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January/February 2022
Welcome from Jacqueline Dunkley-Bent, Chief Midwifery Officer for England
Thank you for all you continue to do to provide safe and personal maternity care and for valuing, respecting and investing in each other. We are familiar with the compelling need to improve maternity care, outcomes and experiences and I know that each and every one of you, continue to work hard to ensure sustained improvements are made for all who use maternity services and and staff. Maternity outcomes continue to show overall improvement and since 2010, the stillbirth rate has fallen from 5.1 stillbirths per 1,000 births to 3.8 stillbirths per 1,000 births in 2020.
This represents a 25% reduction and is ahead of the interim national ambition of a 20% reduction in these rates by 2020. The number of stillbirths is at least 750 fewer than if the rate had stayed the same in 2010, which means that hundreds of babies lives have been saved each year. Mathew Jolly, National Clinical Director for Maternity/Women’s health and I, thank and applaud midwifery students, trainees, maternity support workers, support staff, Maternity Voices Partnerships, midwives, obstetricians, neonatologists, anaesthetists, baby charities, policy colleagues and business and general managers for all that you have done to reduce the stillbirth rate.
Find us on Twitter @TeamCMidO and follow discussions at #teamCMidO
Covid news
Update on legislation requiring vaccination as a condition of deployment
The Secretary of State for Health and Social Care has announced that legislation requiring vaccination as a condition of deployment (VCOD) for all healthcare workers is planning to be revoked.
This is subject to Parliamentary process and will require further consultation and a vote to be passed into legislation.
This change in government policy means we request that employers do not serve notice of termination to employees affected by the VCOD regulations.
A huge effort has been put in to increasing the already high take-up among NHS staff, whether through one to one conversation or the many other methods deployed. This is very much appreciated, and the vaccine remains the best way to protect ourselves, our families, our colleagues and patients from the virus.
A letter from Amanda Pritchard, Em Wilkinson-Brice, Stephen Powis, Ruth May and Nikita Kanani, which summarises latest developments, is available here.
Heads of professions write to staff about vaccinations
The heads of professions including Chief Nursing Officer, Ruth May and Chief Midwifery Officer Jacqueline Dunkley-Bent have written a letter reminding staff of their professional responsibility to reduce risk of COVID-19 infection to patients by taking up the vaccine. You can read the letter here.
Infection Prevention and Control Guidelines
As England fully returned to Plan A on Thursday 27 January, the current infection prevention control guidelines remain in place across all healthcare settings, including the need for universal use of face masks for staff and face masks or coverings for all patients and visitors (unless exempt) and physical distancing of at least one metre.
Communications resources to support NHS providers are available here.
New campaign launched urging pregnant women to Get Boosted Now
Pregnant women who have not yet had their first, second, third or booster dose of a COVID-19 vaccine are being urged to get their jab as soon as possible, as the government launches a new advertising campaign this year.
The new campaign joins forces with the experts at the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to highlight the serious risks of catching COVID-19 and the benefits the vaccines bring to protecting both mothers and their babies.
You can find out more and access the promotional assets by clicking on this link.
‘I’m vaccinated’ Twibbons now available
Vaccination remains as important as ever for nurses, midwives and care staff to help protect themselves, colleagues and patients against COVID-19.
Display one of these Twibbons on your Twitter profile photo and join the ‘Vaccines work’ #teamCNO, #TeamCMidO or wider campaign to show your support for the COVID vaccines and booster, as well as inspiring other colleagues, volunteers and students to do the same. To get your twibbon, simply click on one of the links below and follow the instructions through Twibbon/ Twitter:
Continuity of Carer
Professor Trixie McAree, National Midwifery Lead for Continuity of Carer for NHS England and NHS Improvement talks about the importance of Midwifery Continuity of Carer
There is a sound evidence base that shows Midwifery Continuity of Carer (MCoC) improves outcomes for women and their families and remains the right thing to do.
Through provision of Midwifery Continuity of Carer midwives will gain a predictable and manageable workload: midwives work with a pro-rata live caseload of 27 women with 3-4 bookings and 3 births a month. The rest of the work undertaken at a time to suit woman and midwife alike, when working in the recommended flexible autonomous model.
