More midwives = safety and quality

By RCM Public Affairs Advisor Stuart Bonar on 01 November 2023 RCM UK Research Safety Women Staffing Levels

RCM Public Affairs Advisor Stuart Bonar looks at the number of midwives working in the NHS in England since the last General Election and what needs to happen to improve the retention and recruitment of maternity staff.

A lot’s happened since the last General Election back in December 2019. We’ve been through a pandemic. We have a new monarch. And there are fewer midwives working in the NHS in England now than there were then.

The share of the NHS workforce made up of midwives is now at an historic low. And there are big differences between the English regions – these are the three bleak takeaway messages from the latest NHS workforce statistics for England.

Midwife numbers have been on a rollercoaster since December 2019, rising and plunging by hundreds over that time. If we look just at the past year, things might sound positive. There was a rise of almost 800 midwives in the 12 months to August 2023, the month to which the most recent numbers relate. But if we step back and take a longer-term perspective, back to the last Westminster election, there are 48 fewer midwives than there were then.

Think of all the thousands and thousands of new midwives who have been trained in the almost four years since that time, and yet we have ended up with 48 fewer midwives. We must tackle the intense levels of stress and burnout heaped on our midwives if we are to stop this exodus of staff.

This isn’t the result of some kind of recruitment freeze in the NHS. At the same time as midwife numbers have fallen, the overall NHS workforce has grown by 175,000. Midwifery now makes up a smaller slice of that workforce than at any time on record. Incredibly, if the number of midwives had risen at the same pace as the workforce overall just since the last election, we would today have over 3,500 more NHS midwives. That number would, at a stroke, eliminate a midwifery shortage that has dogged the NHS for at least a generation. It has been a huge missed opportunity.

There is a big difference between the English regions too. In the 12 months to July this year, the number of midwives in the East of England rose almost 9%, but in the North West the number rose just over 1%. The share of the NHS workforce made up of midwives is a third bigger in the East of England than it is in the North West. Some regional differences are inevitable – not every region has the same needs – but these do seem quite marked.

With the recent CQC report on maternity services highlighting the need for more staff if we are to drive up the safety and quality of care, ministers need to wake up to the urgency of the need for more midwives. We hope that the rise in the last 12 months in midwife numbers is the beginning of a consistent upward trend, but it is too early to tell.

As their response to disputes over NHS pay has shown, ministers can sometimes be too aloof, and reluctant to meet regularly with key organisations to sit down and help hammer out solutions to problems. Along with other organisations working in maternity services, we are keen to work with the Health Secretary and his ministerial team to pin down exactly how we can fix these issues.