The RCM policy team represents the interests of midwives and maternity support workers. We strive to promote excellence, innovation and leadership in the care of childbearing women, the newborn and their families, locally, nationally and internationally. We work in partnership with other organisations who share our interests, and use our influence to make the voices of midwives and MSWs heard at the highest level.
Policy Team Updates
Every month we highlight the some of the key policy and public affairs activities we undertake on behalf of our members.
We launched a new guide for midwives on the homelessness reduction act, on 11 March in Salford with Manchester Mayor Andy Burnham, and continued editing a new guide for midwives on infant mental health. RCM reps from London came to HQ for training – we gave them an update on the Long Term Plan. We also spoke about the implications of the LTP to meetings of students at Kings College London, of RCM activists at Exeter of RCM members at the AGM of St Thomas’s RCM Branch. RCM Fellow Laura Abbot gave evidence to the Joint Committee on Human Rights about the plight of childbearing women in prison. You can watch her – and Birth Companions chief executive Naomi Delap - on the UK Parliament website. We responded to consultations about restricting promotions of unhealthy food and drink, and on the priorities for the National Data Guardian, focussing on our opposition to sharing migrants’ NHS data with the Home Office. We met with the NHS Maternity Transformation Choice Pioneers and created a survey for members to tell us what they think of the new draft NMC education standards. At our regular One Voice meeting we joined with our partners in RCOG, RCPCH, Sands and the NCT in discussing joint activities for later this year, including a parliamentary reception and lobbying the House of Commons Health Committee to open an inquiry into maternity services in England.
We were out and about across the country for International Day of the Midwife. We spoke at the TUC in London on human rights, and joined midwives in Exeter, the Whittington and St George’s for the celebrations (and cake!) We joined academics, charities, and other NHS staff organisations for a meeting about migrants’ access to the NHS and went to a lecture on the same subject at UCL, from Patients not Passports and Migrants Organize. We met with the White Ribbon Alliance and Birthrights for a chat about shared priorities for improving maternal health, and with the NHS England Maternity Tariff Expert Group. The RCM Student midwives forum helped us shape a new survey for RCM student members to better understand their experience of student finance across the UK. We answered consultations on Advanced Clinical Practice, Integrated Care Systems; Learning disability and autism training; pregnancy and maternity discrimination; and Improving Multi-Agency Risk Assessment and interventions for victims of domestic abuse (MARAC).
We submitted evidence to the House of Commons Health Committee inquiry into legislative changes relating to the Long Term Plan and also responded to the NHS England consultation on the same subject. We also addressed a policy conference on the implications of the Long Term Plan for maternity services. Working with our colleagues in RCM Wales and our media officers we responded to the Welsh Government’s review into maternity services at Cwm Taf University Health Board.
We launched our latest position statement on Support to Quit Smoking in Pregnancy and a blog to explain its purpose. We worked with the White Ribbon Alliance, Birthrights and Make Birth Better on a submission to the UN Human Rights Special Rapporteur on mistreatment and violence against perinatal women. We submitted our views to the NMC on the new Midwifery Education Standards, thanks to those of you who gave us our views in our survey! We joined Birth Companions for their workshop Beyond the Gate, where NGOs, NHS England, prison staff, midwives and women with lived experience discussed how the justice system and healthcare can work together to improve outcomes for perinatal women. We joined the University of Greenwich and other midwifery leaders to start to map out the first Midwifery Apprenticeship course in England. We launched a survey for RCM student members on their experience of student finance, began work on our presentation to the RCM Education conference in Bath next month.
We met with our colleagues in the policy team at RCOG to discuss future plans and possible collaborations. We supported our colleagues in RCM Scotland with the drafting of an amendment that made it into the final version of the Health and Care (Staffing) (Scotland) Bill. We attended a meeting at NHS Resolution to discuss progress in implementing the early notification scheme for reporting incidents of potentially serious brain injuries in babies.
We were proud to attend the Memcom awards on behalf of the whole RCM team as we were up for three awards relating to our 2018 Student Recruitment Campaign, MSW Week and Annual Conference. We claimed a Highly Commended award for Annual Conference in the Membership Event of the Year. We joined midwives in education and research in a (very rainy!) Bath for our Annual Education Conference and presented our emerging findings on student recruitment and the state of the education workforce. We enjoyed Billie Hunter’s Zepherina Veitch Memorial Lecture and congratulations to our new RCM Fellows who were announced at the conference too. We joined Maternity Action to meet with Health Minister Jacqui Doyle Price MP at Parliament to raise our concerns about survivors of domestic and sexual abuse being charged for their maternity care – and we watched Health Minister Stephen Hammond face some tough questioning in Parliament over why the government isn't publishing its report into the harm charging causes. We collaborated with the BMA on a response to the consultation on health care in detention centres, and also gave our views on termination of pregnancy and role of coroners in investigating stillbirths. We began interviewing Heads of Midwifery in Scotland to investigate delivering maternity services in remote and rural areas.
We attended a meeting at the TUC along with other health unions and campaign bodies to discuss plans for a campaign to call for more investment in mental health services. We attended the annual NHS Confederation Conference in Manchester, which was a good opportunity for networking and lobbying. We attended the first meeting of the People Plan Advisory Board, which is the body charged with overseeing the publication of the final NHS People Plan. We met with colleagues from the Association of Anaesthetists to hear more about their campaign to raise awareness about fatigue in the workplace. The Association are keen to support our Caring for You campaign and we have pledged to support their Fight Fatigue campaign. The House of Commons Health Committee published a report of its inquiry into sexual health services. In our submission to the inquiry we had argued against the fragmentation and cuts to sexual health services and on this the Committee were in agreement with us.
We began the month digesting the new Maternity Strategy for Wales, which contains some very welcome initiatives on caring for women in the best way possible, and a recognition that the wellbeing of staff is critical to the quality of care for women and their families. We closed the RCM student finance survey and began the analysis – thank you to the over 1,000 RCM student members who responded! We worked with specialist midwives on an update to our publication on maternal and infant mental health, and contributed comments to more Blue Top Guidance coming from the RCM later this year. With our fellow members of the We Trust Women Campaign, we successfully lobbied MPs and peers to force Northern Ireland to make a change to their archaic laws around access to abortion through an amendment brought by Stella Creasy MP. We continued work on new position statements, we responded to consultations on accommodation support for survivors of domestic abuse, and began work on updating our Getting the Midwifery Workforce Right document.
