NCT response: King's Fund 'Staffing in maternity units'

Released on: 19 July 2011

A new report from The King’s Fund says using midwives and other maternity staff more effectively is the key to improving maternity care in hospitals, and that the maternity workforce could be utilised more effectively to improve outcomes for mothers and babies.

Belinda Phipps, Chief Executive, NCT, said:


“NCT, as the charity representing the needs of parents, warmly welcomes this report's focus on whether improvements in maternity services for women can be achieved without additional financial resource. This is especially needed in the current financial climate. If there isn't money for improvement then we need to look at what we have in terms of people and skills and make sure the right person is supporting every woman, matching their level of skill to her level of need. 


“We welcome the focus on skills mix but we would warn against any changes driven by lack either of money or midwives.  What is needed is a shift to caseload midwifery, where every full-time midwife cares for 28-30 women right through their pregnancy, labour and the early weeks after birth, building up a trusting relationship which we know from experience and evidence gives the right results for mothers, babies and families. 


“As a voice for parents, NCT is delighted to see recommendations for midwife-led care as the norm for women with straightforward pregnancies. To do this, midwives need to be supported properly. Having more skilled midwifery assistants is an essential part of this. Midwifery assistants should be trained as and be used as assistants to midwives, there to enable the midwife to spend more time with the woman. The midwife is the only professional who is skilled and qualified to give the continuous care to mothers that they need. 


“The King's Fund report gives food for thought and NCT looks forward to being part of the team to develop these ideas further and put the recommendations into practice for every mother and baby. From our knowledge of parents, based on research and constant and ongoing contact, NCT knows parents need:


  • all maternity services – obstetric units, midwife-led units and home birth services – to have enough staff so women may plan their birth, including making a choice of birth setting during their pregnancy and not being forced to change this at the last minute because of staff shortages.


  • no unit to close at short notice, leaving women in labour and their partners having to make their way to another hospital further away.


  • enough midwives available relative to numbers of women so women in labour have one-to-one care and are never left alone and frightened.


  • postnatal care provided in both hospital and community to the level recommended by NICE.”