Hiring Midwives via Agencies Causing Unnecessary Expenditure According to RCM

Figures relating to health trusts in Yorkshire suggest that the county has spent over £70 million on agency midwives in just 12 months.

This number has been dubbed extremely wasteful, particularly as it would be enough to employ over 500 staff.

These latest findings were obtained by the Royal College of Midwives (RCM) through Freedom of Information requests, and indicate that spending increased extremely rapidly over the last year.

Indeed, in just two years, the amount of agency spending by NHS trusts in Yorkshire had increased by over 75%.

The RCM is of the belief that staff shortages should be eradicated by the employment of more midwives.

This could possibly be achieved by offering existing staff incentives to work during national holidays, and also overtime periods.

The report states that at present the cost of overtime is being controlled but agency spend, which is much more expensive, is less mediated. This needs to be corrected, as current practice in the NHS is evidently extremely wasteful.

Although the problem is particularly pronounced in Yorkshire, it has also been proven that roughly one-third of the trusts in the United Kingdom have utilised agency agency staff at some point over the last three years.

Trusts had an average spend of £49.01 per hour on agency staff in 2014, according to FOI requests. This effectively means that agency staff cost the NHS more than double the amount that would be spent on regular staff.

And much of this money is squandered on agency fees and other gratuitous costs.

The report does conclude that the use of agency staff in the NHS had reached an inappropriate level, and called on the Department of Health to address the situation in the immediate future.

According to the information required by the report, the majority of midwives who worked agency shifts do so in addition to permanent posts with the aim of topping up income.

Commenting on the issue, Andrew Gwynne, the shadow public health minister stated that “spending on expensive agency staff is spiralling out of control. Across England, too many maternity units are operating without enough staff, forcing some to turn women away because they are unable to cope.”

The Department of Health has not responded to the findings as of yet, but a spokesperson from the organisation did comment back in November.

It was suggested at that time that the shift rate for NHS staff was intended to address the situation.

“For too long staffing agencies were able to charge hospitals extortionate hourly rates but the tough new controls we introduced last year are helping hospitals clamp down on agency staff, improving continuity of care for patients and will reduce the overall agency staff pay bill by £1 billion over the next three years. We want the NHS to be one of the safest places in the world to have a baby and there are already more than 5,500 obstetricians and gynaecologists in the NHS, including over 2,000 consultants, an increase of 20% since 2010.”

But there will be scepticism following these latest figures that the measures put in place by the Department of Health are effective.

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Royal College of Midwives Critical of Existing Scottish System

One of the top midwives in Scotland has suggested that every health board in the NHS should feature a maternal mental health midwife.

Gillian Smith, director of the Royal College of Midwives (RCM), highlighted the issue as a key area for progress as part of a series of suggestions to improve maternity care in Scotland.

Smith believes that instigating such a mental health system would enable the NHS to provide superior care for vulnerable women all over Britain.

It is notable that 10 per cent of Scottish women suffer from some form of depression and anxiety both during pregnancy and after birth.

Yet nearly three-quarters of the existing health board in Scotland feature no midwifery staff with accredited mental health training.

Smith also suggested that NHS bosses should increase the number of consultant midwives, while also focusing attention on the qualification of individuals working in the NHS in this department.

In particular, Smith believes it is important to emphasise that newly qualified midwives are offered permanent posts in order to secure the workforce on a long-term basis.

The RCM has previously warned that Scotland faces a “recruitment timebomb” as more than one-third of midwives in Scotland are over 50, with many opting to retire early.

Commenting on the issue, Smith stated that “Scotland’s maternity services are performing incredibly well and we can be justifiably proud of them. The government recognise the value of midwives and good maternity care to the quality of care women receive, and to the health of the women and the population as a whole.”

Smith went on to opine that there are many areas in which the Scottish health service can improve over its existing mental health provisions for women.

“However, there are areas where we can and should be looking to make improvements including better care for pregnant women with mental health problems and better continuity of care. Scotland also needs to be ensuring it secures its future midwifery workforce.”

Responding to the claims of Smith, Public Health Minister Maureen Watt made a commitment to update Scottish maternity services by the end of the calendar year.

Watt commented: “We are committed to ensuring mums and babies get the best care from our maternity services and hugely value the role played by midwives. It is thanks to the high-quality care they provide that more than 90 per cent of women rated their care during pregnancy and birth very positively in a recent survey.”

In addition, Watt also claimed that there is no shortage of midwives working in Scotland, and that the nation in fact has an excellent record in terms of dealing with women’s mental health issues.

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Nurses and Midwives to be Subjected to New System of Checks

Media reports today indicate that the system of checks related to nurses and midwives is about to be significantly changed.

The new plans have been instigated in the context of the so-called mid-Staffordshire scandal.

An estimated 400-1,200 patients died as a result of poor care over the 50 months between January 2005 and March 2009 at Stafford hospital.

As a result of the fallout from this case, nurses and midwives will now undergo checks every three years.

NHS watchdogs indicated that the reforms, which will be officially announced on Thursday 8th October, will constitute the biggest change in the history of the regulation of nurses.