We attended workshops organised by the TUC on digital campaigning for trade unions and by RCOG and the Nuffield Trust on issues relating to small, rural and remote maternity services. We signed up to support the All Kids Count campaign which is calling on the Government to remove the two-child limit on benefits payments. We submitted motions on perinatal mental health and migrant charging to this years TUC Congress. We attended the first meeting of the Stakeholder Council of the Children and Young People’s Transformation Programme.
We kicked off August at the NHS Trade Union Leads strategy ‘away day’ where we discussed pay and pensions. We published advice for teams looking to propose an inclusive pay arrangement for continuity teams. We responded to the Association of Anaesthetists consultation on their new guideline Anaesthesia and sedation in breastfeeding women, and the Ministry of Housing, Communities & Local Government consultation on Domestic Abuse Services. We recruited a group of Heads of Midwifery, RCM Fellows, consultant midwives, and workplace representatives to review our archived position statements. The group made recommendations on which position statements we should prioritise for updating. We hope to update the top six statements identified by our group of reviewers and update these over the course of the next year.
We met with the Working Group on vulnerable migrant women to discuss the development of new guidance for midwives. Finally, we met with the One Voice collaboration group where we discussed future activities with our partners from the RCOG, Institute of Health Visiting, NCT and RCPCH. This included developing plans for a manifesto and parliamentary event, to be launched in early 2020, and the development of a guide on appropriate language and terminology for midwives, MSWs, and other maternity staff to use during pregnancy and birth.
In September, the RCM held successful fringe meetings at both the Labour and Conservative party conferences, which took place in Brighton and Manchester respectively. At the Labour conference, we teamed up with the Chartered Society of Physiotherapy, the Fabian Society, and Unions 21 to debate what Labour’s health policy should be. In Manchester, our CEO Gill Walton shared a platform with Mims Davies MP and Maria Bavetta from the Maternal Mental Health Alliance to discuss what more can be done to support women with mental health concerns. We also attended the TUC congress, you can see a write up of our participation here.
The policy team were very active on the issue of charging. We provided advice and support to Maternity Action who launched a report about the impact on midwives of NHS charging for maternity care. Our delegates at the TUC congress successfully moved a motion calling for the immediate suspension of charging for NHS maternity services, and we held a fringe meeting on the same subject. Both the RCM and Maternity Action featured prominently in media coverage of this issue.
We published a blog detailing our trip to Powys to work with their maternity team on developing a continuity team. We responded to the Department of Health consultation on Advancing our health: prevention in the 2020s, and the Ministry of Housing, Communities & Local Government call for evidence on the Homelessness Reduction Act 2017. We attended the NHS Staff Council plenary and presented on the work of the Equality, Diversity and Inclusion sub-group. We published some explanatory guidance on the new Agenda for Change handbook provisions on Enhanced Shared Parental Leave and Child Bereavement Leave. We attended the Chief Nursing Officer’s BME Conference in Bristol, and NHS Employers published our blog on the potential equality risks in the new pay progression system.
In October, ahead of a debate on women’s mental health in the House of Commons, we briefed MPs about the need for investment in perinatal mental health services. We also worked with Stroud MP Dr David Drew to table two parliamentary questions, updating information we hold about midwifery staffing figures. One of the answers the MP got back confirmed that English universities continue to produce over 2,000 newly-qualified midwives each year. However, in the most recent workforce figures (12 months to July 2019) the number of midwives working for the NHS in England rose by just 33 (full time equivalent) or 43 (headcount). The other parliamentary question revealed that there were 1,344 midwives working in the NHS in England who are nationals of an EU member state other than the UK. This is enough midwives to staff a dozen average-sized maternity units. We will continue to defend their interests and speak up for them as the Brexit question continues.
We attended the 11th Chief Nursing Officer’s Black and Minority Ethnic Strategic Advisory Group Annual Conference; ‘Thriving, not just surviving: A focus on Workforce Wellbeing and Wellness’ and the NHS Staff Council subgroup meeting looking at buying and selling annual leave. We attended the Trade Union Practices on Diversity Conference and met with Jacqui McBurnie, Chair of the NHS England Menopause Group to explore how we might work together in future. We chaired the Equality and Diversity Council and met with NHS trade union leads and NHS employers to plan joint communications for year three of the pay deal.
We attended the latest meeting of the Rural LMS network in London, which included excellent presentations relating to workforce planning, Maternity Voices Partnerships, smoking cessation and working in partnership with local authorities. History was made in Northern Ireland, where legislation was introduced to make abortion legal up to viability. The RCM worked closely with the RCOG, BPAS and MPs to support the legislative changes. We are now preparing to respond to the consultation on the regulations which will govern abortion service provision in Northern Ireland.
At the end of October, we gathered at Missenden Abbey for our annual awayday at which we planned our key activities for 2020. We got into the right frame of mind by starting with a five mile walk through the surrounding countryside. We also heard some excellent presentations on campaigning and communications from guest speakers Antonia Bance of the TUC and Kate Mulley and Clear Harmer from Sands.
With the starting gun fired for a general election on 12th November, we got working on a manifesto for maternity services, which calls for, among other things, more financial support for student midwives; a root & branch review of the resources that maternity services need, with at least an extra 2,500 midwives by the end of the Parliament; championing of midwifery leadership; a People's Vote on Brexit; and a new focus on maternal mental health services. We have also published a summary of what each of the main parties contesting the election have said and promised about issues of most importance to our members. You can read that here. We are now seeking to get as many parliamentary candidates as possible to sign-up to support our manifesto.
