Retaining experienced midwives in continuity teams

By Alice Sorby, Employment Relations Advisor on 19 November 2019 Maternity Services Midwifery Continuity of Carer - MCOC NHS NMC - Nursing and Midwifery Council

We have published lots of advice and guidance to support midwifery managers, RCM Workplace Representatives, midwives and MSWs involved in setting up or working in continuity teams. One area that we haven't covered however is how we retain the experienced midwives who might be thinking about reducing their hours as they prepare for retirement. This is a crucial issue for the workforce, the latest figures from the NMC showed that almost one third (32%) of midwives are aged 50 or over. RCM members tell us all the time that this is something they are considering as they aren't ready to stop being a midwife or MSW but they want a better work life balance. The national policy for the NHS in England is that it aims to be the 'best place to work', supporting staff at all stages of their career is key to that.

It's important to say that the RCM can't give individual pension advice, this is because only a regulated financial advisor is able to do that. If you do need this advice you should contact NHS Business Services Authority and take independent advice.

I think it's useful to first discuss some of the options you might be considering applying for as your retirement age approaches. You may simply want to reduce your hours, this would involve a flexible working request (your RCM Workplace Representative can help you with this). Once you have reached your minimum retirement age you can 'retire and return'. This means retiring, taking all your pension benefits and returning to NHS employment. This is common in maternity, it can support your health and wellbeing and is also great for the service as it means valuable knowledge and experience is not lost.

There are other options such as, 'draw down' (taking part of your pension benefits whilst continuing in employment) or working in a different, less physically demanding area. The RCM pensions webpage contains links to lots of useful guidance documents from the pensions agency. It is worth remembering that none of the above is guaranteed, and the decision will ultimately be based on service need. The RCM is here to help you to make your case though. If you do 'retire and return', depending on your earnings, the pension scheme you are a member of, or the age you choose to retire at, you could pay more tax or your pension could be reduced or stopped, meaning you need to seriously consider the number of hours you work.

The conundrum we need to overcome is how midwives and MSWs on limited hours can work in a continuity model based on case loading and on-calls. The benefits to the service of retaining these staff is huge, we just need to think a bit imaginatively! We already have some great examples of innovation. For example, there are some areas where experienced retiring midwives' roles focus on supporting colleagues who are making the transition to working in a continuity model. So, experienced labour ward midwives work for two days a week on labour ward, supporting colleagues who have previously worked out in community, but who are now moving to working in all areas to provide continuity.

Similarly, this can be offered out in the community from experienced community midwives to midwives moving from hospital based roles to continuity roles. Retiring midwives can also be employed to focus on offering support to newly qualified midwives. The RCM has always said that for continuity to work we need more staff not less, using experienced staff to support implementation is a great use of their skills. In Scotland and some other parts of the UK lots of women have babies 'across borders', this leaves them in need of 'traditional' community antenatal and postnatal care as they have given birth out of area. This could be another great option for retiring midwives. Some retiring midwives might relish the idea of working in a continuity model – there will be a need for some part time midwives in continuity teams.

Changing ways of working is not easy and can be daunting, experienced midwives are invaluable to maternity services. Its important that we value their years of service and support them to be able to continue in work. We know that 'good' work is good for us and retaining these midwives makes a valuable contribution to maternity services and the women they care for.

If you have any examples to share with us please get in touch, we always want to share good practice.