A welcome shot in the arm for maternity services

By Sean O'Sullivan, RCM Head of Health & Social Policy on 31 March 2021 Maternity Safety Maternity Services Wellbeing Of Women NHS England England NHS NHS Funding NHS Staff RCOG - Royal College of Obstetricians and Gynaecologists

Last week’s announcement of an extra £96m recurrent funding for maternity care in England provides a timely and long overdue investment in safe and high quality maternity services. Most of the new monies will be allocated to boost midwife and obstetrician numbers and to provide more multi-disciplinary training. The funding is a direct response to the interim Ockenden report, which highlighted key challenges for maternity services, including staff shortages, and poor organisational and behavioural cultures.

Planning guidance from NHS England, also published last week, makes clear that improvements in maternity care will be a priority for the NHS in 2021/22, with a range of objectives that services will be expected to focus on, including:

• Offering every woman a personalised care and support plan.
• Further implementation of the Saving Babies Lives care bundle, including increasing the provision of pre-term birth clinics and on site neonatal care.
• Increasing the availability of NHS smoke free pathways for pregnant women smokers.
• Extending the offer of continuous glucose monitoring to all women with type 1 diabetes.
• Prioritising continuity of carer for Black, Asian and mixed ethnicity backgrounds and those from the most deprived areas.

There is some recognition in the guidance that progress on these objectives will be conditional on expanding the workforce, and so the bulk of the extra money (£47m) will be directed towards recruiting an additional 1,000 midwives, with £11m allocated to increase consultant obstetrician time. A further £27 million will be invested in multi-disciplinary training and the backfilling of posts so that staff can be released to attend the training. There will also be additional investment in national and regional support, with the creation of maternity improvement advisor posts, to work on maternity safety and seven new deputy regional chief midwife posts.

This is a very welcome announcement, and it marks the culmination of sustained lobbying by the Royal College of Midwives and The Royal College of Obstetricians and Gynaecologists (RCOG) for our maternity services to receive the investment, and particularly the boost in staff numbers, which are essential for ensuring safe and better care for women and families. We have long argued that without an urgent injection of funding, the pressures and demands placed on under-resourced maternity services will make it harder to improve women’s experiences and maternal health outcomes. This is borne out by our most recent workforce assessment, which highlights the need for a significant increase in midwife numbers in England.

While we are naturally delighted that additional money has been found for maternity services, we recognise that this is where the hard work really begins. Together with our colleagues in the RCOG, we will be redoubling our efforts to ensure that the extra funding gets converted into frontline midwife and obstetrician posts and into training for the entire maternity team.