On the 12th November we launched the latest RCM position statement on perinatal women in the criminal justice system. The statement calls for women in prison to have access to equivalent maternity care as women outside of the criminal justice system. The position statement You can read a guest blog on the subject from Dr Laura Abbott, RCM Fellow. We published blogs on retire and return midwives and our digital midwifery adviser and we released the results of the FOI on job evaluation and MSWs.
We attended the second meeting of the stakeholder council of the Children and Young People’s Transformation Programme, which oversees the delivery of the children and young people's commitments set out in the NHS Long Term Plan. It is intended to operate in parallel to the Maternity Transformation Programme. We went to Northern Ireland to a Workplace Reps briefing to discuss the pay campaign. We attended the Chief Nursing Officer's BME steering group meeting. We attended the RCM Activist Conference North. We worked with the Sickle Cell and Thalassemia Expert Reference Group on counselling competencies and revising the care pathway. We started work on a new iLearn for Homelessness. We hosted a Swedish midwife delegation and attended a joint trade union meeting with NHS Employers.
For the last week of November, we joined with our colleagues across the RCM in celebrating the contribution of maternity support workers during MSW week. Highlights included a tea party at the Whittington Hospital, a trolley dash at the University of Wales Hospital in Cardiff, an all day event at RCM Headquarters, and an afternoon tea at Guys and St Thomas's.
In December, the RCM published its own manifesto, setting out the top 5 things that we want to see from the 650 MPs elected on the Thursday of next week. RCM priorities for the next Parliament include:
- Help our student midwives to make ends meet
- Review the resources that maternity services get
- Champion midwifery leadership
- Give the people the final say on Brexit.
- Improve maternal mental health care
RCM staff celebrated with the Royal College of Obstetricians and Gynaecologists as they launched their new Women’s Health Strategy, which advocates a life-course approach to women’s healthcare. We also attended the LMS infant feeding working group, and NHS England Domestic Abuse event, and the BAME task and finish group.
We responded to a consultation on removing the right of parents to withdraw their children form sexual and religious education in Wales, and we responded to the Northern Ireland Office’s consultation on the new legal framework for abortion services in Northern Ireland, calling on the Government to introduce a legal framework which is based on the best available evidence and does not introduce clinically unnecessary and administratively burdensome restrictions which create barriers to care.
Finally, we celebrated Christmas together with the rest of Team RCM at the Breakfast Club in Shoreditch!
In January the RCM policy team kicked off the year with a bang. We submitted our evidence to the NHS Pay Review Body, responded to the Commission on Alcohol Harm Inquiry into the Effects of Alcohol on Society in which we called for consistent guidance for women on alcohol during pregnancy, we presented at an ESR Diversity and Inclusion Reporting event, and we held a joint union Heart Unions stall at North Middlesex hospital.
We prepared a paper on Baby Milk Substitute (BMS) marketing regulations and funding/sponsorship of events and CPD by manufacturers of pumps and bottles, we contributed to Public Health England’s Public Health Skills and Knowledge Career Framework, and we worked with and endorsed the Association of Anaesthetists guidelines on Anaesthesia and Sedation in breastfeeding women 2020.
We attended a meeting at the Nursing and Midwifery Council as part of the Equality Diversity and Inclusion Advisory Group, attended a meeting at Maternity Action to discuss parental rights, and attended the parliamentary launch of the Twins Trust, formerly known as Tamba. The Twins Trust aim to raise awareness, invest in research and campaign for the best possible outcomes for families who have had twins, triplets or more babies.
We had a regular catch-up meeting with members of the maternity team at the Department of Health and Social Care, at which we discussed issues such as the Government’s review of proposals to require coroners to investigate all stillbirths and plans for including a pregnancy loss review as part of a forthcoming women’s health strategy.
We had a regular meeting of the One Voice communications network, to oversee plans for the launch of a One Voice manifesto and parliamentary reception this Spring. We also discussed what our collective response should be to the Health Service Safety Investigations Bill (HSSIB), which is due to become law this year. The Bill raises questions for us about how maternity services fit into any new framework for safety investigations and what the future role of the Healthcare Safety Investigations Branch should be.
Members of the Policy Team had the pleasure to be on judging panels for the annual RCM Awards, which take place in May. We were all impressed with the quality of the shortlisted entrants and it is always a hard task to pick a winner from so many impressive and inspiring midwifery services! This is the time of year when RCM branches are having their AGMs and it has been great to receive invitations to speak at these branch meetings. We have been addressing subjects such as what the RCM are doing to support midwives experiencing stress and burnout, what our political strategy is for the next year and the implications for midwifery and the RCM of digitisation. We are always happy to attend branch meetings so keep those invites coming!
During 2020 we intend to focus on issues of particular relevance to rural maternity services and as part of that we met with the Nuffield Trust who have been undertaking reviews of care in rural and small hospital settings. Last year the Nuffield Trust and RCOG convened a workshop on care in rural maternity units, to which the RCM contributed, and a report on the workshop with recommendations is due to be published soon.
During February, the policy team was busy writing to MPs urging them to support an Early Day Motion (EDM) which called for the suspension of charging for maternity care, pending a review of the impact of charging on public and individual health. While it is quite rare for an EDM to lead to a debate in Parliament, they are useful instruments for attracting interest and generating media coverage of an issue. Ahead of the budget in March, we joined a number of organisations in writing to the Chancellor of the Exchequer calling for him to scrap the two-child limit on benefits payments, something the RCM has previously campaigned on.
RCM branches are holding their AGMs at this time of year and members of the policy team attended AGMs at West Middlesex Hospital on subjects such as tackling stress and burnout. We also attended the Working Group developing the Sickle Cell and Thalassaemia Counselling Skills and Knowledge Guide for Professionals which will be releasing its guidance on 15th October, we presented at a multi-professional Smoking Cessation and Health Conference in Birmingham, on ‘Smoke free pregnancy; System wide action to accelerate progress, we attended a sub-group chaired by Liberty to discuss issues related to immigration detention, we attended a policy lab run by King’s College which examined NHS responses to human trafficking, and we attended a meeting with the Chief Inspector of borders and immigration.
