Valerie Gommon Midwife’s Blog

Archive for the ‘Nursing and Midwifery Council’ Category

Very sadly it looks fairly certain that Independent Midwifery will end in October 2013.  The Government and Nursing and Midwifery Council have for a long time been recommending that Independent Midwives should have professional indemnity insurance (negligence insurance) despite it not being commercially available in the marketplace i.e. insurers do not provide this insurance for midwives.  You can read more about the current situation here http://www.independentmidwives.org.uk/?node=11615

An E.U. Directive is now due to come into force to implement this change and our current information is that it will be illegal for us to practice without professional indemnity insurance from October 2013.  This means that women will be denied the choice of choosing an Independent Midwife and we will be denied the choice of working independently and will be forced to stop practising or to return into the NHS.

The Independent Midwives UK organisation has been working tirelessly for years to find a solution and it is just possible that an eleventh hour solution will be found but this is now looking unlikely.

A group of midwives have formed an organisation called Neighbourhood Midwives www.neighbourhoodmidwives.org.uk/ and are working towards setting up an employee-owned social enterprise organization, to provide an NHS commissioned caseload midwifery homebirth service, based in the local community.  This may prove to be a workable alternative to Independent Midwifery but at present (if it comes to fruition) the service will only be able to accept “low-risk” women and this is of concern to all of us who have supported women with more complex situations, for example first time mothers, vaginal birth after a previous caesarean, twins, breech birth and women who are not deemed “low risk”.  The aim of Neighbourhood Midwives will be to extend their remit to include more women as soon as possible.

There is already a precedent for this type of care as One to One Midwives in Liverpool www.onetoonemidwives.org have already managed to set up a caseloading midwifery service (similar to independent midwifery in that a woman will care for a caseload of women throughout the whole of the pregnancy, birth and postnatal period) within the NHS.

It is a very sad time for midwifery and for women’s choice, but perhaps good things will come out of it, I certainly hope so.

Last week nurse Margaret Haywood was struck of the nurses register by the Nursing and Midwifery Council (NMC) -the professional body for nurses and midwives in the UK.

Between December 2004 and May 2005 Ms Haywood worked as a bank nurse on on Peel and Stewart ward at the Royal Sussex County Hospital in Brighton during this time she kept a diary and undertook secret filming on behalf on the BBC television programme Panorama and a documentary was screened in July 2005.

Ms Haywood, a nurse with 20 years experience, was accused and found guilty of:

(i) Raising concerns about patient care in the BBC Panorama documentary “Under Cover Nurse” when you should have reported the concerns in accordance with Trust policy;

(ii) Breaching patient confidentiality.

The actions of the NMC have caused strong reactions, the union Unite accused the NMC of being ‘heavy handed’ in its treatment of Ms Haywood.

Karen Reay, Unite’s officer for health, said: ‘We can’t have a culture where ‘whistle blowers’ feel intimated into not legitimately reporting wrong doing and bad practice in the NHS. We need a safe environment for ‘whistle blowers’ who feel that they can complain without losing their livelihood.

‘There appears to be a number of extenuating circumstances in the case of Margaret Haywood and the NMC could have imposed a lesser punishment than that of being struck off.’

‘The NMC exists as a regulatory body to protect patients and clients first and foremost, and not the alleged failings of members of the nursing profession in caring for the elderly.’

Ms Haywood admitted breaching patient confidentiality, but said that she had agreed to film undercover inside the Royal Sussex Hospital in Brighton to highlight the awful conditions on the wards.

The programme’s producer Elizabeth Bloor had told the tribunal that “there was an over-arching public interest” in the footage being broadcast.  At the time of the filming the hospital had serious problems with the lowest “star” rating, an £8 million deficit and was receiving complaints about the standards of care given.

After the Panorama programme concerns about standards of care were raised in the House of Commons after the programme and Sussex University Hospitals NHS Trust issued a public apology admitting “serious lapses in the quality of care”.

The actions of the NMC appear to raise questions for NHS staff about how they are able to expose inadequacies in our healthcare system, particularly as Ms Haywood indicated that she had attempted to discuss concerns with her manager with little effect.

www.timesonline.co.uk/tol/life_and_style/health/article6106326.ece

www.nursingtimes.net/nmc-defends-decision-to-strike-off-undercover-nurse-margaret-haywood/5000608.article

I have just learnt that the Royal College of Nursing (RCN) www.rcn.org.uk and an organisation called CAUSE (Campaign Against Unnecessary Suspensions and Exclusions in the NHS (UK)) www.suspension-nhs are fully supporting Ms Haywood stating that a “grave miscarriage of justice” has taken place.  There is also a petition in support of Ms Haywood at www.gopetition.com/online/27030.html

I promised that I would be writing properly again and then what happened, another baby decided to put in an appearance two weeks early!  So all in all I’ve had a busy time lately, what with the Tots to Teens Exhibition being closely followed by this birth – a beautiful baby girl.

