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By Sean O'Sullivan Head of Health and Social Policy on 18 January 2022 Midwives MSWs - Maternity Support Workers NHS Staff Politics Government Covid-19 Midwifery Continuity of Carer - MCOC

Head of Health and Social Policy Sean O'Sullivan shares the latest on continuity or carer and the meetings had with the RCM and key decision-makers including NHS England Chief Executive, Amanda Pritchard and Jeremy Hunt MP, Chair of the Health and Social Care Committee, and with the Chairs of the All Party Parliamentary Groups (APPGs) for Maternity and Baby Loss. 

The issue that we receive more feedback from members than anything else, has been the huge challenge of trying to implement continuity of carer during the stress and demands of COVID-19. Midwives are increasingly distressed that all their efforts to provide great care are being undermined by unrealistic targets. Like the Royal College of Midwives (RCM), midwives are passionate and ambitious about improving maternity care and providing women with personalised, tailored, and supportive care through better continuity.

But the message from midwives filling out surveys, attending branch meetings or writing directly to the RCM is unambiguous – now is not the time for targets and pressure on a maternity service already stretched beyond belief. The RCM has been consistently raising this in the press, with the NHS and with politicians.

Gill Walton, RCM Chief Executive, took this message to the heart of the NHS in England, when she recently met with the Chief Executive, Amanda Pritchard. We are delighted to report that the response from Amanda was warm and thoughtful. Already, NHSE/I has written to Directors and Heads of Midwifery in England to pause the requirement of an action plan to achieve continuity as the default setting by April.

This is really good news and demonstrates what the RCM can achieve when we have your voice behind us. It is to be hoped that the pause will be a time for the NHS to rethink and reset its maternity priorities. In particular, fixing the infrastructure with the necessary investment in staffing and, at the same time, reconsidering how improvements can be made and the talents of all who work in maternity better utilised. In this respect, the RCM advocate starting with antenatal continuity and moving at a pace that is sustainable and inclusive. There are of course examples of services that are delivering improved continuity and we can celebrate and learn from them.

Amanda has asked for more regular meetings and we will use these to advocate on your behalf for a realistic approach to change in maternity, one that puts safety and improving outcomes above ideology and one that recognises and invests in midwives and maternity support workers (MSWs).

The other issue that is of course of concern to members are chronic underinvestment in maternity services and the continuing shortages of midwives. The House of Commons Health and Social Care Committee, in particular, has publicly called for substantially more investment in maternity services, to ensure that all maternity services are able to operate with safe staffing levels.

Last week Gill had a very positive meeting with Jeremy Hunt MP, Chair of the Health and Social Care Committee, and with the Chairs of the All Party Parliamentary Groups (APPGs) for Maternity and Baby Loss. The upshot is that we will be uniting with both APPGs, the Health Committee, the RCOG and Sands behind a call to put more resources into maternity and that we will be taking this campaign to the Department of Health and the Treasury.

We have heard your concerns about the implementation of continuity, and lack of investment in maternity services, loud and clear. What matters to you, matters to us and at last it feels like the decision-makers are increasingly receptive to these messages. 2022 can be the year we reimagine our maternity services!

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