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Increase in maternity unit closures 'from staffing shortages'

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Almost 40% of maternity units had to close temporarily last year because they could not cope with demand, a survey of senior midwives has revealed, highlighting ongoing pressures on services.

Units closed their doors on 281 separate occasions in 2016, according to the UK survey of more than half of all heads of midwifery.

The survey by the Royal College of Midwives found 38% of maternity units shut their doors at least once in the past 12 months, which was only slightly less than the 41% in 2015.

However, the average number of times units have had to close has increased from five times last year to eight times in 2016.

“Yet again we are seeing senior midwives describing services that are being battered by increasing demands…and staffing shortages”

Cathy Warwick

In addition, eight units were forced to close on 10 or more occasions and one closed its doors 50 times in a year.

The RCM said the closures reflected rising demands on services from increasingly complex births and reduced staffing levels.

Nearly all – 93% – of heads of midwifery who took part in the survey said their unit was dealing with more complex cases than last year. This is slightly up on last year when 91% said the proportion of complex cases had increased.

Meanwhile almost a fifth – 18% – said their budgets had decreased in the last year compared with 14% in 2015.

Nearly two fifths of midwifery heads said they did not have enough midwives to cope with the demands on the service. This is significant increase on last year when 29% said they did not have enough staff.

”The government must start to invest in NHS staff because we all know that an investment in staff is an investment in high quality, safe care”

Cathy Warwick

The survey found almost 80% per cent of heads of midwifery had vacancies in their unit, with almost 60% of the vacancies being for band 6 to 9 midwives compared with around half last year.

More than 80% said they had to redeploy staff to cover essential services either very or fairly often, which meant antenatal and community care services were being hit, said the RCM.

RCM chief executive Cathy Warwick said the survey results showed midwives “had never been so challenged”.

“Yet again we are seeing senior midwives describing services that are being battered by increasing demands, inadequate resources and staffing shortages,” she said.

“It is very often only through the hard work, goodwill and sacrifice of maternity staff that services are able to deliver the safe and high quality care women need,” she added.

Professor Cathy Warwick

Professor Cathy Warwick

“Every week I speak to midwives who tell me they are exhausted by the pressures they are facing, and they lack the time to do their jobs as well as they would like. This situation isn’t sustainable. The government must start to invest in NHS staff because we all know that an investment in staff is an investment in high quality, safe care,” said Ms Warwick.

The survey results formed part of the RCM’s evidence to the NHS Pay Review body this year, which advises the government on annual salary increases.

In its submission the RCM calculated a midwife’s salary would be more than £6,000 higher than it is now if pay had increased in line with inflation since 2010.

That difference will increase to more than £9,000 if limits on pay continue up to 2020 in line with government plans, according to the RCM, which is calling for an end to pay restraint along with other unions.

The RCM also carried out a separate survey in August this year of midwives who had left the NHS in the past two years or were intending to leave in the next two years, which was completed by more than 2,700 people.

The biggest factors in wanting to leave midwifery were staffing, workload and not having enough time to spend giving women and their families high quality care.

Many identified lack of flexible working as a reason for leaving the NHS, while 80% of those intending to leave the profession in the next two years said they could be persuaded to stay if their pay improved.

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