The money that the NHS spends on short-term measures to cope with the shortage of midwives would be almost enough to end the whole shortage if it was spent more wisely hiring full-time midwives, according to newly released data.
A Freedom of Information request by the Royal College of Midwives has found that the NHS has spent almost £100m a year on temporary replacement midwives, staff working overtime or those who had been seconded to extra duties.
That would be enough to pay for more than 2,700 experienced full-time midwives or nearly 4,400 newly qualified midwives which would virtually wipe out the national shortage of midwives.
The RCM, the union representing midwives, sought the data while investigating the true costs of relying on temporary-worker agencies and overtime to fill the chronic staff shortages.
The union said it believed the current shortage of 3,500 midwives and the difficulty of recruiting new staff after seven years of pay restraint were the two most significant factors behind the increased spending on temporary staff.
The findings were published as the RCM’s annual conference got under way in Manchester. It compiled the figures using FOI legislation that prompted responses from 159 local maternity services, close to 99% of those who were asked for he information.
Services were asked for their spending on three types of temporary staffing arrangements – those employed through an agency, those working overtime and those brought in through NHS “staff banks” or pools of short-term workers.
Staff banks are used to supplement permanent midwifery teams and help cope with with peaks and troughs. They provide cover for shortfalls in staffing, job vacancies and staff absences as well as bringing specific skills needed for short periods of time.
By far the biggest area of spending was on the NHS staff bank, which accounted for two-thirds of the £97m bill.
Waste of Money
Jon Skewes, RCM director for policy, employment relations and communications said the report showed that maternity services were “under-staffed and under-resourced.”
“The use of temporary midwives to staff permanent shortages is counter-productive and smacks of short-termism when there need to be sensible and strategic long-term planning in midwifery and across the NHS,” he said.
“The first positive step the Government could take is to end public sector pay restraint and fully fund a pay rise for midwives and other NHS staff.”
Skewes added that it was costing more, in the long run, to pay agency, bank and overtime staff than it would “if services employed the right numbers of midwives in the first place.”
The report highlighted the level of pay required to get the additional temporary staff to fill shifts. A staff midwife earns on average £18.20 with 10 years’ experience in England and Wales. The hourly average cost of agency staff was more than twice that – £43.65.
Skewes said midwives’ salaries had seen a “decrease in value” of more than £6,000 since 2010. “So it is little wonder why midwives are looking for opportunities elsewhere,” he added. “We have an NHS and maternity service that is heading for a crisis and the Government’s policies are clearly failing. This Government must ensure NHS services have the staffing and the resources they need to meet the demands they are facing, so that they can deliver the safest and best possible care for women and their families”.
The RCM carried out similar research in 2015, and while it is not exactly comparable it suggested the spending on temporary staff had increased in England. The Department of Health in England pointed out it had brought in a cap on agency spending which was reducing that element of the bill, while overall midwife numbers were rising.
“We want the NHS to be the safest place in the world to have a baby,” a spokeswoman said.
Shona Robison, Scotland’s Health Secretary said Scotland relied less on temporary staffing arrangements than the other three UK nations, with no agency spending at all.
by Bob Graham
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