Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the effect of reducing the ratio of registered midwives to maternity support workers in midwifery services on (a) workforce skill levels, (b) quality of care, (c) patient safety, (d) staff morale and (e) staff retention.

There is no mandated ratio of registered midwives to maternity support workers in midwifery services. Maternity services should develop, update and administer workforce plans, using agreed midwifery specific workforce planning tools. These plans should include the skill mix of midwives and support staff required to provide the quality of care that meets best practice standards. National Health Service provider boards are responsible for making judgements about staffing and the delivery of safe, effective, compassionate and responsive care within available resources. NHS providers for maternity services are supported by guidelines and improvement resources, including the National Quality Board’s ‘Safe, sustainable and productive staffing - An improvement resource for maternity services’ (January 2018), which can be accessed at the following link:

https://improvement.nhs.uk/documents/1353/Safe_Staffing_Maternity_final_2.pdf

Maternity support workers (MSWs) are an integral part of the maternity workforce and play an important role in supporting midwives and the wider maternity teams, mothers and their babies through pregnancy, labour and during the postnatal period.

On 14 February 2019, Health Education England published a new Maternity Support Worker Competency, Education and Career Development Framework, which can be found at the following link:

https://www.hee.nhs.uk/sites/default/files/document/MSW_Framework_Final.pdf

The framework gives clarity to the role and sets out the career and skills opportunities available to existing MSWs and those new to the role. The role of MSWs is to undertake, under the direction and supervision of a registered midwife, tasks and duties for which midwifery training and registration are not required (either by statute or professional guidance).

Morale was included in the NHS Staff Survey for the first time in 2018. The overall score for midwives was 5.8 (scores range from 0 which is the worst possible to 10 – the best) which was close to that of staff overall at 6.1. We are working with our arm’s length bodies to improve staff morale to ensure the NHS is the best place to work, proposals for which should be included in the interim People Plan to be published in April 2019.

As at December 2018, there are over 2,200 more Hospital and Community Health Service midwives than there were since the start of this Government.