on 13 September 2023 RCM Maternity Services Midwifery Midwives Government NHS Education

Midwifery education facing ‘unprecedented challenges’ says the RCM

The Royal College of Midwives (RCM) is warning that plans to recruit and educate new midwives will be severely undermined unless substantial and sustained investment is made in midwifery education.

The RCM’s State of Midwifery Education report highlights major challenges to the ambitions of policy-makers to increase the midwifery workforce, including a rise in staff to student ratios and the experience of those in teaching roles. Most worrying is the growing exodus of people leaving midwifery education due to a combination of poor working conditions and low pay.

The report found a clear link between the stress that midwives face due an unacceptable workload exacerbated by a lack of staff, and those desperate to leave the profession at the earliest opportunity. The RCM has previously reported that over one in five educators wanted to leave their organisation as soon as possible. In 2022/23, there were fewer new recruits than previous years, and, if this trend continues, there won’t be enough experienced educators to adequately train student midwives, says the RCM.

To address this, the RCM is calling on universities to take immediate steps to attract and retain appropriately qualified staff. This includes offering competitive salaries and more joint training opportunities with the NHS to attract those with the best clinical experience to teach the next generation of midwives.

Commenting on the report Gill Walton, Chief Executive of the RCM, said:

“It’s clear that midwifery education in 2023 is facing unprecedented challenges. Senior midwifery educators are leaving the profession in droves, taking their valuable experience with them. Overworked and underpaid, they simply don’t see being an educator as a viable career option. We all support the goal of growing the midwifery workforce, but if there is no one to educate this next generation of midwives the plan won’t work. Along with a lack of development opportunities to become educators, pay in higher education is clearly an issue. We need to address the huge disparity between pay for senior midwives in the NHS and those in higher education.”

There is also a growing tide of students leaving midwifery courses before they graduate. In 2021/22, around 15% failed to complete their degree despite an actual increase in student numbers. The reasons for this attrition are manifold, from personal finances to access to timely support and supervision, but all lead to the fact that, despite most midwifery degree courses being oversubscribed, many students are finding it hard to stay the course.

Staff to student ratios are growing in midwifery education. As a result, students just don’t get enough time with their educators and as its stands there are not enough midwifery educators to train students effectively, says the RCM. Students also suffer due to financial difficulties and lack of accommodation near their placements.

Gill commented: “Students clearly need support. There are simply not getting the time they need with educators. We’ve called for a mandatory student to staff ratio for midwifery degree courses, as happens for other disciplines such as physiotherapy. This will enable students to be better supported during their training to meet the high standards expected of them. Given the Government has said that they want to recruit more midwives as part of its long term NHS workforce plan, there needs to be action to help students complete their studies. As well as the investment in midwifery educators, this includes stronger mental health support for students, more readily available placement accommodation and financial aid for students.”

Among key changes the RCM is calling for are:

• Universities to take steps to attract and retain high quality midwifery educators including offering higher salaries and better professional development.
• Staff to student ratios are no greater than 1:19 to ensure effective support is provided and students meet the required standards.
• The NMC to make supporting and supervising midwifery students a part of midwifery revalidation.