Fresh calls for NI maternity strategy to address midwife staff shortages
Last updated 11th Oct 2023
The Royal College of Midwives has issued fresh calls for the introduction of a Maternity Strategy in Northern Ireland.
A key aspects of the strategy is to look at staff numbers and workflow following years of concern about workforce numbers.
Karen Murray, Northern Ireland Director for the RCM, said when the organisation published its State of Maternity report in May 2023 the initial concern related to the number of midwives due to retire.
However, she now thinks that NI’s work profile is more balanced, with more midwives in their early twenties being introduced into the workforce.
She said: “We have a better profile of midwives in their early twenties through until those midwives approaching the end of their career.
“But what we haven’t seen is an increase in the size of the workforce. So, while the profile has changed the actual number of midwives working in Northern Ireland hasn’t increased significantly."
There are around 1300 midwives across the country.
Part-time working, maternity leave, and staff sickness
Part-time working and staff absences have been a key contributor to the issues facing the workforce.
She added: “A significant number of midwives work part-time, probably over 70%.
“It’s a predominately female profession so they work part-time to manage family and caring commitments.
“We are also concerned that some of that part-time working is to manage the stresses and pressures that being a midwife brings.”
The NI Director discussed how the profession is predominantly female and with a younger workforce more midwives are at the start of their own family life.
She added: “So, we are seeing an increase in the number of midwives who are taking maternity leave and often that maternity leave is nearly a full year, which is quite a hit in terms of the available workforce.
“Because we don’t have any unemployed midwives in Northern Ireland it’s incredibly difficult to fill that gap.
“We know Covid is still prevalent, and we are seeing Covid absence but also a range of other absences. Quite often it’s things like stress and muscular skeletal disorders.”
The RCM NI Director said a focus is needed on the workforce coming through university, into practice and ensuring the right numbers of midwives are in the right place.
New Decade New Approach
She continued: “When we launched our state of maternity report in May we were clear we needed to sustain that level of student places, that we had enough students coming out to fill the vacancies.
“But unfortunately, the decision was made to drop back to the numbers that were in the system prior to the New Decade New Approach deal.
“We would be expecting 80 students this September and instead we have 65.
“15 Doesn’t sound like enough, but when you have a small service 15 new midwives coming through is still a significant number.”
The DOH has said it has invested significantly in the nursing and midwifery workforce including the 900 additional places.
However, continuing to support the much-needed growth of the health service workforce will require sustained investment.
The report outlines three steps to deliver high quality safe services for women and families: develop, publish, and fund the implementation of a new maternity and neonatal strategy for Northern Ireland; sustain the number of places for new student midwives at their recent, higher level; and focus on retaining the midwives in the HSC.
The review highlighted how increasing complexity, compounded by significant staffing shortages, pose considerable challenges for service delivery. Despite these challenges, the Expert Review Team also saw examples of good practice, strong teamwork, and commended the dedication of midwives, doctors and staff in maternity services who work on a daily basis to ensure the delivery of safe and effective care to women and babies.
23 recommendations were made including the need for a co-produced regional NI Maternity Strategy and to explore ways to improve recruitment and retention of staff, and support staff wellbeing.
As part of the ‘Enabling Safe, Quality Midwifery Services and Care in Northern Ireland’ report, Professor Renfrew will develop recommendations for policy, practice, education, and research in Northern Ireland.
This work will inform a consistent approach to midwifery services, including a comprehensive and independent review of freestanding midwifery led units.
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