Health, News

Midwifery staff turnover halves but complex cases ‘increasing exponentially’

By Lauren Monaghan, Junior Local Democracy Reporter

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Recruitment and retention of midwifery staff has continued to improve in Nottingham – but hospital officials say care for complex maternity patients is “increasing exponentially”.

Nottinghamshire County Council’s Health Scrutiny Committee met on Tuesday (March 18) to discuss progress in maternity care at Nottingham University Hospitals Trust (NUH).

The trust is currently at the centre of the largest maternity inquiry in NHS history, led by senior midwife Donna Ockenden.

The review is looking into injuries and deaths of mothers and babies at NUH dating back to 2012 and is now expected to involve around 2,500 families – publication of its findings have now been pushed back from September 2025 to June 2026.

The committee heard how midwifery staffing at NUH has continued to improve, with more than 60 midwives joining since April 2024 and agency usage stopping in January 2025.

Staff turnover has continued to reduce overall –  almost halving since 2023 – being 6.89 per cent in December 2024, down from 8.45 per cent in July 2024 and 13.41 per cent in July 2023.

NUH Chief Executive, Anthony May, said: “Qualified band five midwives, most of the ones we’ve taken on in recent years, have stayed with us at least a year and I think that’s reflective of the support they [receive].”

Councillor John Wilmott (Ind) said: “We’ve got to remember the population is growing rapidly- how are we going to combat this situation? The service cannot improve because you haven’t got the capacity to improve it- how can we combat that?”

Cllr Wilmott suggested some maternity services being brought under community health, away from the acute hospital trust.

Sharon Wallis, Director of Midwifery, said: “Our birthrate is reducing, in 2010 the number of babies born in Nottinghamshire was around 10,000- we’re now just over 7,000 in 2024.

“What we’re seeing is a complexity, the women that come into our care and having the babies have medical conditions, social complexity as well which adds a different dimension to the care we provide.”

She added that while the number of births has reduced, the amount of care required for complex maternity cases is “increasing exponentially”.

Cllr David Martin (Ind) said: “[It’s not just] staff retention but staff training. One of the problems first highlighted when [reviews] first came round was staff weren’t fully trained in the equipment that was available.

He noted the importance of “knowledge transfer” between senior midwives and newly-qualified midwives.

He asked: “Some of those complexities can only be dealt with by people trained in that particularly area. I think that’s one of the areas we may need to focus on, so if you could give us a bit of reassurance that, that kind of process is being micromanaged?”

Ms Wallis spoke of the measures in place to support newly qualified midwives.

There is a 24-hour manager on call to support the maternity service, daily morning meetings which can assess any escalated cases and a minimum of two band seven midwives – senior midwives – per shift on the labour suite.

She added: “We have really excellent support from critical care outreach teams who have that more specialist knowledge around medical conditions.

“We also support our midwives to do enhanced midwifery care to support those women who have those higher needs. Our new incoming midwives have dedicated training on all aspects we need including the equipment training.”

NUH performed above the average on the last national maternity survey on five questions relating to antenatal, labour and postnatal care but scored 50 per cent, against an average of 59 per cent, on patients being able to see a midwife as much as they wanted.

Cllr Bethan Eddy (Con) said this “worries” her.

Ms Wallis said: “We do have a schedule so women have three, as a minimum, postnatal visits from a midwife or a support worker, we always have the first visit with a midwife and then it’s based on clinical need. Women can see a midwife as much as they need to so it’s not restricted to that three.

“I’m confident that women who do need that additional care have that care.”