Training midwives as nurses first is 'absolutely worth considering' says author of Nottingham maternity report
Donna Ockenden warned midwife training has not kept pace with the increasingly complex needs of today's mothers
Midwives training as nurses first is "absolutely" worth considering, the author of the inquiry into the biggest childbirth scandal in NHS history has said.
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Donna Ockenden made the comments days after publishing a major review uncovering failures at Nottingham University Hospitals (NUH) NHS Trust.
James Murray, the health secretary, has promised to publish an action plan by December but Ms Ockenden warned: "We do not have the luxury of six months to develop an action plan".
She also added that midwives had told her they didn't feel "ready" by the time they entered the profession, and did "not believe they have the skills to care for today’s complex women".
Since the 1990s, the UK has allowed midwives to qualify into the profession without training as a nurse beforehand, meaning students could specialise from the age of 18.
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While the UK is not the only country offering direct entry into the midwife profession, many others - including the USA, Australia and Spain - require prior nursing training.
Ms Ockenden told the Times: “I trained in a very different system. I was a registered nurse first. When nurses joined midwifery then, they had diverse backgrounds: they might have had intensive care experience, gynaecology experience, surgical experience.”
She said returning to that system was something "absolutely worth considering", along with a comprehensive review of midwifery education.
She added that maternity wards were often largely staffed by midwifes who had been in the profession for as little as a year to 18 months.
Ms Ockenden warned that new mothers have more complex needs than in the past, but that midwife training has not kept pace to equip midwives with the skills to spot deterioration in mothers and infants early on.
It comes after the publication of her report on Wednesday uncovering that hundreds of mothers and babies died or were harmed following 'systemic failures” at Nottingham University Hospitals NHS Trust.
More than 2,500 families and over 800 members of staff contributed to the largest maternity inquiry in the history of the NHS, with NUH having already paid out millions of pounds in compensation and fines after being prosecuted for poor care.
Some 520 mothers and babies suffered potentially avoidable harm or death.There were at least 156 cases involving the deaths of babies, and six mothers died.
Of the baby deaths where potential or actual harm occurred, 94 were stillbirths.Some 62 cases were neonatal deaths shortly after birth.
The more than 500 cases of mothers and babies were graded as 2 or 3 for harm, with grade 2 representing “significant concerns” and grade 3 “major concerns” over care.
Looking at the catalogue of errors spanning many years, the report found failures in the monitoring of babies, poor CTG interpretation, a failure to recognise babies were in distress during labour and a failure to escalate some cases to senior doctors.