NHS staff shortages – the impact on maternity care

Posted: 02/03/2016

Following a Freedom of Information request, the BBC has reported that, as of 1 December 2015, there were more than 23,443 nursing vacancies in the NHS across England, Wales and Northern Ireland. There were also 4,669 doctor vacancies. 

Many NHS trusts and health boards are trying to recruit staff from overseas to fill the posts and often have to resort to using expensive agency care to provide cover. 

BBC health correspondent Dominic Hughes says that there are now more posts for doctors and nurses than ever before, but there is a significant time lag in terms of training doctors and nurses to fill these roles. Nursing places were cut a few years ago and, while the numbers are rising again, it will take time to fill the slots. The lead-in time for doctors is particularly lengthy. Both the Royal College of Nursing and the British Medical Association blames poor workforce planning for the current shortages. 

Staff shortages have significant implications for patient safety, as identified by Sir Robert Francis in his report on the issues at Stafford Hospital. In response to this report, the NHS has tried to recruit more staff but there are not enough trained individuals to meet demand. Using agency staff to try to fill posts is extremely expensive and has implications for patient safety as agency staff are often less aware of a team’s working practices and policies. There are also risks associated with both training standards and communication issues for overseas recruits. 

Staff shortages affect many areas of the NHS including accident and emergency, the maternity sector and paediatrics. There remains a shortage of midwives, leading to significant issues for the safety of expectant mothers and their babies. 

A lack of midwifery cover has been a factor in a number of cases recently conducted by Penningtons Manches. For example, a lack of cover meant that a high risk mother’s induction was delayed because there was no-one to attend to her for a Syntocinon infusion. No attempt was made to address the staff shortage by calling in support and, as a result, the condition of the baby deteriorated in utero leading to a birth injury. 

Alison Appelboam Meadows, a partner in Penningtons Manches’ clinical negligence team, commented: “Although attempts are being made to recruit more staff to meet demand, clear strategies are required to ensure that patient safety is not compromised and the risk of claims against the NHS is reduced.”

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