midwives are more likely than nurses to think that their job is bad for their health. They are more likely to face pressure to come to work, and to feel unwell due to stress.

Midwives are more likely to do overtime, both paid and unpaid.

The Royal College of Midwives’ Director for Policy, Employment Relations and Communications Jon Skewes said: ‘Midwives are the backbone of the NHS.

‘As the survey results show, they consistently work considerable unpaid overtime to give mothers and babies the care that they need and deserve.

‘This survey shows that their motivation to deliver good care is high, but their morale is low.

‘Investment in good maternity care and early intervention strategies delivered by midwives will save the NHS millions in the future and safeguard our next generation.’

The 2012 staff survey summary found 63% of NHS staff said that if a friend or relative needed treatment they would be happy with the standard of care provided by their organisation.

In addition, 62% said that care of patients and service users is their organisation’s top priority.

There continues to be an improvement in the proportion of staff receiving appraisals, up from 80% in the 2011 survey to 83% in 2012, however only 36% of staff said these appraisals were well structured.

Only 40% of all staff were satisfied with the extent to which they felt that their trust values their work, this figure is lowest for ambulance staff (23%) and highest amongst social enterprise staff (47%).

However, the proportion of staff who indicated that they would recommend their organisation as a place to work has increased for the first time in three years (55% in 2012 compared to 51% in 2011, 53% in 2010 and 55% in 2009).

Only 35% said that communication between senior managers and staff is effective, this figure is the lowest for ambulance staff (20%), and less than a third of all NHS staff (26%) reported that senior managers act on feedback from staff.

Despite this, 74% said that they are able to make suggestions on how they could improve the work of their team or department.

Fifteen per cent of NHS staff reported experiencing physical violence from patients, their relatives or other members of the public in the previous 12 months and 30% of all staff report that they

experienced bullying, harassment and abuse from patients, their relatives or other members of the public in the previous 12 months.

Just under two-thirds of incidents of physical violence and 44% of bullying, harassment and abuse cases were reported.

It is important to note that ambulance staff work in a distinct and different environment from others in the NHS and they report poorer experiences on many of the issues picked up by the staff survey.

The Royal College of Midwives is the UK’s only trade union and professional organisation led by midwives for midwives. The vast majority of the midwifery profession are members.

The RCM has also voiced its concerns about the Department of Health plans around ‘health tourism’ which includes a proposal to charge students and foreign workers who come to the UK for more than half a year a fee, estimated to be about £200.

RCM chief executive, Cathy Warwick, said there was no reference to maternity services in the document.

Warwick said: ‘We need to know what this means for users and for midwives as to what maternity care women will be entitled to, because this could create uncertainty and confusion.’

She said an extension in charges for primary care, such as GP services, may deter women from vulnerable groups who could ‘fall through the cracks’ and it also could lead to midwives having to

‘police’ access to services, which would be unacceptable.

She was concerned vulnerable pregnant women would find their way into the system only ‘when it is too late, if at all’.

‘Previous guidance to provide care to pregnant women irrespective of the woman’s ability to pay should still stand.

‘Midwives owe a duty of care to pregnant women and their babies and they should be free to provide care to any women who walk through their doors,’ Warwick said.