31.01.14
Lack of midwives ‘truly worrying’ – PAC
The Public Accounts Committee has warned that England has insufficient numbers of midwives, in a new report.
The MPs found that although the number of births was increasing, including an increase in the proportion of complex births, there is a shortage of approximately 2,300 midwives.
The MPs said there was too much confusion around the Department of Health’s policy on maternity services, and called for clear objectives and clarity on who is responsible for their implementation.
The DH must also demonstrate whether these objectives are affordable, and to review current tariffs for maternity services. The report recommends an investigation into the factors which inhibit women’s choice of place of birth, as well as NHS England to set out a plan to reduce inequalities and to take action “as a matter of urgency”.
Better use of existing and emerging data would also help to monitor progress on maternity objectives and to inform policy decisions.
Margaret Hodge MP, chair of the committee, said: “The vast majority of women who use NHS services to have their babies have good experiences, but outcomes and performance could still be much better. Despite an overall increase in the number of midwives there is still a shortage of 2,300 that are required to meet current birth rates – a truly worrying figure.
“What’s more, the Department of Health and NHS England struggled to tell my committee who is accountable for ensuring something as fundamental as whether the NHS has enough midwives.
“We know that many women do not want to give birth in hospital, with care led by consultants, and this is also more expensive. However, 87% of women still gave birth in this setting in 2012. Women who have a low risk pregnancy should be able to choose where to give birth, such as in a midwife-led unit. More could be delivered for less money with better results if there were more midwife-led birth centres available.
“As things stand there is evidence that many maternity services are running at a loss, or at best breaking even, and that the available funding may be insufficient for trusts to employ enough midwives and consultants to provide high quality, safe care.
“NHS England must set out as a matter of urgency how it intends to reduce inequalities, and report annually on progress.”
Cathy Warwick, chief executive of the Royal College of Midwives, welcomed the report and said: “Maternity services are many thousands of midwives short of the number needed to deliver safe, high quality care. The birthrate remains exceptionally high and as this and the Audit Office report states, births are also becoming increasingly complex. This puts even more demands on midwives and maternity services.
“We are seeing areas such as antenatal and postnatal care in particular, suffering because trusts often do not have enough midwives to provide consistent and high quality care before and after pregnancy. These periods are just as vital for the health and wellbeing of women and their babies as the time around the actual birth.
“Many maternity units often close their doors because they simply do not have enough staff to deliver safe care. This reduces or removes choice for women, leaving them upset, stressed and deeply disappointed with their experience. We will also struggle to tackle the often huge inequality that exists because of the lack of midwives. This means that many women, often the most vulnerable and those that need the most help and support, are not being served well by the NHS.
“Investing in maternity services and investing in midwives now will reap dividends in the future, for women, their babies and for the nation’s pockets.”
The latest results of the Friends and Family Test for maternity services, covering December 2013, were also published yesterday, showing that three out of four women would recommend their unit.
RCM director for midwifery, Louise Silverton, said: “There are no better judges of maternity services than the women who use them. Getting their feedback will help put mothers, babies and families at the centre of care.”
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