Maternity providers need to make sure that firm foundations for sustainable transformation are in place for Midwifery Continuity of Carer to succeed. NHS England published guidance to support this in October 2021. Each provider needs to get the building blocks in place, in order to build up to wholescale change, each trust will be different, and each can design their own bespoke plan with their LMS and region, supported by the national team. There is no national mandated target for implementation, the aspiration is to offer all women MCoC as soon as is feasible, targeting those most in need first. Writing the plan is the first step to establish what is needed and when movement to the next phase of the plan will occur.
There are some really good examples of best practice too: one trust that has achieved 85% MCoC, as set out in the guidance, while another will have achieved 100% by August 2022, and many others progressing at different stages of their journey from 10 -50%. Each has used the NHSEI Midwifery Continuity of Carer toolkit to plan their programme and ensured the building blocks are in place before commencing their journey. Each provider will have different challenges and opportunities to implement MCoC with various factors influencing the pace of roll out.
An evaluation is planned for next year that will as a minimum aim answer the following:
- Impact on clinical outcomes
- Impact on user’s experience
- Impact on maternity staff
- Impact on organisations
- Financial analysis of the new model of care
In those providers that are moving forwards with this work as described above, it is continuing to lead to new reports of happy mums and midwives, reduced sickness and absence and greater job satisfaction.
Leadership
Addressing workforce challenges and achievements / update
Funded establishments for midwives have increased [NP1] significantly in line with the wider [NP2] funding provided to maternity services and support has been provided to regions to bolster retention and boost recruitment as we look to grow our midwifery workforce.
We are excited to see the response to International Recruitment of Midwives as regions continue to work hard, with support from the national team, to respond to the interest shown by international partners.
This quarter we are piloting the All4maternity morale boosting / leadership programme and we are providing a psychological support training boost to bereavement midwives, safeguarding midwives and PMH specialist midwives, with the hope to roll out to further cohorts from April 1st 2022.
We have heard how successful the band 7 support roles have been in practice where services have brought back ‘legacy midwives’ to provide support to NQ midwives. One NQ midwife said: ‘It has been so very successful and everyone appreciates it when our retention / pastoral support midwife is around’
Thank you for all you are doing to support and encourage our valuable workforce, lets all commit to encouraging a colleague at least once a day 😊
Jess Read : Deputy CMidO Professional matters and Leadership
Supporting our workforce
Chief Sustainability Officer’s Clinical Fellow Scheme - Applications open
Climate change presents a major threat to our health. That’s why the NHS became the world’s first health service to commit to reaching net zero emissions. The NHS Chief Sustainability Officer’s Clinical Fellow Scheme offers clinicians with a passion for sustainability a unique opportunity to help build a greener NHS and improve health now and for generations to come. Successful candidates will step out of clinical practice for 12 months to work with NHS senior leaders and teams on key projects that will accelerate progress towards a net zero health service, while strengthening their leadership and management skills. The scheme welcomes applications from allied health professionals, dentists, doctors in training, healthcare scientists, nurses, midwives, and pharmacists from across the UK.
Apply by 23 February 2022 - find out more.
Midwifery training placements increase year-on-year
Health Education England (HEE) has been working with stakeholders to deliver an additional 3,650 expansion of midwifery training places in England by 2023.
A growth of 626 was achieved in 2019/20 and 1,140 in 2020/21, and HEE remains confident of achieving the overall target by the end of 2022/23, ensuring there is adequate workforce supply in the medium and long term to support women, their babies and families. Find out more about the work underpinning this, including coaching models and education routes, here on the HEE website.
Funding for shortened programmes
And more good news! HEE will fund salary, fees, and tariff for up to 300 shortened programmes across all 7 regions. This will include existing Spring cohorts starting February/March 2021/22 and then all cohorts that start between April 2022 and April 2024.
New roles for maternity unit retention
New midwifery retention lead roles are now in place at 107 NHS maternity units to support student, early career and return to practice midwives. The posts have been funded by the NHS England and Improvement maternity workforce programme and are being undertaken by current midwives, who’ll also develop and build on their local midwifery retention improvement plans.
