No newly-qualified midwife resignations ‘proof’ culture is changing at Nottingham hospitals

The director of midwifery at Nottingham hospitals has insisted work culture is changing after revealing none of the trust’s newly-qualified midwives has left over the past 15 months. Nottingham University Hospitals NHS Trust ( NUH ), which runs the Queen’s Medical Centre and City Hospital, is at the centre of what is thought to be the largest inquiry of its kind in NHS history into its maternity services.

The inquiry is being led by senior midwife Donna Ockenden. A culture of bullying and racial discrimination at the trust was raised back in 2021 in a Care Quality Commission (CQC) inspection report, and the issue had been causing staff to leave, with many too frightened to speak up.

As part of ongoing improvement work in maternity services, a total of 49 new midwives have since been employed. During a Nottingham City Council Health and Adult Social Care Scrutiny Committee meeting on Thursday (October 24) the trust’s midwifery director, Sharon Wallis, said: “Our turnover in maternity is 8.9 per cent and sickness is down as well.

“We’ve just on-boarded 49 midwives over the past few weeks and we have interviews on November 9 for our remaining 20 full-time vacancies. I can say we are getting midwives that work in other trusts coming to us because they have heard how good things are at NUH with the support staff get.

“We’ve not lost any of our band five newly-qualified midwives for well over 12 months.” Another concern raised had been the skill mix of staff.

Cllr Maria Joannou (Lab), a member of the scrutiny committee, questioned how the new midwives would be supported and supervised. She said: “[Newly-employed midwives] creates a problem in itself doesn’t it, because they do need a lot of supervision?”

Ms Wallis said: “We’ve got a really good preceptorship programme that sets out what we expect those midwives to do, and they have a period of at least two weeks where they are moving around the different areas, so they are not counted in the numbers.

“They have dedicated mentors, supervisors, and we have our professional advocates that do a monthly learning session and feedback from them.

“We have preceptorship midwives as well who go and work with those individuals, because we recognise the pressure it creates with those midwives who are well-established in the workforce that have to cast and eye and supervise.

“The proof is that it has been 15 months since we have had band five leave the trust, and they progress to a band six within 12 months. We always have at least two senior midwives 24 hours a day on those sites as well.”

Ms Wallis further noted there had been a reduction in incidents reported to the Maternity and Newborn Safety Investigations (MNSI) programme, which is part of a national strategy to improve maternity safety across the NHS in England.

All NHS trusts are required to tell the MNSI about certain patient safety incidents, so it can carry out an independent investigation and make necessary safety recommendations. Cases that have been reported to MNSI now stand at five, whereas two to three years ago the number reached highs of up to 17.

“So it is seen those really serious incidents have reduced,” she added. An update on the wider trust and how it is working to become safer and more inclusive was also given during the meeting.

Recent introductions include the setting up of a Female Genital Mutilation (FGM) clinic in Sneinton, and there are now 84 inclusion ambassadors at NUH. Clive Clarke, Director of Inclusion, added: “There are firm foundations and clear green shoots on this agenda within NUH.”