Proposed changes to maternity staffing at North Cumbria University Hospitals Trust could harm patient care and prompt an exodus of skilled midwives, warn health unions.
The trust is consulting staff on plans which include the creation of new “integrated” midwifery roles, but also involve the down-banding of a significant number of senior midwives.
Staff are unhappy and those nearing retirement age may choose to go, warn the Royal College of Midwives, Royal College of Nursing and Unison, which are all involved in talks.
The changes mainly affect around 30 community midwives currently working at band 7, according to RCM regional officer Susanna Cafferty.
With only four band 7 posts on offer, most would be forced to accept band 6 roles if they stayed on, she said.
Midwives are also being asked to become “integrated midwives”, working between community and hospital care.
“They have no problem with that but at the moment they are either community or hospital,” Ms Cafferty told Nursing Times.
“The proposals don’t say how often they would be rotating and they’re worried about continuity of care and gaps in the service, especially given the large volume of safeguarding cases in the community.”
She added that 42% of midwives at the trust were aged 51 to 60 and many could opt to retire in the next few years, leading to possible staff shortages.
“We don’t feel the risk assessment or quality impact assessment is robust enough, including how they’re going to provide care if midwives leave,” she said.
“Recruitment isn’t fantastic at the moment and they need experienced midwives to mentor any new midwives coming in.
“Staff have responded very well to the consultation, but don’t feel some of their concerns and suggestions have been listened to.”
Union representatives have met with trust HR staff and the head of midwifery. However, Ms Cafferty claimed senior managers heading up the review had refused a request for a meeting.
The trust’s head of midwifery Anne Musgrave said the trust was working closely with staff.
“The midwifery service staffing structure is being reviewed to ensure it continues to provide a safe, efficient and high-quality service while also maintaining the correct number and skill mix of midwives,” she said.
“We have reviewed the number of midwives and skill mix across the trust in line with national benchmarks and been working very closely with our midwifery staff and their representatives as part of a formal consultation.”