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Rising NHS staff shortage figures spark alarm

Brexit is only making the situation worse, say healthcare leaders

Caroline White

Wednesday, 12 September 2018

Rising NHS staff shortages in England have sparked alarm among healthcare leaders amid a flurry of statistics*, revealing the extent of the problem, from NHS Improvement and the Royal College of Midwives (RCM).

Brexit is making a bad situation worse, they say.

The latest annual report** on the state of maternity services, published by the RCM, shows that some 21,601 full-time midwives were working in the NHS in England in May this year, a difference of just 67 on the previous year. Yet 2,132 midwives graduated from English universities in 2016-17.

RCM chief executive Gill Walton said: “It is of deep concern that we’re only seeing an increase of about one NHS midwife for every 30 or so newly-qualified midwives graduating from our universities. It’s not that new midwives aren’t getting jobs, they are. The problem is that so many existing midwives are leaving the service that the two things almost cancel each other out.”

She added: “The government has committed to training an extra 3,000 midwives. That’s great news and we welcome it wholeheartedly, but if the trend identified in this new report continues, those 3,000 additional training places may only produce an extra 100 midwives on the NHS frontline. We must see still more trained, as well as action on retaining the staff that we already have.”

The report, which estimates that the national midwife shortage remains unchanged with 3,500 full-time staff, also highlights the challenge of keeping EU-trained midwives, as Brexit looms.

In the year to March, just 33 midwives who trained in the EU registered in the UK to work as midwives. This compares with 272 only two years previously, before the 2016 referendum. Over the same period the number of European midwives leaving the register jumped from 160 to 234.

“We have around 1,700 EU-trained midwives registered to work here in the UK, and they will be caring for tens of thousands of women every year. Their numbers are already falling quite dramatically, however, and my fear is that if Brexit goes ahead, especially without a deal, then their numbers could quite simply collapse,” said Gill Walton.

Her concerns have been echoed by the British Medical Association (BMA) and the Royal College of Nursing (RCN).

Dr Rob Harwood, BMA consultants committee chair, described the NHS Improvement figures of 11,000 NHS medical staff vacancies, and rising, as “worrying.”

The figures confirmed “consistent warnings from frontline doctors about the deepening workforce crisis and the impact this has on their ability to guarantee safe, high-quality patient care,” he said.

“As doctors and other healthcare workers are forced to spread themselves more thinly, the cost to patient care is clear. However, with hospitals relying more heavily on temporary workers, the financial implications are also huge. At a time when an under-resourced NHS is operating at capacity, millions are spent plugging rota gaps – and this cannot be allowed to become a long-term solution,” he insisted.

“While these worrying trends show no signs of reversal in the short-term, Brexit is also likely to have a profoundly negative effect on the NHS workforce, with almost half of EEA [ European Economic Area] doctors telling the BMA they are considering leaving the UK, 40 per cent of whom have already made plans to go,” he added.

Nursing vacancy rates are also up 17 per cent since the previous quarter, and nine per cent on the same point last year.

Tom Sandford, director of the RCN in England, said: “[The NHS Improvement] report paints a bleak picture of rising demand and unsustainable workforce shortages, and betrays a huge over-reliance on bank and agency staff in England. The government must immediately investigate this sudden spike in vacancies.”

The report highlights the need for a comprehensive workforce plan that responds to population need and ensures the right number of nurses are in place to provide safe and effective patient care in England, says the RCN.

*State of Maternity Services Report 2018. A report prepared by the Royal College of Midwives, September 2018.
**Quarterly performance of the NHS provider sector: quarter 1 2018/19. A report prepared by NHS Improvement, June 2018.

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