The National Audit Office has given notice that it intends to conduct a study into value for money in maternity services in England. We met with some of the NAO team who are scoping this subject to give them the RCM’s perspective on how maternity services are currently resourced and we look forward to receiving a formal invitation to submit evidence to the NAO inquiry.
We attended the second meeting of the stakeholder council of the Children and Young People’s Transformation Programme. The Programme oversees the delivery of the children and young people's commitments set out in the NHS Long Term Plan. As such it is intended to operate in parallel to the Maternity Transformation Programme. On the 12th November we launched the latest RCM position statement on perinatal women in the criminal justice system. The statement calls for women in prison to have access to equivalent maternity care as women outside of the criminal justice system. The position statement You can read a guest blog on the subject from Dr Laura Abbott, RCM Fellow.
Despite the Government’s announcement, following the general election, that it will provide student midwives and nurses with a £5,000 grant with effect from September 2020, the RCM will continue to lobby for better financial support for student midwives. This is because, student midwives will still be required to pay tuition fees and will therefore still accumulate significant debts during the course of their studies. In addition, it does not appear that the new financial grant will be accessible for student midwives who began their studies in 2017, following the abolition of the bursary.
With this in mind the RCM met with representatives of the National Union of Students, Unison and the RCN to discuss how we can campaign together to secure more financial support for our student members. We also met with Paul Blomfeld MP, who is chair of the All Party Parliamentary Group for students, to brief him on how the current financial arrangements impact on student midwives, and Student midwife Jo Williams from Bradford spoke to a panel of MPs on the all-party parliamentary group on students about the financial challenges facing healthcare students. This followed a meeting between the RCM and the MP behind the group, with more meetings with MPs and members of the House of Lords happening soon. We also submitted a response to the Office for Students consultation on implementing savings in 2019-20 and 2020-21 to seek assurances the recurrent teaching grant funding for health courses including midwifery would not be cut.
Finally, we submitted a response to the Commission on Alcohol Harm’s enquiry into the effects of alcohol on society, and echoed the call for consistent guidance on this issue and we were pleased to see the publication of the Safety guideline: neurological monitoring associated with obstetric neuraxial block 2020 which we contributed to via the working group.
As the COVID-19 outbreak has accelerated in the United Kingdom, the RCM Policy Team has pulled together to ensure midwives interests are adequately represented throughout the crisis.
Together, we have focused on:
- Ring fencing maternity services to ensure they are properly resourced, to protect midwives and women
- Keeping services running
- Pushing for appropriate testing of NHS frontline staff
- Ensuring midwives have access to adequate PPE
To ensure maternity services are properly resourced, midwives are appropriately supported, and services keep running, we have:
- Surveyed Heads of Midwifery on staff shortages and closure of services and called on NHS leaders to ensure maternity services are ring-fenced.
- Published guidance for midwives who are working throughout the crisis, including those who are pregnant or are otherwise vulnerable.
- Published guidance for retired midwives returning to work, and for students and educators who may have had their studies disrupted or who may be volunteering to join the NHS early.
- Together with the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health, published clinical guidance for those treating pregnant women during the crisis, and advice and guidance on birth partners.
- We have also published public health guidance and mental health guidance for practising midwives delivering care, as well as mental health guidance for maternity staff.
- Called on Government to ensure midwives are included in the emergency visa extension plan.
To push for appropriate testing of NHS frontline staff, we have:
- Continuously engaged with government on ensuring NHS frontline staff can access appropriate testing.
To ensure midwives have adequate access to PPE, we have:
- We have called on government to ensure midwives and maternity support workers receive appropriate personal protective equipment to ensure they remain safe and well so they can continue to care for people.
- We have surveyed midwives on whether they have access to PPE.
- We have published wrap-around guidance on PPE, to sit alongside Public Health England’s guidance on PPE.
To get this information communicated, we held three live Q&A’s sessions on Twitter.
We have also:
- Together with the RCOG, called on government to ensure women can access abortion services across the UK during the crisis.
- Welcomed the announcement that pregnant prisoners who do not pose a risk to the public will be released to enable them to be protected from the virus, thanks to the efforts of our partner Birth Companions.
As the crisis has progressed, the RCM Policy Team has continued their efforts to ensure midwives, MSWs, and the women they care for are protected.
We have continued our efforts to ensure maternity services are properly resourced, to keep services running, to push for appropriate testing of NHS staff and to ensure midwives have adequate PPE.
To ensure maternity services are properly resourced, midwives are appropriately supported, and services keep running in April, we have:
- Published updated employment guidance for midwives working during the pandemic as well as employment guidance for pregnant healthcare professionals.
- Published updated guidance for healthcare professionalson coronavirus infection in pregnancy.
- Published guidance on guidance for midwives, student midwives and maternity support workers on keeping safe while providing community care, as well as midwife led settings and home birth.
- Published guidance on antenatal and postnatal appointments.
- Published a range of professional clinical guidance including for example, public health during COVID-19.
- Published updated advice for students and educators.
We have also:
- Succeeded in convincing the government to ensure midwives are part of the group of healthcare workers entitled to automatic visa extensions, to protect our workforce during COVID-19.
- Called on NHS employers to offer proper training and support to those working in maternity services.
- Called on the Heath Secretary torecognise the significant contribution by – and disruption to - nursing, midwifery and allied healthcare students during the current crisis by abolishing tuition fees and reimbursing those already paid.
To push for appropriate testing of NHS frontline staff in April, we have:
- Surveyed midwives on testing – finding that under a third of midwives and MSWs who reported suffering symptoms of Coronavirus have been tested and Called on NHS employers to offer proper training those working in maternity services.
To ensure midwives have adequate access to PPE in April, we have:
- Surveyed midwives, 99% of whom cited fears of exposure to the COVID-19 virus, while almost half (46%) said it was because of a lack of appropriate personal protection equipment (PPE).
- Published wrap around PPE guidance for healthcare workers, primary outpatient community and social care workers.
We have also been working to respond to new evidence that a disproportionate percentage of pregnant women who have been hospitalised due to coronavirus are BAME. To respond we have:
- We have published wrap around risk assessment guidance for BAME midwives working during the pandemic.
