30 Nov 2020

Clinical Negligence

More than 75% of midwives claim staffing levels are unsafe

According to a survey by the Royal College of Midwives, more than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, with many reporting that services were at breaking point. Our head of Clinical Negligence, Ken Thomas, gives his view on this worrying report.

We were very concerned to read this news about the enormous pressure that midwives are currently under. The survey suggests that the UK is facing an exodus of trained maternity professionals, as morale is at rock bottom and many midwives are working in fear.

According to the survey of 1,400 staff, the majority of whom work in England, 42% of midwives said that shifts were understaffed and a third reported that there were “very significant gaps” in most shifts.

Half of respondents felt unsafe at work because of Covid-19 as a result of short staffing and the inability to physically distance. Almost two-thirds (63%) said they worked unpaid beyond their contracted hours, and 37% worked paid overtime. Just 2% said they felt valued by the government in Westminster. Seven out of 10 had considered leaving the profession while more a third were seriously thinking about it[1].

Press reports state that the senior team at the Royal College of Midwives believes that midwives are exhausted, demoralised and have been “pushed to the edge” by the failure of successive governments to invest in maternity services.

This report really is very worrying as we all know that overworked staff on understaffed wards cannot possibly provide the level of safe, high quality care that is needed for pregnant women and babies. Midwives are clearly doing their best to support the mothers in their care, but without support from their employer or the government, standards are bound to deteriorate and mistakes will happen.

It goes without saying that the long-term impact of any medical mistakes made during the late stages of pregnancy and childbirth can be absolutely devastating for a family. To have a long awaited baby that then suffers at the point of delivery is heart-breaking. Even relatively minor harm that occurs during childbirth can result in long term trauma for the mother.

The nature of a midwife’s role means even a small error can have serious consequences so it is essential that they are alert at all times, able to take regular breaks and are given the support that they need to perform their role effectively.

Over the course of my career, I have undertaken countless medico-legal investigations into the obstetric management of pregnancy and birth. Unfortunately, this is a practice area that leads to significant numbers of claims for damages, often for tragic cases.

The midwife’s role is essential to the health and safety of both mother and child. Problems can arise during pregnancy when serious conditions in mother and baby are not diagnosed or properly treated. At the time of delivery, injuries can be caused as a result of the mismanagement of labour and birth, such as failures to properly monitor the baby’s heart rate during labour. Then, after the birth, failure to diagnose and act on signs of infection or jaundice in a baby can cause long-term issues.

The most severe types of injury relating from midwife negligence are cerebral palsy, Erb’s palsy, brain injury, stillbirth and death, all of which can be devastating for the family involved. For the mother, negligence can also cause injuries such as perineal lacerations and 3rd or 4th degree tears, post-partum haemorrhage, uterine rupture, incontinence, infections, stroke or emotional trauma.

We all understand that the whole health service has been under colossal strain throughout the Covid pandemic but this report makes it clear that action needs to be taken as soon as possible to provide more support to midwives and maternity support staff. The enormous pressure on staffing and safety needs to be eased, to avoid potentially devastating consequences for pregnant women and babies in their care.

 

Ken Thomas is head of clinical negligence at Harding Evans. With over 25 years’ experience, he has acted exclusively on clinical negligence cases in all that time and has claimed over £30 million in compensation for his clients. Ken was recognised once more in this year’s Legal 500 as a ‘Leading Individual’ and praised for his ‘standout reputation’ on behalf of clients across a range of clinical negligence claims, including those of the utmost severity.

 

[1] Royal College of Midwives survey of 1400 midwives, October/November 2020

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