Chart of the week: How serious is the fall in job satisfaction among midwives?

Each week we present analysis of data in chart form to illustrate some key issues and invite discussion. The recent NHS staff survey showed worrying results across all staff groups, but it was midwives who reported the sharpest decline in how satisfied they are in their work. Lucina Rolewicz takes a closer look at their responses to the survey, and emphasises the importance of improving the situation.

Chart of the week

Published: 28/04/2022

In recent months, there have been damning findings into the safety of NHS maternity services in England. Over four in 10 maternity units across the country are now rated as “inadequate” or “requires improvement” by the Care Quality Commission, and independent reviews have also highlighted failings in specific NHS trusts.

Although the results of the recent NHS staff survey across all staff groups are concerning – undoubtedly exacerbated by reduced morale throughout the Covid-19 pandemic – it’s midwives who are reporting the sharpest decline in how satisfied they are in their work.

The chart below shows the difference in midwives’ experiences in 2021 compared to 2017, as depicted by the stripped orange bars, as well as responses given by adult nurses (shown by the dark grey lines). In particular, fewer midwives felt that their organisation acted on concerns raised by patients (something that fell by 8.5 percentage points), and there were also big decreases in midwives’ satisfaction that their organisation was providing safe maternal care.

This aligns with recent findings from the Ockenden Report, which found significant failures in one NHS trust in providing safe, high-quality care, leading to poor outcomes for mothers and babies. Culture was also highlighted as an issue, including bad working relationships and a failure to learn from mistakes. Staff survey responses also supported this, with a decrease in the proportion of midwives reporting that their teams often meet to discuss how effectively they are working. This fell a huge 16 percentage points below the responses from adult nurses.

Midwives also raised worrying concerns about staffing levels, with just 6% of midwives responding to the 2021 survey believing that there were enough staff in place to do their jobs properly – down from 16% in 2017. On top of this, midwives’ own health and wellbeing has deteriorated as a result.

There are evidently a multitude of issues that have led to a poor culture and, subsequently, dissatisfaction among midwives. There is now a real risk that lowered morale will lead to recruitment and retention difficulties, which in turn could impact on the quality and safety of maternity care for patients. It is therefore imperative that these trends in midwives’ experiences are reversed.