Nearly half of NHS trusts surveyed in England have neither a dedicated budget nor a policy permitting extra spending to cover maternity leave, exposing gaps in arrangements for maintaining services when staff are absent.
The Chartered Society of Physiotherapy found that 49 per cent of trusts responding to its freedom of information requests lacked both provisions. It said inadequate cover leaves already overstretched teams handling the same caseload with fewer people, making patients wait longer for treatment and rehabilitation.
The findings also show a difference between clinical professions. Maternity cover arrangements did not extend to physiotherapy staff at 22 per cent of trusts, compared with 9 per cent for nursing posts. Women account for about 79 per cent of the NHS physiotherapy workforce.
The figures concern the trusts surveyed, rather than establishing that every NHS organisation in England has the same arrangements. They nevertheless identify a planning problem affecting both staff and the patients who depend on their care.
Unequal cover arrangements
Ash James, the CSP’s director of practice and development, said trusts must ensure maternity cover arrangements are fair across clinical professions. The organisation also called on the government to end recruitment freezes.
The distinction between having a budget and allowing an overspend matters. A dedicated budget reserves money for cover, while permission to overspend allows a team to go beyond its usual allocation to pay for replacement staff. The headline finding concerns trusts that had neither arrangement.
That does not establish that no maternity cover is ever provided at those trusts. It shows that they lacked the specified financial provisions, leaving a question about how services are expected to manage predictable absences within their staffing arrangements.
The comparison with nursing highlights a separate issue: whether cover available within a trust reaches all clinical teams. An organisation can have maternity cover arrangements without extending them to physiotherapy staff, as the responses demonstrate.
With women making up about 79 per cent of NHS physiotherapists, maternity cover is particularly relevant to workforce planning in the profession. The findings raise a question about sex equality, but do not establish a legal finding of discrimination.
Consequences for patients
Physiotherapy supports treatment and rehabilitation, helping patients regain or maintain movement and function. For London patients, as elsewhere in England, the practical issue is whether enough staff are available to provide the care they need.
The CSP’s warning centres on the workload remaining when a member of staff goes on maternity leave. If there is no replacement, the remaining team must carry the same caseload with fewer people. It said that this translates into longer waits for treatment and rehabilitation.
The Patients’ Association said patients should not have to wait longer because the NHS has failed to plan for predictable staff absences. Its response places the emphasis on service planning, rather than on employees taking maternity leave.
Maternity leave is an established part of working life. Planning for it means considering how a service will maintain its work during an absence, rather than assuming that colleagues can absorb the responsibilities alongside their existing caseloads.
Planning the next steps
The figures identify differences in financial provision and professional coverage, but do not quantify the resulting delays for patients. They also do not establish which London teams have funded cover or how individual trusts arrange replacements in practice.
That limits what can be concluded about any particular service. The findings cannot be used to assign a waiting-time increase to a specific trust, or to say that every physiotherapy team without a dedicated budget operates in the same way.
The CSP’s proposed response combines fairer cover arrangements across professions with an end to recruitment freezes. The practical test for trusts is whether maternity leave can be covered without leaving remaining staff to manage an unchanged caseload, and whether that provision reaches physiotherapy patients as well as those using other clinical services.
