WORKFORCE: Proposed changes to maternity staffing at North Cumbria University Hospitals Trust could harm patient care and prompt an exodus of skilled midwives, unions have warned.

The trust is consulting staff on plans which include the creation of new “integrated” midwifery roles working between community and hospital care but also involve the down-banding of a significant number of senior midwives.

Midwives have raised concerns about continuity of care and, with more than one in four nearing retirement age, many may choose to leave in the near future, unions have warned. The Royal College of Midwives, Royal College of Nursing and Unison are all involved in talks with the trust.

The changes mainly affect around 30 community midwives currently working at band 7. Most face being down-banded to band 6 if they stay on, according to RCM regional officer Susanna Cafferty.

“The proposals don’t say how often they would be rotating and they’re worried about continuity of care and gaps in the service, especially given the large volume of safeguarding cases in the community,” she said.

“We don’t feel the risk assessment or quality impact assessment is robust enough, including how they’re going to provide care if midwives leave,” she added. “They need experienced midwives to mentor new midwives coming in.”

The trust’s head of midwifery Anne Musgrave said the staffing structure was being reviewed to “provide a safe, efficient and high-quality service while also maintaining the correct number and skill mix of midwives”.

“We have reviewed the number of midwives and skill mix across the trust in line with national benchmarks and been working very closely with our midwifery staff and their representatives as part of a formal consultation,” she said.