NHS midwife shortages: Bill for temporary staff costing service £100m a year

The NHS is spending more than £97m on temporary staff and overtime to plug gaps left by a shortfall of 3,500 midwives, a report by the Royal College of Midwives (RCM) has found.

This annual spend could fund 2,731 experienced “band 6” midwives, or 4,391 newly qualified midwives, according to the RCM.

The college said it was little wonder that midwives are “looking for opportunities elsewhere” as the Government’s public sector pay cap has seen the average midwife’s salary “decrease in value by over £6,000 since 2010”.

The figures, released under the Freedom of Information Act by 99 per cent of the UK hospitals with a maternity unit, found 27 hospitals were spending more than £1m a year on midwife cover. Nine organisations spent more than £2m.

It also shows that spending on self-employed agency midwives fell from £25m in 2015 to £21m in 2016, in the first year after the introduction of an NHS-wide cap on trust spending on agency staff.

The average hourly spend on an agency midwife was £43.65, compared to the £18.30 hourly rate of a permanently employed NHS midwife with 10 years’ experience.

But the spending on NHS part-time and temporary “bank staff” has grown in its place, from £43m to £59m.

And the RCM fears these pressures could grow further as a result of the removal of bursaries for student nurses and midwives, and the uncertainty around whether all public sector workers will see an end to Government pay restraint.

Jon Skewes, director for policy, employment relations and communications at the RCM, said: “The use of temporary midwives to staff permanent shortages is counter-productive and smacks of short-termism when there needs to be sensible and strategic long term planning in midwifery and across the NHS. It is costing more in the long run to pay agency, bank and overtime than it would if services employed the right numbers of midwives in the first place.

“The first positive step the Government could take is to end public sector pay restraint and fully fund a pay rise for midwives, maternity support workers and other NHS staff. This would retain our hard-working, experienced midwives in the service so that when new midwives are trained they are reducing the shortage rather than replacing the midwives who’ve had enough of seeing their pay packet dwindle while they’re working harder and harder.”

The Department of Health has now announced the end of its policy of mandatory pay restraint for public sector workers, but health secretary Jeremy Hunt has said any future pay uplift will be dependent on sectors’ “productivity”.

Mr Hunt is also vying with fellow Conservative cabinet ministers to have their budget increased to cover any uplift.

A letter to Chancellor Philip Hammond signed by representatives from across the NHS, social care and charity sector ahead of next month’s budget called on him not to be distracted from the health service’s plight by Brexit.

A Department of Health spokesperson said: "We want the NHS to be the safest place in the world to have a baby and patients should be reassured we continue to have rising numbers of qualified midwives in England as a whole — there are over 1,800 more midwives working in the NHS since May 2010 and more than 6,500 currently in training.

"We are clamping down on the use of expensive agency staff, saving £700 million in 2016/17 including in midwifery, and also have a clear plan to ensure the NHS remains a rewarding and attractive place to work by introducing measures to allow NHS staff to work more flexibly and balance work-life commitments.”