The RCM’s Director of Employment Relations explains the changes to the NHS role profiles mean to maternity support workers and midwives

If you’ve been following recent developments around Agenda for Change (AfC), you might have heard that the NHS Staff Council has now agreed on new national profiles for nursing and midwifery staff. And if you’re wondering what that means for you; your role, your pay, and your professional future – you’re not alone. At the Royal College of Midwives, we’ve been deeply involved in this work with the involvement of our members, and we’re here to help unpack what it’s all about.

So, what are these profiles?

The NHS Job Evaluation Scheme uses national job profiles to match roles to the appropriate pay band. The profiles describe the responsibilities, skills, knowledge, and effort required for roles across the NHS. They’re the backbone of Agenda for Change and, for a long time, the midwifery profiles have needed updating.

That’s why the new profiles are such a big deal. They bring the job descriptions used in grading decisions up to date with modern midwifery practice, which has evolved dramatically over the past two decades, as well as the language we use to talk about women and families.

The profiles can be found here but in summary, these profiles:

• Introduce a new Band 4 MSW specialist role.
• Updates the Band 5/6 role to reflect modern practice and language
• Streamlines Band 7/8 senior and managerial roles across primary, acute and research settings.

Why now?

The RCM has spent years making the case that the existing profiles didn’t reflect the true scope and complexity of modern midwifery. From continuity of care models to safeguarding, autonomous clinical decision-making to public health responsibilities; today’s midwives do a lot more than what was captured on paper.

After pressure from the RCM and input from working midwives like you, the NHS Staff Council has agreed new profiles that better reflect the reality of the profession.

What does this mean for your job?

Here’s the important bit. The new profiles provide clearer, fairer benchmarks for job evaluation. That means:

• National consistency: Employers must now use these updated profiles when evaluating midwifery roles, reducing local inconsistencies.
• Recognition of your work: The new profiles better reflect the complexity, responsibility, and autonomy midwives carry every day.
• More accurate pay banding: Midwives and MSWs whose roles have grown in scope may now have a stronger case for a higher banding.

The profiles don’t change your pay overnight, but they do give RCM workplace reps and NHS employers a better tool for making sure midwives are placed in the right band, with the right recognition.

Will this mean pay rises?

To be realistic, most roles will remain within the same bands as before but be more accurately described. The profiles are a tool for banding decisions. If your current role seems to fit better with one of the new profiles, there may be grounds for re-evaluation. Your RCM rep can help with that process.

For some, this could result in a re-banding and a pay rise. For others, it may affirm that your current band is appropriate and will be based on a much clearer, more accurate national standard.

What should you do next?

1. Talk to your RCM workplace rep. They’ll be trained in the new profiles and can support you in understanding how they apply to your role.
2. Review your job description.  Does it accurately reflect what you do? If not, that’s something to raise locally.
3. If you’re an RCM rep, talk to staff side colleagues about setting up a joint working group to review all the new profiles and ensure there is a robust Job Evaluation process.  The accompanying technical guidance includes an audit tool to grade your current process – use this to argue for better resources and training for Job Evaluation.
4. Stay informed. The RCM will be running sessions, publishing guidance, and supporting reps and members through this transition.

This is a major step forward in the long-overdue recognition of the complexity and value of midwifery. The new profiles aren’t just about pay, they’re about professional respect, fairness, and making sure RCM members are seen and valued for what they really do.

We know there’s more work to do but today, this is a win worth celebrating.

Have questions or want to know more about what this means for you? Your RCM team is here to help; reach out, get involved, and let’s make these new profiles work for midwives everywhere.