Shortage of midwives - really surprised at the variations in staffing levels around the UK

[piprabbit]

I came across this map showing midwife to births ratios around the country.

The recommended ratio for a safe service is 1 MW for every 28 births, so how come some areas have 1 MW for every 46 births while another area might have 1 MW for every 10 births?

[treedelivery]

because some places are a nightmare to find a house with the starting salary at band 5. The whole of the SE really.

Because some trusts are strapped for cash and wont recruit.

Because some trusts are in huge cities with a high turn over of people, midwives move on, travel, relocate and so on.

Loads of reasons, I'm not surprised at all.

[treedelivery]

Plus, if you do get a job at a unit with high ratios, it will be physical and mental hell some of the time. Clearly anyone looking at a 40 years shift work in a business is going to try relocate - so those trusts will struggle with retention. As does midwifery as a whole, or at least it used to.

[piprabbit]

Even neighbouring areas (like Mid Essex and South West Essex) seem to have huge differences - I'm guessing that may be where house prices kick in.

It's funny - many people from South West Essex opt to give birth in Mid Essex units as they are seen as being a bit posher, but SW Essex seems to have more MWs - perhaps because there is a wider range of house prices. Although I have heard rumours that poorer areas struggle to recruit the doctors because they don't want to live in cheaper areas. Swings and roundabouts.

[treedelivery]

Yes it is.

Plus you could have two trusts on the same street but they operate as individual companies. They have the say in how and when they recruit. They may or may not have individual funding considerations. Of course their budget stems from the DofH, but individual trusts are exactly that. Individual.

Those trusts with high ratios may not be advertising for staff.

[piprabbit]

But if 28 is the 'safe' ratio - why wouldn't a trust with a much higher ratio be actively recruiting (albeit finding it hard to find staff)?

Are they allowed to operate at an 'unsafe' ratio without taking steps to try and correct it?

[piprabbit]

BTW treedelivery - thank you for taking the time to answer my questions .

[thursday]

according to that where i had DS is 1 to 21 births, and where i had DD is 1 to 23 births (and i'm not in scotland btw). i wonder what population spread has a lot to do withit? both those areas ^^ are largely rural so more mws needed geographically with less women.

[treedelivery]

That number is an RCM statement and is no doubt based on the formula that were developed in the early 90's ( I think). I am not aware of any legal need to comply, but would be delighted to hear different.

A trust with very sound, evidenced and implemented guidelines may be able to operate safetly on less or more. Who knows how the complexities of risk assessment work.

Tis a complex business.

[VivaLeBeaver]

Yes they are allowed to carry on without trying to recruit. The 28 figure is not a legal requirement.

[spudulika]

My local hospital (which I'm always banging on about) is here - very poor staffing ratios. Last year they had far more maternal deaths than they should have done for the number of births, and staffing problems have been fingered as contributing to this in the report which is coming out about it. "if you do get a job at a unit with high ratios, it will be physical and mental hell some of the time" - I bet. Our local hospital is a hotbed of bullying too.