AIMS Responds to NHS 10 Year Workforce Plan Open Call for evidence

NHS workforce planning needs to be fit for the maternity service

The current system of NHS workforce planning in England is not delivering a safe, personalised and equitable maternity service. That’s why we’ve responded to the Department for Health and Social Care’s open call for evidence. See our response here.

1. Safe, personalised and equitable maternity care is undermined by poor workforce planning. This is particularly noticeable in relation to: choice of place of birth, where women’s choices to birth outside of a busy obstetric unit are too often denied ‘due to staffing’ (e.g. birth centres not open to women in labour/ agreed plans to support birth at home not being honoured); appointments which are too short to enable informed decision making.
   • Workforce planning must recognise the need to provide a full range of birth place options & adequate time to ensure personalised and equitable care.
2. Short staffing is cited as a reason for a lack of progress with key maternity transformation initiatives, including the implementation of ‘continuity of carer’ (a QI initiative that responds to the safety-critical need to ‘listen to women and families’, and is intended to reduce harm and litigation costs). Curiously, however, implementation efforts remain poor even when staffing is apparently sufficient.
   • QI initiatives must be explicit about workforce requirements; where progress is impeded by local staff shortages, updates should be publicly accessible.
3. Safety is underpinned by a healthy working day. We want to see the end of an NHS maternity service culture which normalises missed breaks. We question the logic and safety of 12 hour shift patterns: these have become standard, and indeed often cherished by NHS maternity staff, but at what cost for patients?
   • Proper breaks for staff & a patient safety centred review of long working hours are needed.
4. Highly skilled & expensively trained clinical maternity staff increasingly take on roles more suitable to non-clinicians, e.g. organisation/scheduling of training.
   • Clinical staff should be available for patient care.