Progress needs to be at pace, but not a snail’s pace

By Abbie Aplin, RCM Director Maternity Reform on 04 April 2023 Maternity Services RCM UK Education Midwives Midwifery Workforce MSWs - Maternity Support Workers England Pay and Agenda For Change Government NHS Pay Review Body NHS England Politics

As another report details failings in maternity care, Abbie Aplin, the RCM’s Director for Maternity Reform, outlines how the College is speaking truth to power and giving practical support to those working on the frontline.

Last week, another report into maternity safety was published. The Parliamentary & Health Service Ombudsman (PHSO) report Repeated failings putting mothers and babies at risk records that they upheld or partly upheld 27 maternity complaints between 2020 and 2022 in which nearly two-thirds (65%) involved issues with communication. They found failings relating to diagnosis, aftercare and mental health support for women and families. Examples of complaints revealed poor experiences for women not only in early pregnancy in emergency departments but also poor experiences within maternity services. In the same week, the British Social Attitudes Survey reported that public satisfaction with the NHS has slumped to an all-time low, with only 29% saying they were satisfied in 2022.

The RCM hears from midwives and maternity support workers every day about the pressures they currently face. We know you’re often working with unacceptable numbers on shifts caused not only by the 2,500-midwife shortage but also the high levels of sickness absence for colleagues due to anxiety and stress.

Midwives and maternity support workers tell us they want to go to work and give the best care. They do achieve this for many women and families every day, but it is impossible to achieve for all women in the current climate. This inability to provide the care to the standards they want is exacerbating the poor retention of newly qualified midwives and more experienced maternity staff.

We know you’re striving to make the changes required to ensure women and families receive consistently high-quality care. We would all agree this needs to happen at pace to reduce the repeated poor experiences described by some women in this and so many other reports. However, we also know that staff shortages and a lack of investment makes this feel impossible.

Despite these many reports, and their many recommendations, the pace of change seems glacial, and the interest of the Westminster Government minimal. This is simply adding to the frustration of maternity staff, from Directors of Midwifery to maternity support workers.

The RCM, by contract, is doing all that we can to support our members – and, by extension, the services in which they work. We are working hard to improve retention with projects to support the early career midwives, developing a platform for them to receive peer to peer support and championing effective preceptorship models. We are speaking to our activists and members who are sharing initiatives to help to retain the workforce supporting the RCM Caring for You charter, and wonderful wellbeing initiatives provided in some services to help the staff feel valued and cared for. There is much written about how care for service users is affected when those caring for them do not feel supported or valued and we all need to work together for this to lead the change that is required.

As co-chair, with the Royal College of Obstetricians & Gynaecologists (RCOG), of the Independent Maternity Working Group (IMWG), set up in response to one of the ‘immediate and essential actions’ made by Donna Ockenden in her report last year, we are already working across maternity care. The RCM and RCOG, other Royal Colleges, professional bodies, frontline staff, and women’s voices representatives, have all committed to work together to achieve change. Together, we advise and guide those who have responsibility for the implementation of the changes required to improve safety in maternity services. We are not afraid to speak up when we believe the focus is not sharp enough, and we are using this role as leverage to have our concerns heard by politicians and policy-makers.

The RCM is committed to working together across the system to improve safety in maternity services but to achieve this we need to continue to not only listen to women, families and all those who access maternity services but also those who deliver the care. Our membership from students, those midwives who educate them, to all those who provide frontline clinical care in all settings want to be able to deliver kind, compassionate, expert professional care and we all need to continue to work together to make the change that is required to achieve this.