Workforce fundamentals workshops for midwives in leadership roles
Online workshops are being held to provide support to NHS midwives in leadership or management roles. The events will focus on workforce-related issues which people may be newly responsible for but have little previous experience in, or in which a refresh would be useful. They will explore national safer staffing policies in the context of maternity services and support an understanding of the essential requirements for board reporting, governance and assurance and how safer staffing tools such as Birthrate Plus® can help safe and efficient workforce planning and development. The events will be held on Tue 22 March and Tue 5 April, 1.15-5pm and delegates are strongly advised to attend both workshops. Register for your place here.
Maternity workforce funding is promoting progress
Funding released by NHS England and NHS Improvement in December last year to support improvements in maternity services and accelerate the recruitment, development and growth of the NHS maternity support workforce is already making a difference in trusts. In total, 123 organisations took advantage of the funding to reduce vacancies and implement developments in six key areas, including retention, workforce deployment and wellbeing. Work so far includes setting up a pilot with band 2 and 3 staff running antenatal classes to release community midwives’ time, recruiting admin staff to support with rostering and increasing the number of professional midwifery advocates (PMAs) to support retention work.
If your NHS organisation is doing great work in maternity workforce recruitment, please share it at NHSI.Workforce@nhs.net.
Health and wellbeing support for all throughout winter and beyond
The full national health and wellbeing offer continues to be available for all NHS colleagues throughout winter and beyond, it also includes how to access your local mental health hubs and the new physical health offer.
Physical health and wellbeing programme for all our NHS people
NHS England & NHS Improvement have partnered with Be Military Fit (BMF) to offer a new dedicated, physical health and wellbeing offer that has been specifically developed for our NHS people. This offer is for colleagues of all abilities - from those who have never exercised before, through to those who already enjoy regular exercise. The online platform also features a learning and development programme that aims to help you look after and improve your wellbeing, particularly through winter.
To explore what is on offer, try something new and see what works for you, please follow this link.
Healthcare evidence and knowledge now a simple search away
The new, HEE funded, NHS Knowledge and Library Hub, is a ‘one-stop’ gateway which, for the first time nationally, connects NHS staff and learners seamlessly to a significant range of free, high-quality knowledge and evidence resources, services, tools and databases, all in one place.
Content of the easy-to-use platform includes over 7,000 journals, e-books - including OUP handbooks, clinical decision support tools - such as BMJ Best Practice, NICE pathways and guidelines and clinical and medical databases.
Accessed via OpenAthens, users will be able to tap into the same system wherever their career takes them. Start your search or learn more through our short user guides. Updates will be posted on our new Twitter channel – follow us @NHSKFH
National Maternity and perinatal Audit (NMPA) compares obstetric intervention and pregnancy outcomes in England
A new study from the National Maternity and perinatal Audit (NMPA) compares obstetric intervention and pregnancy outcomes in England during the COVID-19 pandemic (23 March 2020 to 22 February 2021) with births during the corresponding pre-pandemic calendar period one year earlier. You can find out more here.
User testers required
Our colleagues at Health Education England are looking for volunteers to review their websites so that the content attracts the right future ‘nursing/midwifery’ workforce and is appropriate for current ‘nurses/midwives’ as well as partners who work to deliver education and training. The time commitment is a 40/60 call with a third part carrying out this research. Read more and sign up on HEE’s website. https://www.hee.nhs.uk/news-blogs-events/events/website-discovery
National funding helps retain midwife in Kettering
Kathy Patrick retired form her post after 32 years at Kettering General Hospital as a Delivery Suite Coordinator in June 2020. She deferred her initial retirement date due to COVID-19 and stayed to support the service for a few months longer. Kathy led on many different projects during her time as a senior midwife at KGH including Sure Start and Back to Basics. She also spent many years as a Supervisor of Midwives. When we were notified of the potential for national funding in regard to the retention midwife, we (the senior midwifery team) knew exactly who would 'fit the bill' and offered this role to Kathy in September 2020. Kathy 'jumped' at the chance to come back to support our midwives. We were obviously delighted!
