Boost in training places for midwives backed by Government

A new NHS Long Term Workforce Plan, backed by the Government, marks the 75th anniversary of the NHS this month. It also comes in the middle of a crisis for safe staffing. England's NHS is currently 2,000 midwives short of the number needed. For many healthcare professionals, disputes over pay continue.

The Plan pledges a huge recruitment drive for doctors, nurses, dentists and other healthcare professionals.  

The aim is to almost double the number of adult nurse training places by 2031, with 24,000 more nurse and midwife training places a year by 2031. More midwives will be trained through traditional, shortened and degree-level apprenticeship routes, the Plan says.

The plan aims to double medical school places by 2031 with more places in the areas of greatest need.  

At present, for example, there is a shortfall in specialist pathologists. When babies are stillborn or die shortly after birth, paediatric and perinatal pathologists are essential for helping parents and researchers like our team at the Tommy’s Maternal and Fetal Health Research Centre in Manchester to understand why. It’s a vital step in our work to develop interventions to save babies’ lives.

In May this year our Sands and Tommy’s Joint Policy Unit launched its first Saving Babies’ Lives progress report which showed how the pressure that staff are under is impacting on the NHS's ability to deliver safe, personalised, care for everyone.

Staff sickness rates, overtime and job satisfaction are all seriously affected by staffing shortages and there is particularly concerning data for midwifery staff.

In response to the NHS Long Term Workforce Plan, published on 30 June 2023, Robert Wilson, Head of the Sands and Tommy’s JPU says:  

“A long-term workforce plan is a welcome first step. However, the plan needs to be urgently turned into action, and needs more detail on retention as well as recruitment.

“Staffing levels are just one aspect of improving safety in maternity and neonatal services. There’s also a need for culture change to ensure openness, learning and transparency. We need to move from diagnosing issues with teamwork and culture to introducing effective interventions to address them.”

The Long Term Workforce Plan focusses on retaining existing staff while also making the best use of new technology so staff can focus on using their expertise to help patients. The NHS will continue to harness advances in AI, the Plan explains.

At Tommy’s we know that both investment in technology and in staff is essential for improving the maternity experience and giving all parents the best possible chance of bringing a healthy baby home.

Our National Centre for Maternity Improvement – a partnership between Tommy’s, the RCOG and the Royal College of Midwives, is continuing to develop and roll-out the Tommy’s Pathway. This online clinical decision support tool for use by healthcare professionals and pregnant women and birthing people helps ensure that everyone is offered the right care at the right time.

Early in pregnancy, the tool can identify each person’s chance of preterm birth or of developing problems which may lead to stillbirth. It supports healthcare professionals to offer care recommendations in line with national clinical guidelines for best practice maternity care, to help lessen the chance of these complications developing.

This aims to reduce the variation in care across the NHS and ensure that everyone is offered the right care at the right time, no matter where they live. Evidence published in 2022 showed that the algorithms used in the Tommy's Pathway can help reduce health inequality in Black, Asian and other minority ethnic pregnant women.  A national roll out of the tool has the potential to prevent up to 600 stillbirths and 12,000 premature births a year.

With £1.8 million from the NIHCR, the Tommy’s Pathway is currently being trialled across 26 NHS hospitals.

Kath Abrahams, Tommy’s Chief Executive says:  

“The Government-backed commitment to funding an ambitious expansion in training places is long overdue and extremely welcome. But it must be recognised that recruiting and training takes time - this isn’t a solution which will change the experience and outcomes of parents and their babies overnight.  

"Alongside measures like improving staff levels and focusing on a better supported workforce, we must continue to invest in research into miscarriage, stillbirth, preterm birth and other pregnancy complications and find ways to improve people’s experience of care.  

“It’s only through investment in implementation science and the work done through our National Centre for Maternity Improvement that we can understand how we can turn research discoveries into best evidence-based practice and drive further improvements in care. This is how we will make pregnancy and birth safer for everyone, and how we will help more parents and families take their babies home.”