- We are continuing to work on our broader response to this new information.
In June, the policy team continued to consider the impacts of COVID on maternity. Following the development of test and trace systems across the UK, we helped to draft some RCM guidance for members. We submitted written evidence to the House of Lords Public Services Committee inquiry into learning lessons from Covid-19, and we briefed the Trades Union Congress on issues relevant to maternity services ahead of their own evidence session.
We had a meeting of the One Voice partnership at which two pieces of work were agreed upon: that RCM and RCOG would lead some work planning for a likely inquiry into maternity safety to be announced by the Commons Health and Social Care Committee; and that One Voice policy teams to plan and prepare a publication that would pull together learning points/what works examples from the way in which maternity services have responded and adapted to the coronavirus crisis.
We continued to consider the impact of COVID on BAME persons in light of the recent publication by the Public Health England of the report ‘Beyond the data: Understanding the impact of COVID-19 on BAME groups’, as well as a recent study published by the University of Oxford which found that more than 50% of pregnant women admitted to hospital with COVID-19 were from BAME backgrounds. In response, we have called for the swift implementation of Jacqueline Dunkley-Bent, Chief Midwifery Officer’s plan to minimise the additional risks faced by BAME women. We also continued to call on NHS Employers to conduct appropriate risk assessments for BAME staff and as part of the NHS Staff Council published practical good practice principles on health and safety risk assessments.
We also kicked off our RCM wide Race Matters campaign which challenges the RCM to do better when it comes to tackling race, equality, and discrimination issues. The campaign is based around five key pledges:
- Training for all RCM staff and activists to support and empower them to recognise and challenge racist behaviour.
- Listening and learning from all members to reflect their experiences accurately and actively use what we have learnt to influence and promote positive change in the workplace.
- Using our position, both as an organisation and through our reps, to challenge discriminatory behaviour in the workplace.
- Ensuring that the RCM at every level is representative of the membership we serve.
- Supporting research and championing positive change in outcomes for pregnant women from black, Asian and minority ethnic backgrounds.
The Team has begun the process by undertaking race training with the fantastic organisation BRAP.
As we begin to adjust to the new normal, the RCM Policy Team has also begun to pick up on our core work. In June, we also joined Maternity Action in campaigning for better redundancy protection for pregnant women, and pledged our continued support for their campaign to end charging for maternity care, despite the disappointing High Court ruling on their case on the same matter. We also chased up the government to demand they cease forcing midwives to pay the immigration health surcharge while supporting our NHS.
We met with Make Birth Better to learn about what they are doing to address birth trauma, which affects 20 per cent of women in the UK. We attended the launch of the pathfinder project a systems-change initiative which brings together national good practice around responding to domestic abuse in different health settings and we called on the government to adjust the Domestic Abuse Bill to ensure a coordinated healthcare response to domestic violence.
We launched our student midwife questionnaire which will help us learn about student midwives experience, including interruptions to their learning, during the pandemic. We responded to the NHS Clinical Innovations consultation to advocate for continued enhanced support for midwives’ mental health and we began a concerted campaign to provide NHS workers, including midwives, who have carried us through this pandemic, with an early pay rise.
In July, the team continued to settle into the new normal. We continued with our focus on race and racism in health care. We attended a parliamentary roundtable with Nadine Dorries, Parliamentary Under Secretary of State for Health, to contribute our key learnings on the existing inequalities in maternity outcome and we welcomed the launch a major study, which the RCM will support, on the impact of COVID-19 on black, Asian and minority ethnic (BAME) healthcare workers.
We also briefed the Joint Parliamentary Committee on Human Rights on issues relating to the impact of COVID-19 on BAME pregnant women and maternity staff. This was ahead of a meeting of the Committee on 20th July at which the Chief Midwifery Officer (Jacqui Dunkley Bent) was asked about the Government’s plans for tackling inequalities in outcomes for pregnant BAME women, particularly the maternal mortality rate which is five times higher than for white women.
We called on NHS organisations to break the burnout cycle and support maternity staff better in response to a report from the Society of Occupational Medicine (SOM) on the mental health and wellbeing of midwives and nurses in the UK, noting in particular that BAME staff often find themselves under even more pressure because of the overt and unconscious bias that can all too often be part of their working lives. The team also continued with the second phase of our race and bias training with the fantastic organisation BRAP.
With the easing of some lockdown restrictions, and changes to advice for those shielding or self-isolating, we worked closely with the RCOG on advising of the implications for pregnant workers and getting agreement from NHSE and PHE that they will publish this advice. As part of the NHS Staff Council we published guidance on shielding due to COVID-19 which can be found here, quarantine due to COVID-19 which can be found here and annual leave during the pandemic, which can be found here.
We took part in a meeting of the Maternity Transformation Programme Stakeholder Council on 16th July, which discussed what the priorities should be for the restoration of maternity services and resumption of the MTP. We made the point that the needs of the workforce, particularly after the impact of the pandemic on the health and wellbeing of staff, must be taken into account when determining when and how services can resume.
We supported Maternity Action's call for better redundancy protections for pregnant women and new mothers. This protection will be vitally important in the coming months, as mothers are likely to bear the brunt of the economic turn down, being 50 per cent more likely to lose their jobs than fathers.
We responded to the announcement of a new pay rise for the public sector, excluding nurses and midwives, by calling on the Government to bring forward a pay deal set for April 2021, and to negotiate a much more substantial increase for these staff. We responded to the publication of the People Plan for 2020/21 and produced a summary of the main recommendations along with a blog, which gave the RCM’s take on the plan.
We began to analyse the result of the RCM student survey, finding that the overwhelming majority of students (97%) have reported that the pandemic has interfered with their ability to study. But despite the difficulties they have faced, the majority of students (89%) are still looking forward to their future midwifery career. The policy team also worked with colleagues across the RCM to successfully lobby for assurances that second year and final year students who had been deployed into the maternity workforce, in response to COVID-19, would be paid until the end of their deployment. This followed reports that some NHS employers were only going to pay students until the end of July. We also met with MP Kerry McCarthy to discuss student issues like pay and tuition fees.
