Senior midwives and obstetricians are concerned about a lack of board engagement with maternity services, a King’s Fund report said this week.

The report, part of the think tank’s ongoing Safer Births project, said there were widespread complaints of staff shortages and poor communication.

Some midwives, obstetricians and risk managers who contributed to the report said NHS boards were “not aware of the safety agenda in maternity services”, and had not paid attention to staffing levels.

They said there was a lack of leadership at board and unit level, which led to “feelings of disenfranchisement and disaffection among staff”. One midwife said: “Poor practice becomes the norm because there is inertia in addressing it.”

Another problem identified was teamwork, which many teams felt was “poor or even non-existent” in their units. They reported bullying and racism, poor relationships between senior midwives and senior registrars, and ineffective communication.

The report said: “Although there are significant challenges facing maternity services…teams were able to see that many solutions did not depend on having greater resources or more staff, but on better deployment of limited resources, stronger leadership within units and across professional disciplines, and more effective teamworking.”

Professor Sir Sabaratnam Arulkumaran, president of the Royal College of Obstetrics and Gynaecology, agreed that existing resources needed to be used more efficiently.

“Careful resource allocation is important. In a time of financial difficulty, many trusts are looking at innovative ways to ensure that money is well spent. You can pour money into the system; however, what is fundamental is not what you buy but how you go about planning your services when funds are tight.” 

But Frances Day-Stirk, director of learning, research and practice development at the Royal College of Midwives, said: “There is no doubt that midwifery numbers need to increase.”

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