Life seems hectic and full-on, but that is the life of a midwife, never knowing when next I will be called.  I do have particularly busy times, followed by quieter periods, in fact I have been relatively quiet for a while, but am now going into a busy period, two more babies expected over the next few weeks.

I am just off for my annual Supervisory review.  All midwives have a Supervisor of Midwives, someone who ensures that they are up-to-date with emergency training and someone who can also help to ensure that a midwife gets any support she needs, a confidential listening ear should it be needed.  So in fact Supervision is there to protect the public, but also to protect and support the midwife.  You can read more about Supervision here www.nmc-uk.org/aArticle.aspx?ArticleID=2098 and members of the public can also ensure that a midwife is registered with the Nursing and Midwifery Council (our professional body) by searching the register here www.nmc-uk.org/aNewSearchRegister.aspx

When out and about doing promotional work for my Independent Midwifery Practice www.3shiresmidwife.co.uk I am often asked what is involved to become a midwife.  It is obviously a profession that many women are called to; for some it is just a whim, they have a baby and think that it is such a wonderful job that they might have a go, but for others it becomes a serious intent.

Midwifery is not just about “delivering” or facilitating a birth.  Midwives are often the first person a pregnant woman will see; we give information and support throughout the pregnancy, labour and birth and postnatal period; we help mothers make informed choices about the services and options available.

The role of the midwife is very diverse; we undertake clinical examinations, provides health and parent education and support the family through pregnancy, birth and early parenting.  We also work in partnership with other health and social care services and midwives are responsible for their own individual practice and have a statutory responsibility to keep up to date with current knowledge.

I have had four children, three born at home and I read voraciously and set about informing myself to achieve my homebirths at a time when homebirth was definitely discouraged.  Having successfully achieved (challenging) but wonderful births at home I have to admit that I did become slightly evangelical about birth and homebirth and wanted other women to feel the same empowerment that I felt.

I was fortunate to have a midwife friend and I began teaching birth preparation classes alongside her, eventually teaching myself, never really thinking that I would be a midwife.  To be honest, I thought I knew too much; I didn’t think that I could bear three years of training to teach me something I already knew!

Time moved on, and I decided that I did want to be a midwife.  It was a long process.  I needed to undertake some up-to-date studying as it had been sometimes since my O levels.  I honestly don’t remember now how long it took, but it was certainly several years – I did an A level, I did an aptitude test, I applied, was rejected, waited a year and applied again (may even have been rejected again), the selection process was hard.  I think 250 applicants for 12 places.  They asked me what I thought were really stupid questions, really difficult questions.  I thought they were mad to turn me down; I was committed, knowledgeable and knew that I would make a good midwife!  Eventually I got lucky and gained a place to study.

The course itself was challenging.  A roller-coaster of a ride; highs and lows; lack of self-belief; difficult things to encounter and teachers that I disagreed with – but three years later I did it, I emerged as a brand new midwife and guess what, I did need those three years (and more) to become a midwife!

The process of applying for midwifery training has changed somewhat since I did my training.  Training is now a University Degree course; usually 3 years unless you are already a Registered Nurse and the minimum requirement to train is two A levels, science subjects are preferred. NVQ/SVQ Level 3, the BTEC National Diploma, or equivalent access to higher education programmes run by colleges of further education, are alternatives. Application is through UCAS www.ucas.ac.uk and you will gain a degree and Registered Midwife qualification.

It is important that you carefully check the financial status of being a student midwife.  The situation is under review, but some recent students have been unable to claim any financial support whilst training and have completed their training in considerable debt.  You will also be expected to attend University and work as a Student Midwife in a clinical setting, this will include shift-work and unsocial hours.  There will be many moans and groans along the way, it is not an easy job – it is challenging and exhausting, you will have to deal with staffing shortages and bureaucracy, but it is still the best job in the world!

More information about midwifery training can be found at:

www.nmc-uk.org/aArticle.aspx?ArticleID=2100

www.rcm.org.uk/jobs-and-careers/becoming-a-midwife/