Kathy has extensive clinical knowledge and a nurturing approach to her work. She always undertook her role as a Deliver Suite coordinator as an educator and would support our midwives on delivery suite (regardless of skill set) in a physical, emotional and developmental way. We knew the impact she would have on this role in supporting our early career midwives, but also our midwives who are 'fearful' of delivery suite. Kathy immediately understood the role specification and especially the importance on her remaining supernumerary; to provide the holistic one to one support that staff require. Her leadership attributes play to this as she remains strong in ensuring she is not deployed into providing direct patient care or taking her own caseload of patients. This gives staff the confidence knowing they will receive the one-to-one support they require/ have requested. She is flexible and works different shift patterns to suit the needs of our midwives.
Kathy was asked to give a summary of her role:
As the 'Retention Midwife', I work in collaboration with the 'Practice Development Midwife' and the 'Preceptorship Lead'. My role is always supernumerary - this is essential to be able to offer the focus and support needed by the individual. To date, I have never encountered a problem with this. My colleagues have been most supportive.
I see my role as supportive, nurturing and enabling newly qualified midwives make the transition from student to qualified practitioner. It is a huge step - more so in these challenging times. By offering this service, I feel the Trust are demonstrating that midwives are highly valued, and acknowledge this transition is often a cause of much stress - causing some new midwives to leave entirely. I have also supported staff with confidence issues, or just as a refresher, where they have not worked in a particular area for a long period. Occasionally I have worked with colleagues on an improvement plan, positively encouraging working towards set objectives.
I try to be as flexible as possible. I look forward to each working day, and my reward is witnessing the midwives I support reach their full potential, and stay within the profession.
Equity and equality
National Maternity Equity and Equality:
Ethnic Minority Workforce Steering Group
Nurses and midwives form the largest collective professional group within the NHS. One in every five are from ethnic minority backgrounds, rising to much higher levels (up to 40%) in some regions and parts of the country, such as London.
Improving equity of opportunity for nurses, midwives and care staff of all ethnicities is a top priority for the Chief Nursing Officer (CNO) for England. In 2020, the CNO established an action plan which makes clear her ambition and goals for development, opportunity and leadership for ethnic minority nurses and midwives. The plan spans a range of actions and initiatives with a common goal to ensure all nurses and midwives are valued and respected, and have equality of opportunity, irrespective of their ethnicity
To deliver high quality care for people and communities, we need a supported and fully engaged workforce. Yet evidence shows that the treatment and opportunities of black and minority ethnic (BME) staff still far too often do not correspond to the values and principles that the NHS represents.
The NHS Workforce Race Equality Standard (WRES) was introduced in 2015 to ensure employees from black and minority ethnic (BME) backgrounds have equal access to career opportunities and receive fair treatment in the workplace.
Workforce Race Equality Standard (WRES) data shows that people from ethnic minorities are significantly more likely to be nurses, midwives and health visitors compared to their representation in the population, yet they are under-represented in senior Agenda for Change pay bands across the NHS.
The National Equity and Equality Ethnic Minority Maternity workforce steering group was inaugurated in December 2021. The group will explore issues that challenge Equality and diversity of service delivery and the , wellbeing, and professional advancement of ethnic minority staff. Looking forward to providing further updates – Wendy Olayiwola National Midwifery lead for Inequality
- Regular National maternity webinars to connect, inform, update, and empower midwives
- CNO CMiDO BME SAG: midwifery forum
National Maternity Health and Wellbeing Taskforce
In the next edition we will share how we will work hard to support civility and respect with staff working in all maternity care settings and provide an update about the national maternity health and wellbeing taskforce, the vehicle for supporting health and wellbeing, in line with the NHS People Plan.
New starters
Welcome to new colleagues
We continue to strengthen leadership to support improvements in maternity services. The aim is to ensure that there is a Chief Midwife, Deputy Chief Midwife and Regional Obstetrician in each NHS England and NHS Improvement Region. All regions have a Chief Midwife and we are making steady progress in recruiting Deputy Regional Chief Midwives and Regional Obstetricians.
Welcome to:
- Rachael Glasson – Deputy Regional Chief Midwife, South West Region
- Kaye Wilson - Deputy Regional Chief Midwife, South East Region
Useful resources
Quick links to resources you might find useful - to be updated
Improving equity and equality in maternity and neonatal care
Make every contact count – pregnancy Covid-19 vaccination infographic
