Midwifery education in the UK is continuing to be under pressure, highlighted most recently by the RCM’s State of Midwifery education report. Neil Stewart, Editorial Director, reflects on the report and invites you to join the Midwifery education: Educating future midwives conference to discuss the issues
___________________________________________________
In the parliamentary debate on birth trauma on 19th October 2023 there were several statements welcoming the expanded number of student midwives in training in the expectation this would help address the shortage of midwives being experienced in the NHS.
The evidence suggests that the midwifery education service is running up a down escalator, never quite getting to the top.
Student Dropout Rates
If all those that started midwifery education were guaranteed to complete their courses things would be much better. But, as the recent RCM report on midwifery education showed, 15% of them don’t. There is anecdotal evidence that this is getting worse.
Plus, there is increasing evidence of student midwives, as in other professions, completing their degree to show they have passed a university degree, but then going on to a different career.
15th November Midwifery Education Conference to address shortages
The Midwifery Education: Educating Future Midwives Conference on 15th November will be addressing this and many more issues that are putting unprecedented strain on midwifery education.
Fiona Gibb, Director, Professional Midwifery and Heather Bower, Head of Education, from the RCM will take delegates through the findings and the implications of the excellent RCM report with comment, suggestions and campaign points from other speakers. These include Professor Jenny Gamble, Coventry University, Research Centre for Healthcare & Communities, Institute for Health and Wellbeing, Dr Jacqui Williams, Senior Midwifery Advisor (Education), Nursing and Midwifery Council, Dr Yana Richens OBE, Director of Midwifery Services, Liverpool Women’s Hospital NHS Trust and Nicky Clark, Lead Midwife for Education/Senior Lecturer, University of Hull; Chair of the NMC LME Strategic Reference Group.
The conference is online and the Maternity and Midwifery Forum a lectures can get their department to book a viewing party in a lecture or seminar room in midwifery schools so lecturers can watch in a group, drop in a out as timetables allows but be sure that the whole team gets the video recordings to catch up and hear what is coming down the line, what is new, solutions to problems, and what they can do to make thing better.
RCM State of Midwifery Report
The findings of the RCM report are stark.
- 20% of educators want to leave.
- In 22/23 there were fewer new recruits to midwifery education.
- 40% of educators were over the age of 51 storing up an experience gap as the older staff leave.
- In 2017/18 70% of educators had a master’s degree five years later it has dropped to 43%.
- Those with a doctorate had dropped from 20% to 12% over the same period.
Close the Pay Gap
There is also a “huge pay disparity between pay for senior midwives in the NHS and those in Higher Education” says the report. Some LME’s report that with shift payments and other special NHS payments the gap can now be as high as £10,000. Such a gap blocks the important and essential flow of experienced staff between NHS practice and University teaching. This may be part of the explanation of lower qualified recruits into academic education.
It’s time to close the gap but this will not be easy as NHS and University Pay scales have drifted apart and recent negotiations, or the lack of them, in both sectors, have neglected these important niche issues. The Maternity and Midwifery Forum will be running a series on these issues to push them up the agenda.
Staff Student Ratios
The RCM report highlights deterioration in staff student ratios and asks why midwifery education cannot have a fixed staff student ratio (suggesting 1:19) when other disciplines such as physiotherapy do have one:1:15.
Placements and midwifery student supervision
With current staffing pressures in NHS maternity units not all midwives are willing to step up to support and supervise midwifery students, leaving many feeling isolated and vulnerable. The RCM propose that the NMC should “make supporting and supervising midwifery students a part of midwifery revalidation” to improve the situation.
Although lockdown is finished there are still hang overs reported from that period that are still being worked through.
The opening of new courses in universities which did not previously have student midwifery courses is putting pressure on to find placements for those students as, under severe staffing pressure, hospitals maternity units are either sticking with their historical partners, or putting up a “full” sign.
The CQC report on 20th October 23 that rated 65% of maternity units as “inadequate” has the potential to spill over into the evaluation of midwifery education if properly supervised placements cannot be provided. Midwifery Education departments risk being judged on things they have no control over, damaging the reputation of the course and deterring students. The lack of joint working is reported as an increasing problem.
Midwifery Educations’ Voice
To address this the midwifery voice needs to be strengthened at the top table in both the NHS and in universities. In addition, as the RCM recommends, there need to be joint meetings between universities and NHS trusts, with a full place for the Lead Midwife for Education, to monitor midwifery programmes. This will not be an easy ask. NHS trusts and Universities have huge challenges in professional training and education from medical students, nursing and midwifery, professions allied to medicine in addition to extensive joint medical research projects.
It is too easy for the midwifery education voice to be lost in this labyrinth of interorganisational meetings but given the high profile in the media, in government and parliament of the maternity services challenges, the shortages, and the demand for new skills this has never been a higher priority.
Register your midwifery school for a group licence and viewing party as Hull, Hertfordshire, Northumbria and others are doing.
Enjoy watching and texting questions with colleagues dropping in and out when you can. Get all the talks and discussions on demand to catch up later for your local campaign.
Then pick the video presentations from national midwifery leaders most closely addressing your local challenges and sit your Dean and other key figures down and ask them what they are going to do about them.
See you online 15th November. Step up for Midwifery Education.
