Royal College of Midwives Cymru calls for urgent action on staffing

Jules Millward

The Royal College of Midwives (RCM) Cymru has responded to the publication of the Maternity and Neonatal National Assurance Assessment — Paths to Safer Beginnings in Wales — calling for urgent action on staffing after the report identified critical vulnerabilities in services across Wales.

The independent report highlights dedicated care in maternity and neonatal services in Wales but warns of vulnerabilities in key areas.

An independent national assessment of maternity and neonatal services in Wales has found many examples of compassionate care delivered by dedicated staff, while also identifying vulnerabilities that must be addressed to improve safety, consistency and outcomes for women, babies, parents and families.

The Maternity and Neonatal National Assurance Assessment was led by an expert independent panel chaired by former Children’s Commissioner for Wales, Professor Sally Holland.

It listened to the experiences of more than 600 women, parents, families and staff across Wales.

Members of the panel visited maternity and neonatal units in each health board, reviewed extensive evidence, analysed national data, documentation and feedback to understand both strengths and areas of concern.

Professor Holland said: “Excellent maternity and neonatal services are central to our health as a society.

“They have life-long impacts on physical health, mental health and family relationships.

“Our assessment was rapid but thoughtful, and it put babies and their families at the centre of all our thinking.”

The panel heard from many women and families who felt listened to, cared for and treated with kindness and respect. Staff across Wales consistently demonstrated professional dedication, empathy and
commitment, often under intense pressure.

However, the assessment also found key areas where safety and quality remain vulnerable.

Over-stretched

While most families described positive experiences, some shared concerns about communication, involvement in decision-making, and inconsistent postnatal support. A small number of families who had experienced loss or significant harm described how their trauma was compounded by defensive responses instead of openness, compassion and learning.

Staff also reported feeling over-stretched by increasing complexity in care needs, lacking time to offer the continuity and postnatal support they want to deliver and know families require.

The panel highlighted an unevenness in how services are organised and are urging stronger national coordination. Newly available digital records should be used for real-time data monitoring to enable earlier identification of safety concerns, and a national triage line should be implemented to ensure a consistent, round-the-clock response to urgent pregnancy concerns.

Over the past decade, maternity and neonatal services in Wales have been subject to more than 500 recommendations from reviews and inquiries. Rather than add to this number, the panel has instead
identified eight priority areas it believes would deliver the greatest improvements.

Professor Holland said: “None of us want these essential services to be anything other than the
best they can be. “Wales has the expertise, commitment and foundations needed to deliver excellent care for every family, in every community.

“But this will take collective will, long-term investment and clear accountability.

“It’s my hope we will see cross-party consensus on giving these services the support they need, and that women, parents, families and babies deserve.”

The report, The Path to Safer Beginnings in Wales: A National Assurance Assessment of Maternity and Neonatal Care and Services, sets out the evidence behind the findings and the priority actions needed to strengthen maternity and neonatal services for the future.

The challenges are solvable 

Chair of the report, Professor Sally Holland said: ” Our recommendations will require action, funding and accountability.

“I expect Welsh Government to lay out clear mechanisms to address the issues highlighted in this report, including transparency on how this process will be measured, monitored and reported. The challenges are large, but they are solvable, if they include those who rely on or work in Wales’s maternity and neonatal services every step of the way.”

The report has been met with criticism from the Welsh Conservatives. Shadow Cabinet Secretary for Health and Social Care, Peter Fox MS said: “After 27 years of Labour running our NHS, propped up by Plaid, this report lays bare a maternity system that is overstretched, under-supported and lagging behind the rest of the UK.

“Families are being let down by poor postnatal care, inadequate mental health provision and inconsistent investigations when things go wrong, while staff are left battling unsafe staffing levels and rising intervention rates.

 “The Welsh Government must take responsibility for these failings and urgently fix systemic problems in maternity care. The Welsh Conservatives would bolster the workforce, improve vital data collection, and establish a dedicated mother and baby unit to plug the gap in provision for people living in North Wales.”