Source · Select Committees · Health and Social Care Committee
Recommendation 5
5
Deferred
Lack of diverse representation in NHS leadership and midwifery education limits care.
Conclusion
Addressing the current lack of diverse representation within NHS leadership and midwifery education is one practical action that can be taken to address concerns. When those entrusted with shaping clinical knowledge and practice and leading our healthcare organisations overwhelmingly reflect a single demographic, it limits the breadth of what is taught, prioritised, and thus, how care is delivered. (Conclusion, Paragraph 38)
Government Response Summary
The government provides statistics on increases in the overall midwifery workforce and discusses rising complexities in births and potential digital tools for care. It mentions the 10 Year Workforce Plan but refers to a previous response for details, thereby deflecting from the specific recommendation about strategies for diverse representation in leadership and midwifery education.
Government Response
Deferred
HM Government
Deferred
Over the last 10 to 15 years, there have been significant increases in the midwifery workforce. In 2010 to 2011, there were around 34 deliveries for each full-time equivalent (FTE) midwife. The number of qualified midwives has since increased by around a quarter and, in 2023 to 2024, there were around 25 deliveries per midwife. As of 31 August 2025, there are now 24,706 FTE midwives employed by the NHS. This is an increase of 1,249 (5.3%) compared with 31 August 2024. The qualified midwifery workforce has also been supplemented by the introduction of midwifery support workers. Increasingly complex births and the increase in rate of deliveries by caesarean section has led to new and different demands on the whole maternity workforce. Between 2017 to 2018 and 2023 to 2024, the proportion of caesarean deliveries has risen from 28% of hospital deliveries to 42%. Additionally, the number of maternity outpatient attendances increased from 9.2 per delivery in 2014 to 2015 to 12.6 in 2022 to 2023 - this is equivalent to an annual growth rate of 4.1%. NHS England remains committed to the enhanced continuity of carer model for those living in the most deprived areas. An independent evaluation of the enhanced model of continuity of carer model found that: • service users and staff appreciated the model • enhanced model of continuity of carer teams provided greater capacity for midwives to deliver enhanced care to the women that are most likely to experience poor outcomes An evaluation of longer-term outcomes will be available in 2027. Funding that was provided for the pilot was moved into ICB baselines in line with other NHS England programmes for 2025 to 2026. Regional teams are working with trusts to understand how this funding is being used to tackle inequalities in outcomes. There are considerable opportunities to provide midwives and women with digital tools to support care - these include: • automated translation tools to provide specific maternity-related support to women whose first language is not English • electronic health records to ensure all data about a women’s wider health is shared with staff • the use of digital tools to ensure more accurate diagnosis of complications Work is ongoing to explore how best to introduce technology and support improved packages of care. The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it. We are working through how the plan will articulate the changes for different professional groups, including midwives and obstetricians. You can read more about the 10 Year Workforce Plan in the previous government response to recommendation 3 in the ‘Culture, leadership and racism’ section above.