The impact of the pandemic has meant 75% of midwives are considering leaving the NHS, an inquiry has heard.
Emma Currer, from the Royal College of Midwives, told the Scottish Covid-19 Inquiry on Wednesday she felt the “acute” nature of maternity care was not understood, and she described the profession as “at breaking point” with three-quarters of respondents to a survey saying they are considering leaving.
She said there was a “conflict” around protective personal equipment (PPE) during the pandemic which meant some midwives threatened not to go to work, while demand for homebirths went up due to concerns about hospitals and staff faced “increased hostility” from families due to enforced separation.
Ms Currer said: “We would have midwives saying we are expecting to be fitted with FF3 masks, because of resuscitating newborns, but management were saying that wasn’t required. I remember some members saying I’m not going to work if I’m not being fitted for an FFP3 mask.”
She said staff faced “increased hostility” because of forced separation during “unique and critical” times, which was “distressing”.
Ms Currer said: “They weren’t the decision-makers but they had to comply (with Covid regulations), but they were seen by the public as enforcers.”
Midwives faced “extreme burnout” and the profession has not recovered, the inquiry heard.
Ms Currer said: “We were very aware of extreme burnout in our membership. One of the biggest stresses being felt was newly qualified midwives without the support of more experienced staff and were sometimes turning up to work when the whole shift might have been newly qualified.
“You can’t defer post-natal care, it’s acutely required. You can’t prevent women from being in labour – these are things we can’t control.
“The way the (Covid) guidance was written didn’t really take into account maternity settings.
“We were having to say to some women their partner couldn’t be with them during labour and might not be there for the first few days of the baby’s life.
“I don’t think the Government understood or fully recognised the acute nature of maternity care. A huge component of maternity care is transition, it’s a significant life event, it’s a family event.
“The figure of 75% thinking of leaving was arguably influenced by the pandemic. The impact of the pandemic was still very much being felt and is very much unaddressed.”
Esther O’Hara, convener for Unite the union at NHS Greater Glasgow and Clyde, also gave evidence to the inquiry on Wednesday.
She said expired face masks were handed to staff during the pandemic despite the manufacturer saying they were not fit for purpose.
She said unions had to warn staff of the risks of using PPE which had been “redated”, and branded some decisions “foolhardy, unfair and wrong”.
Ms O’Hara said: “We found that guidance coming through was not really addressing some of the issues.
“I think it’s fair to say that staff were concerned about potential implications if the practice was not in line with the guidance, people were worried about being held responsible.”
She paid tribute to a “hardworking” hospital porter who died after contracting Covid.
Ms O’Hara said: “I know a porter who volunteered for extra shifts, his wife’s perspective was he was never away from the hospital. He contracted Covid and died. In my personal opinion decisions were being made along the lines of relative values of staff roles.”
She said “redated” PPE was distributed by the NHS although the manufacturer had said expired masks “can no longer be guaranteed to be protective”, but it was left to unions to inform staff.
Ms O’Hara said: “After a day or so of reflection the health board were not going to withdraw masks from circulation but if someone refused to wear redated masks, they would be provided with an alternative.
“However the health board did not communicate that, it was the trade unions. It’s fair to say that not everyone in the NHS is a trade union member, we circulated it as widely as we could. I believe people did say they didn’t want to use these masks.
“This could happen again, at any time. If something like this happens again, the service is not battle-ready.”
Today's session has now adjourned. We thank @unitetheunion, @MidwivesRCM, @ScotPensForum, @unitenhs and their members for their important contributions to the Inquiry's investigations.
We will return tomorrow at 9.30am:https://t.co/t3Ru85rNAh
— Scottish COVID-19 Inquiry (@covidinquirysco) April 24, 2024
The inquiry was later told that many nurses are suffering from some form of post-traumatic stress disorder following the pandemic.
Annie Hair, also of the Unite union, said she would receive messages at 1am from colleagues who had worked in hazmat suits without a break.
She told the inquiry: “There was increased stress and I set up a WhatsApp group for colleagues, there were nurses who would contact at 1am who were working long hours in high level PPE – hazmat suits – and were dealing with holding patients’ hands as they died, holding a phone so their loved ones at home could spend a few minutes with a dying relative.”
She said a South Asian colleague was eventually given an Army gas mask after working in ICU with face masks which were too big.
Mrs Hair said: “She felt slightly vulnerable but continued to work with an ill-fitting mask until the Army were drafted in and made Army re-breathers available, which is what the Army would wear in a gas attack. Everything was geared towards Caucasian faces.”
She said Covid policies changed “daily”, and added: “It just was chaotic – when you wore PPE, what services were stopped, what services were starting, who could visit who when, it really was hard to keep up with.”
She also said a meeting at the start of the crisis made her feel “too old to matter” aged 64.
She said the in-person meeting about setting up a treatment centre in Glasgow made her feel “vulnerable and worried”, and added: “It left my blood running cold, I just felt the room turn chill and for the first time felt vulnerable and I’m too old to matter.”
She said mental health issues had arisen as a result of the pandemic and remote learning had also caused problems.
Mrs Hair added: “I think all of that group would say they are suffering some form of PTSD, we are seeing an increase in competency issues in staff that trained during that time, they had a remote learning experience and they are certainly feeling that.”