Background

A head of midwifery (HoM) is a senior, highly experienced midwife manager and leader within the maternity care setting. The post holder is the professional and organisational lead for maternity services with an operational overview and responsibility for those services. In some organisations, the Head of Midwifery may report to the Director of Midwifery. In other organisations, the Head of Midwifery will hold Director responsibilities as they are the most senior midwife in the organisation. Depending on the size of the trust/health board they may also be managerially responsible for other departments such as gynaecology and neonatal services.

They should be jointly accountable to the Nursing and Midwifery Council’s code and that of the National Health Service managers’ code.

What does a Head of Midwifery midwife do:

Heads of midwifery have broad areas of responsibility:

• Professional and clinical leader of midwives
• Operational manager who may manage a budget
• Advocate for maternity services through the education and training of self and others; research and evaluation

The HoM practices midwifery with an enhanced scope of practice and commands a high level of clinical credibility. It is key that they are able to work with the wider multidisciplinary and professional team to ensure delivery of high quality, safe clinical care, education and research. To support and influence the broader corporate leadership they work closely, collaboratively and productively with the Consultant Midwife, Director of Midwifery (DoM), Chief Nurse and the Clinical Director in influencing and providing safe, high-quality care across the trust, community and Local Maternity and Neonatal System.

The HoM is accountable for:

• the professional and clinical leadership and governance of practice
• the provision of high-quality midwifery care to women and their families that reinforce
• the compassion, values and standards of care of where they work in the NHS
• leading, managing and delegating to a team of highly experienced and clinically skilled
• midwives such as consultant midwives and professional/clinical leads/matrons/senior
• midwives and ward managers
• the provision of high-quality nursing care to women and their babies if the responsibility
• includes disciplines such as gynaecology and neonatal services

The HoM should provide:

• strategic, professional leadership to ensure an appropriate focus on professional midwifery matters and maternity service delivery. To achieve this they should be enabled to report directly to board level or where appropriate or through a Director of Midwifery
• transformational, compassionate and focussed leadership that empowers the midwifery management team and staff with responsibility, accountability and freedom to act (leadership and improvement capability)
• positive, equitable professional role modelling and mentoring that develops clinical competencies, leadership and management skills within the team

Organisational and operational manager

The HoM is accountable for:

• the organisational and operational management and control of the maternity unit and other services where appropriate including safe staffing
• building and sustaining a positive work culture in which staff thrive, perform at their optimum, are engaged with their organisation, are energised to contribute and derive personal and professional fulfilment
• ensuring sustainable, high quality, safe care is always provided
• ensuring that proper governance of resources is always applied
• is experienced in operational services – at least 3 years’ experience in a senior midwifery management role
• advising the director of midwifery and board on all matters related to maternity care

Education training and development

• The nature of the Head of Midwifery role requires a portfolio that demonstrates career long learning and development.
• In order to effectively lead and manage at this level they must be able to demonstrate their academic and clinical credibility.

Research and evaluation

Research and evaluation are key for best practice and the provision of high-quality standards of care. Heads of midwifery are central in promoting research across the profession and must have the skills to be:

• leaders with responsibility to use appropriate resources to evaluate, develop and improve service provision
• ensure that services are based on high quality evidence through the implementation of research activity, findings and recommendations
• use evaluation findings to improve future education and training interventions
• Issues for some

How do I become a Head of Midwifery midwife?

The nature of the Head of Midwifery role requires a portfolio that demonstrates career long learning and development. To effectively lead and manage at this level they must be able to demonstrate their academic and clinical credibility.

A HoM will hold the minimum of a master’s qualification for example management, midwifery, public health or research.

During their management career they should have been supported by an appropriate preparation and development programme that provides training in management including business administration and leadership with a focus on the promotion of the role of midwifery and Head of Midwifery as a profession.

Given the experience gained during their development the HoM should:

• contribute to the strategic development of education for students and staff locally and regionally
• work collaboratively with education providers and other stakeholders to review and implement education programmes
• encourage and contribute to the communication of scholarly activity, research and new developments to support the integration of evidence-based practice within learning environments, in peer reviewed journals, at conferences and meetings

What development opportunities are there to support me to become a HoM?

The RCM offers aspiring Heads of Midwifery Programmes and Director of Midwifery Programmes. Leadership – Royal College of Midwives

The Florence Nightengale Foundation offers leadership programmes, some of which are regional and country specific. More information can be found here: Courses – Florence Nightingale Foundation

Are there Networks to support this role?  

The RCM has several forums for Heads of Midwifery. These forums offer networking and sharing opportunities to HoMs. More information or to join a forum please click here: Networks – Royal College of Midwives

What are the realities of working as Head of Midwifery?

• Clinical leaders struggle with a lack of role definition in comparison to their clinical role – Self identification
• Identity conflict leading to reduced job satisfaction and reduced organisational commitment (hybrid clinical / managerial role)
• Moving away from clinical work altogether can lead to a sense of loss of professional identity i.e. as a midwife.
• Risk of rejection from peers and colleagues and loss of professional credibility if they do not maintain a clinical case load.
• Relationship between clinical leaders and non-clinical leaders as different leadership models/styles.
• Negotiating clinical leader vs. Non-clinical leader.
• Staying within the unit as leader or moving on

What Next?

Where could this lead to?

Director of Midwifery, Director level roles in government bodies, Lead Midwife for Education, Consultant Midwife, ICM, RCM

Resources

Solution Series: Solution series – Royal College of Midwives