Workforce and Training

12.12.16

RCM warns against permanently altering midwife roles to plug staff gaps

The Royal College of Midwives (RCM) has issued guidance urging NHS organisations to ensure that midwife roles are protected as they struggle to ensure safe staffing levels.

The RCM argued that an additional 3,500 midwives are needed as the NHS faces persistent staffing shortages at a time of rising demand due to a historically high birth rate, increasingly complex pregnancies and expectations that midwives will deliver more support and advice.

In ‘Getting the Midwifery Workforce Right’, a new report it published today, the RCM agreed that midwives may need to take on changed roles and new skills in order to cope with a changing role.

However, it added: “Whilst the RCM accepts that NHS organisations wish to maximise the flexibility of their workforce, it is not acceptable to permanently alter midwifery roles to compensate for staffing shortages or changes in doctors’ roles (for example, by routinely requiring midwives to assist in caesarean sections).

“We do not believe that this kind of response solves the fundamental problem of medical shortages, but merely moves the problem onto another profession.”

The organisation claimed that maternity support workers have “proved time and time again their value” since being created 20 years ago. Despite this, it noted that maternity support workers (MSWs) suffer from a lack of a national standard role or pay grade, and from a paucity of options for career progression.

The RCM therefore called on the NHS to properly develop and support MSWs instead of creating an equivalent to the new nursing associate role for midwives or apprentice midwives.

At the other end of the spectrum, the RCM report said that while there had been discussions about introducing advanced practitioner roles in nursing to augment junior doctors’ roles, this would not be suitable for midwives. Instead, it argued more consultant midwives were needed.

Separately, the RCM also published guidance on how to fulfil NICE standards on midwife staffing levels, which emphasise introducing enough midwives to provide one-on-one care for every woman. It strongly recommended using Birthrate Plus, the tool it used to calculate the 3,500 midwife shortfall, despite an alternate method being used by NICE.

Cathy Warwick, chief executive of the RCM, said: “These are challenging times in maternity services and the wider NHS. Getting the right staffing levels and skill mix in can be a difficult and frustrating process.

“I am sure these publications will help senior midwives and other NHS managers to apply rigorous procedures for getting the best possible levels of care from available resources.”

RCM research has previously found that a third of maternity units have had to temporarily close in the past year because they couldn’t cope with demand.

(Image c. David Jones from the Press Association)

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