Finally, the team attended a number of AGM’s to present on a range of topics including the RCM project on severe and multiple disadvantage, digital midwifery, and RCM’s post COVID priorities, and we packed up and said goodbye to our Mansfield street offices, and are looking forward to our move to our London Bridge office later this year, where we will be co-located with the Royal College of Obstetricians and Gynaecologists and the Faculty of Sexual and Reproductive Health.
August has been a busy month for the Policy team. This month the team has worked hard to ensure our members views are considered as government continues to relax restrictions, and the NHS turns to the restoration of services.
We wrote to MPs to demand that midwives receive a fair a decent pay rise which appropriately recognises the professionalism and commitment midwives have demonstrated throughout an extremely anxious period and to improve recruitment and retention which will be necessary to safeguard the midwifery workforce going forward. We surveyed members to learn about their experience of the pandemic and found that members were missing meals and delaying going to the toilet because they do not have enough time for breaks. They were also working additional unpaid hours, on top of long shifts. We blogged about how all this links to pay and helps us in building our evidence for a fair pay rise for RCM members, and we used this information to respond to the Health and Social Care Committee inquiry on workforce resilience and burnout.
We met with the Department of Health to discuss how to reduce unnecessary bureaucracy in the NHS and facilitated our members to submit particular instances of unnecessary bureaucracy for consideration. We continued to meet regularly with Public Health England to discuss issues like immunisation, safeguarding, PPE and restoration of community services, and we called on NHS England to publish guidance on partners attending births, scans and other ante- and postnatal appointments.
As part of the NHS Staff Council Executive we published frequently asked questions on pay protection for staff who are redeployed during the coronavirus pandemic. We met regularly with the Royal College of Obstetricians and Gynaecologists to plan and draft our joint evidence which we will be submitting to the Health and Social Care Committee inquiry into maternity safety and together with the RCOG we wrote the Parliamentary Joint Committee on Human Rights to urge the Government to adopt a target to halve the disparity in maternal mortality rates between black women and white women before 2025.
We criticised the government’s decision to axe Public Health England. We submitted evidence to the Department of Business, Energy, and Industrial Strategy inquiry on domestic violence and the workplace, and attended a meeting with the Department and a range of organisations to reinforce our views, that better support is needed for midwives who experience domestic violence at higher rates than the average population. We wrote to the Home Office to ask that the Department reconsider their decision not to establish buffer zones outside abortion clinics, and we submitted advice to the Economic Affairs committee inquiry on Employment and COVID-19 that the government should act quickly to protect pregnant women and new mother’s jobs throughout this period of economic contraction.
Finally, we met with a group of unions who represent healthcare students and wrote to the Secretary of State for Education to ask that he clarify that the new £5000 grant for midwifery students will not impact on the calculation of any other benefits which are provided to students who are disabled or who have caring responsibilities.
September was a busy month for the Policy Team. Throughout the month we surveyed midwifery students about their experiences of the pandemic and published the results of that survey, calling on government to provide additional financial support for students and to provide additional support for their mental health. We also called on Government in Scotland to invest in midwifery education and increase training places.
We responded to the Department of Health and Social Care Early Years review consultation to raise the important role midwives play in early years health and wellbeing. We responded to a NICE consultation in which we raised concerns that women would be stigmatised by new measures introduced to screen women for substance misuse during pregnancy. We responded to the NICE Diabetes in Pregnancy consultation, noting our regret that the consultation had been quite narrow, and we responded to a NICE consultation on integrated health and care for people who are homeless, noting midwives key role in this area.
We responded to the Public Accounts Committee consultation on digital transformation in the NHS, and the Department of Business, Energy, and industrial Affairs consultation on domestic abuse in the workplace. We attended All Party Parliamentary Group meetings on contraception and baby loss, and the Doctor’s of the World migrant health consortium, and we contributed to an Institute of Public Policy Research inquiry into the NHS charging system.
As COVID-19 cases began to rise again, we called on the NHS to learn lessons and avoid redeploying maternity staff, together with the RCOG we urged NHS England to publish guidance on partners and visiting during pregnancy. We also responded to a Department of Health and Social Care consultation on the delivery of COVID-19 vaccines.
We responded to Health and Social Care Committee inquiry into workforce burnout and resilience in the NHS and social care to alert government to the incredibly high levels of burnout amongst maternity care professionals as a result of consistent understaffing and the impacts of the pandemic. And we responded to an Economic Affairs Committee consultation on Employment and COVID-19, and raised many of the issues pregnant women experienced during the pandemic, urging the government to ensure their employment is protected.
We kicked off October with our RCM conference, which, as our first ever virtual conference, was a huge success. At the conference, our CEO Gill Walton called for greater equity and equality for those working in – and supported by – maternity services. Members of the Policy Team assisted with the planning and moderation of a range of sessions from how to support women digitally to addressing ethnic inequalities in maternity. We also celebrated reaching 500,000 members for the first time.
We continued to lobby for midwives to receive an early and significant pay rise, and developed a guide for members on how to join us in lobbying by contacting their MPs. We published a position statement on flu vaccination which urged midwives to be vaccinated, we attended a meeting with NHS England and NHS Improvement on the new payment system for 2021, and our head of quality and safety participated in a podcast series to celebrate the Year of the Midwife and Nurse. We also published the What if series for students midwives in continuity teams which aims to support student midwives who are working in midwifery continuity of carer models during their clinical placements.
We responded to the government’s Public Services Pension Schemes Consultation which concerned remedying the discrimination that resulted from providing existing members of the pension scheme protection to remain in their existing (legacy) schemes when a new (reformed) scheme was introduced in 2015. The element of the consultation that effected RCM members, was seeking an opinion on how the discrimination is corrected. The Government have indicated that they will give scheme members the choice to remain in their legacy scheme for the 7 years between 2015 and 2022 (the remedy period). The consultation asked whether there should be an immediate choice or whether that choice should be deferred until the scheme member decides to retire. The RCM have responded to the consultation supporting the deferred choice option.