The new regulations were considered essential in order to ensure that poor standards were not replicated on a wider scale in the NHS.

As a result of the new system of checks, nurses will be required to provide evidence demonstrating that they are both skilled and compassionate.

This can include feedback from patients, managers and fellow members of staff.

The new regulations are a first for the nursing profession, as it had previously been standard practice for workers in this sector to declare themselves fit for work without third-party evidence as support.

But recommendations from the public enquiry into the Staffordshire scandal have led to this new system of checks and balances.

The new system will be implemented by the Nursing and Midwifery Council, and will further require nurses to prove to regulators is that their professional skills are adequate, and that regular training has been undertaken in order to ensure complicity with contemporary practices.

Nearly 700,000 registered nurses and midwives in the UK will be subjected to the checks.

It has been pointed out with regard to the decision that it would generally not be expected for an individual to be present on a professional register for several decades without significant checks on their ability to conduct their duties.

Yet this was precisely the situation for nurses ahead of this new regulation and legislative measure.

In particular, nurses will be tested against the code of conduct of the Nursing and Midwifery Council.

And the hierarchy of the council has already placed a particular emphasis on the importance of patient feedback.

It is clear that this measure is intended to restore public confidence in the health service, and also to ensure that nurses and midwives engage more readily with the general public.

Sir Robert Francis QC called for the system of “revalidation” two and a half years ago, in his public inquiry into the scandal at Mid Staffordshire NHS Foundation trust.

And it seems that the radical overhaul recommended by Francis is now ready to be implemented.

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Royal College of Nursing Scathing on Bursary Scrappage Plans

Student nurses and midwives could be forced to fund their own education under a scheme currently being considered by the government.

The new Treasury plans would see these critical NHS workers being forced to pay their tuition fees and living costs, if proposals currently being assessed by the government come to fruition.

This will be a particularly worrying precedent for many concerned about the state of the health service, considering the fact that there is already a shortage of nurses in the NHS.

Indeed, it is often argued that the health service is one of the biggest beneficiaries of migrant labour of any organisation in the United Kingdom.

This certainly applies to doctors, physicians and surgeons, but also to nursing staff as well.

Due to the relatively small numbers of qualified nurses among the UK population, hospitals have frequently resorted to paying up to £2,200 per shift for locum staff, with thousands more being recruited from abroad.

And many people applying to train as nurses in the UK are currently turned away, with three times as many applicants as funded places, figures indicate.

Nonetheless, the government is apparently pressing on with the assessment of plans to compel student nurses and midwives to pay tuition fees and living costs.

The Councils of Deans of Health and Universities UK have already submitted plans to the government’s spending review.

This critical document is due to be published next month, and seemingly seeks to axe the existing system of free education completely.

All bursaries will be scrapped completely, replaced by a loan system. Tuition fees would also be introduced, and these would have to be funded by student applicants.

Many people will be extremely critical of the government scheme, viewing it as merely another opportunity for the financial sector and private equity to gain a valuable source of revenue.

Considering the importance of nurses within the NHS, and the obvious gulf between the required number and existing qualified individuals, putting such a significant barrier in the way of qualification will surely exacerbate the problem.

Critics will suggest that this scheme rather grates with the rhetoric that has issued forth from the government in recent weeks and months about the importance of the NHS in general.

Already nursing and midwifery unions have spoken out about the proposed changes.

The complaints of the largest nursing unions in the country indeed seem rather plausible, and are focused on the suggestion that many potential entrants will be deterred, particularly those from financially disadvantaged backgrounds.

With nursing already attracting a relatively meagre starting salary, the prospect of large debts will doubtless be viewed as a millstone by many potential applicants.

Tom Sandford, director of nursing at the Royal College of Nursing raised concerns that such changes could put potential nurses off entering training completely.

“Financial hardship is the top reason nursing students drop out, and the full time demands of the course make it very difficult for nursing students to earn extra money while they are training,” Sandford said.

Meanwhile, the Royal College of Midwives claimed that the plans risked worsening a shortage of 2,600 midwives.

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New revalidation guidance for nurses and midwives now available

New guidance for nurses and midwives is now available ahead of the introduction of the Nursing and Midwifery Council’s (NMC) new rules on revalidation which come into force from April 2016.

The new rules will affect all nurses and midwives working in the UK.

Nurses and midwives can discover how the process is changing, and why, by downloading a set of FAQs from the NMC website.

The FAQs are designed to answer concerns you may have, such as: (i) why is the NMC introducing revalidation?; (ii) what sort of activities count as CPD?; (iii) what will I have to do to revalidate?; (iv) who will approve my revalidation?; and (v) how will the NMC check that revalidation requirements have been fulfilled?

Further guidance will be provided at a one-day conference on revalidation, hosted by the Nursing Times and the NMC, at the Montcalm Hotel in London on 13 November.

Scheduled attendees at the conference include Jackie Smith, chief executive of the NMC.

The revalidation FAQs, as well as more conference information, is available on the Nursing Times website.

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