We met with Marie Washbrook and Richard Griffin from Birthrate Plus to get their advice on updating our assessment of the midwife staffing shortage in England. Based on the new methodology, there is an estimated shortage of just over 3000 midwives in England. We also had a meeting with the Institute of Public Policy Research which we hope will lead to our participating in a research programme they will be running in 2021 on workforce issues affecting health and care staff.
As the United Kingdom entered the second phase of the lockdown, the work of the Policy Team also turned again to consider the continuing impact of COVID-19 on maternity services.
We called for lessons to be learnt from the first phase of the pandemic, and we continued our call to ringfence and protect maternity services. We met with members of Labour's health team and updated them on current pressures on maternity services, our perspective on the framework for visitors to maternity services, our lobbying on addressing disparities in maternal mortality rates. We continued to update our joint guidance on Coronavirus (COVID-19) infection and pregnancy, and we updated our occupational health guidance. This guidance will now be published on the government’s website.
We joined with Maternity Action, RCOG and TUC in writing to the Chancellor to ask that the Government adapts the Job Support Scheme, to enable employers to reclaim 100% of the cost of a maternity suspension on full pay for women who are 28 weeks pregnant or beyond (or who are clinically extremely vulnerable or otherwise medically advised to shield), the aim of which is to avoid the widespread problem of pregnant women being unlawfully sent home on sick pay or unpaid leave by their employer. Finally, we published advice on car sharing for student midwives and community midwives on how to manage the issue of transporting students around community placements.
In November the Policy Team continued its focus on ensuring midwives and MSWs are supported to manage the impact of the continuing COVID-19 pandemic. We continued to meet with the Department of Health and Social Care to discuss ongoing issues like PPE and testing. The Department has also now agreed to publish our occupational health guidance on their website. This advice will support pregnant women and employers during the pandemic.
We conducted an extensive all member survey, which asked members about their experiences working during the pandemic, including experiences with enforcing visiting guidelines. The survey found that 83% of midwives do not feel that their Trust/Board has the right number of staff to operate a safe service, 50% do not feel safe at work because of COVID, largely down to lack of staff availability and the ability to social distance, 42% say half of shifts are understaffed, and a third say there are very significant gaps in most shifts, and 63% are working beyond their contracted hours, unpaid, with 37% working additional paid overtime. Further, the survey revealed 70% of midwives had experience abuse when enforcing visiting guidelines.
Following the results of the survey, we launched a major campaign to secure an early and significant pay rise for its members. We believe the Government must act now to give maternity services what they need to cope with the demands on them. This means addressing the serious midwifery shortages and rewarding staff for their efforts with a decent pay deal. You can watch our Public Affairs adviser Stuart Bonar break down the campaign on Facebook.
We welcomed the news that health care workers (including midwives) who are on visas which expire between 1 October 2020 and 31 March 2021 will have their visas extended free of charge for one year, following a parliamentary question we supported on the same issue.
We launched a new position statement on supporting midwives to care for women experiencing severe and multiple disadvantage. The position statement notes the growing body of evidence which demonstrates that good midwifery care can have a tangible and positive impact on maternity outcomes for disadvantaged women, and calls for changes to support midwives to deliver good care.
We welcomed the Healthcare Safety Investigation Branch report, and particularly its focus on systems failure, as it is often the systems staff work in that can place staff, and the people they care for, in unsafe conditions. We were also very pleased to learn the Joint Committee on Human Rights, acting on our request, made a recommendation to Government to introduce a target to end the disparity in maternal mortality between Black women and white women.
To mark the first day of the 16 days of activism against gender based violence, together with the Royal College of Obstetricians and Gynaecologists (RCOG) we issued a call to end the ‘scourge’ of domestic abuse in the UK, which affects a quarter of women and is more likely to begin and worsen during pregnancy. We put forward several recommendations to tackle this terrible problem and have published guidance for midwives and other health professionals. We also published two blogs on issues related to domestic abuse.
We responded to the National Institute for Healthcare Excellence consultation on postnatal care and caesarean birth, as well as to the Health and Social Care Committee consultation on lessons learnt during the coronavirus pandemic.
The Team was also pleased to see a new Tommy’s study published which aimed to understand more about reducing the risk of stillbirth in the UK by reducing caffeine in pregnancy. The research shows that 1 in 20 women increased their intake during pregnancy, despite evidence that some caffeinated drinks such as energy drinks can cause a heightened risk of stillbirth.
Finally, we celebrated MSW week an annual event run by the RCM, which raises awareness of support workers in maternity, highlighting how integral they are to the maternity team.
In December the Policy Team was pleased to learn that healthcare workers in Scotland would receive a £500 bonus in recognition of their contributions during the ongoing COVID-19 pandemic and we continued our major campaign to secure an early and significant pay rise for staff in England.
We continued our policy response to the pandemic and called on NHS leaders not to take maternity staff away from services which are already understaffed and overstretched to backfill other areas of the NHS. The team was ecstatic to learn of the efficacy of leading vaccines, including Pfizer, Moderna, and Astrazeneca. We met with our One Voice colleagues to discuss vaccine strategy and the evidence surrounding pregnant women and vaccination, and we published a new briefing for midwives on vaccination of pregnant women. We also added a new section in the Q and As for women about vaccines.
Together with the Royal College of Obstetricians and Gynaecologists (RCOG) we welcomed the Ockenden Review and its recognition of the need to challenge poor working relationships, improve funding and access to multidisciplinary training and crucially to listen to women and their families to improve learning. Along with the RCOG, we also gave evidence to the Health and Social Care Select Committee maternity safety inquiry and later proposed a bold and ambitious vision for maternity services.
We responded to the NHS’s new guidance on visiting in maternity services and produced follow up guidance for trusts. We met with our Student Midwife Forum about issues impacting students who are working through the pandemic, for example issues surrounding delays to graduation and financial support. We also responded to the most recent MBRRACE report which found that stillbirth rates for black babies are over twice those for white babies, with lower, but still high, rates for Asian babies. Rates of deaths of babies in these groups are also falling more slowly than for white babies.
We published the results of a survey of midwifery educators which revealed that over 95% of midwifery educators surveyed by the RCM felt increasing workloads resulted in high stress levels and less than a quarter (24%) felt there were enough staff in their educational organisation to enable them to do their job properly. In response we called for called for more investment and support for midwifery educators.
Together with the Royal College of Obstetricians and Gynaecologists and Society and College of Radiographers we developed and published a consensus statement which gives professionals clear advice on how to speak to women and their partners about screening options, test results and where families can go for additional support.
In January, we repeated our call to NHS leaders to avoid redeploying staff away from maternity services except as a last resort to ensure care for women and their babies remains safe. We updated our vaccinations advice and continued to engage with the NHS England, Health Education England, and Public Health England on the rollout of the vaccines. We also made a joint statement with the Royal College of Obstetricians and Gynaecologists, reassuring women that the vaccines will not have any impact on fertility.
We continued our campaign to deliver a decent pay deal for midwives and MSWs pay, and released a new video setting out our arguments for an early and significant pay rise. We also wrote to the Prime Minister, Boris Johnson to urge him to speed up the process to increase NHS workers’ pay.
We continued to develop our organisation’s response to the Ockenden review and held and internal session on midwifery continuity of carer and our policy going forward, taking into account the impact of the pandemic on maternity services. We responded to the consideration of the reintroduction of CO testing and updated our guidance on public health during the pandemic.
We launched new guidance on Parental Emotional Wellbeing and Infant Development and called for more investment and training to enable midwives and maternity support workers (MSW) to offer better mental health support for women throughout pregnancy and postnatally. You can watch our launch event here.
We launched a new podcast and webinar series for members. In the first podcast, we spoke about the recently launched position statement on supporting midwives to care for women with severe and multiple disadvantage. The first webinar of the year was on the pressing issue of pay. In the webinar, the RCM’s Executive Director of External Relations, and lead negotiator on pay, Jon Skewes and Alice Sorby, Employment Relations Advisor, discussed what is being done to secure RCM members a decent pay rise and the next steps for its pay campaign, calling on the Government to Deliver a Decent Deal.
Towards the end of January, we held a virtual event during which student midwives and nurses spoke directly to MPs, their staff, and peers about their experiences of the COVID-19 pandemic. Student Midwife Forum members, Jo Williams and Fiona Howard called for more support for financial, mental, wellbeing and protection needs as the pandemic adds extra weight to the already existing inadequacy in the system.
We responded to the Nursing and Midwifery Council’s decision to reintroduce emergency standards for third year nursing students in the worst COVID-19 affected areas of the UK. You can read about our views on the use of emergency standards for student midwives here.
We also responded to the National Institute for Healthcare Excellence consultation on neonatal infection, the NHS England consultation on integrating care, and the Scottish, Welsh, and English government consultations on the efficacy and safety of early medical abortion via telemedicine.
Finally, we celebrated international thank you day by thanking our wonderful midwives and MSWs.
In February, we again updated our joint guidance on managing COVID-19 infection in pregnancy. We held a number of Q&A sessions on social media, including one for pregnant women and for students, which were well attended, and we launched a new short film on social media to encourage maternity staff to take up the vaccine. You can watch it here.
We continued to campaign for a decent deal for our members on pay, and published a new blog about what we’re doing about pay here. Along with other health organisations and unions we also wrote to the Prime Minister calling for better protection and PPE for midwives, maternity support workers (MSW), and other NHS staff as they battle with the pandemic. The call comes as over 900 health workers have died from COVID-19 with many more suffering the effects of having had the virus.
We were very pleased, after months of lobbying, to receive assurances from the government student midwives who are delayed in graduating due to COVID-19 disruption will not be asked to pay additional tuition fees and will continue to have access to their training grants, as well as a new emergency fund where students are experiencing financial hardship. You can find all of this information in our student Q&A’s.
With applications for the EU Settlement Scheme closing on 30 June 2021, we reminded members from any of the European Union states, Iceland, Liechtenstein, Norway, or Switzerland, to secure their right to continue living and working in the UK long term.
We joined the Vaccines4all campaign due to our concern at growing reports suggesting that marginalised groups are experiencing difficulty in accessing the COVID-19 vaccine, and we published episode 2 of our new podcast series. The new podcast focuses on the RCM's Caring for You campaign. You can listen here or on apple podcasts, Spotify, Google podcasts plus more platforms.
We responded to the publication of a UK Government White Paper on the future of the NHS in England in a blog published here, and we began preparing a formal response to the consultation on the white paper to be published shortly.
Following the publication of the Workface Race Equality Standard (WRES), which showed that there has been inconsistent positive change across the NHS on race equality, we called for the pace of change for to be swifter. We welcomed the release of the Women and Equalities Committee report on the gendered impact of COVID-19, which we submitted evidence to last year. We were pleased to find the report took on a number of the actions/issues we raised, including a recommendation on redundancy protection for pregnant women and new mothers. We also launched a series of animations about Female Genital Mutilation during the week leading up to International Day of Zero Tolerance to FGM on 6 February.
In collaboration with the Bangladesh Midwifery Society, we were successful in our application for a grant from THET, to support COVID-19 related activities in Bangladesh. The grant will come from the UK Partnerships for Health Systems programme (UKPHS), which supports low and lower middle-income countries (LMICs) to build stronger and more resilient health systems, making progress towards achieving Universal Health Coverage (UHC) through improved health service performance. The programme particularly targets poor and vulnerable populations and will ultimately contribute to better health and wellbeing (SDG 3), including ending preventable deaths.
Finally, we responded to the National Institute for Healthcare Excellence consultation on intrapartum care for healthy women and babies and screening indicators, the Nursing and Midwifery Council consultation on the future use of emergency powers, the Scottish government consultation on the national guidance for child protection, the Department of Justice consultation on the new policy framework and guidance for pregnant women in prison, MBUs, and maternal separation, the NHS England consultation on the standard contract for 2021/22, and the Public Accounts Committee consultation on supporting vulnerable people through COVID-19.