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Northern ireland
The RCM Northern Ireland is your trade union and professional organisation. We work for midwives, midwifery students and maternity support workers (MSWs) to support you in every aspect of your career from pay and employment conditions to professional development. We also work to ensure that the voices of midwives and MSWs are heard by the Northern Ireland Assembly, policy makers and employers.
This content is for RCM Members only
Statement from HSC trade unions Northern Ireland – 15 November 2024
Health Trade Unions in Northern Ireland met with Health Minister Mike Nesbitt on the 14 November regarding pay for 2024/25.
Q&A on the Mary Renfrew Report
The findings of an independent review into maternity services in Northern Ireland led by Professor Mary Renfrew were published on 22 October 2024.
The RCM has said it is ‘hopeful the long-awaited report would bring about a much-needed reset of midwifery services in Northern Ireland. However, the RCM has warned that addressing the longstanding workforce challenges identified in the report is fundamental to delivering safe midwifery care. While we believe listening, understanding and acting on the experiences of women and midwifery staff must be the driving force for change.
Click the link below to read the RCM’s full response to the report and we have also developed a helpful Q&A for our members on what the Renfrew report means for you and how you practice.
What is the Renfrew Report?
Professor Mary Renfrew has undertaken a comprehensive review of midwifery services in Northern Ireland. ‘Enabling Safe Quality Midwifery Services and Care’ sets out her findings. The aim of the report is to ensure that Northern Ireland has safe equitable, high quality maternity care and services going forward. Improving our relationships and how we as professionals care and communicate with women and their families has been highlighted in the report. Understaffing and system pressures have also been acknowledged as a barrier.
How will this report start to improve safety within our maternity services?
The report has identified what needs to change and to be strengthened to ensure Northern Ireland’s maternity services are safer. Each area of concern has a recommendation and action to improve it, which includes a clear strategic direction. This will ensure that Northern Ireland maternity services are on the right path towards improving safety.
Were staffing issues recognised in the report?
Yes, the report identified that understaffing impacts the quality of care being delivered. The RCM has said that for far too long understaffing has meant that midwives can’t always deliver the high-quality care women and their families need and deserve. The impact of understaffing on services in community settings was also highlighted, which has a particular impact on women in more rural locations. The RCM believes having the right staff, in the right places with the right training and skills in fundamental to delivery safe maternity services.
Did the report highlight good midwifery practice?
Yes, the report has shared some good examples of safe personalised care, good multidisciplinary working across the maternity team, and the sharing of quality information that enabled women to make informed decisions and choices that were right for them. The RCM believes this forms part of the gold standard of what maternity care should look like and has said that staff must be better supported not only by the system, but by those leading midwifery services to ensure they can always practice in this way. The RCM has said our members need to be better supported to ensure they can deliver high quality safe care.
I’ve read in some media reports that women said they felt they weren’t listened to by staff.
Women’s voices and experiences were central to this report, as were the voices of staff. Some shared experiences of poor care, in particular that they weren’t listened to by maternity staff. While this was disappointing to read, it gives us an opportunity to learn and improve. As professionals it’s so important that we are sharing all the evidence-based information we can with women and their families, to enable them to make decisions about their care that are right for them and their families.
The report says that some staff also felt not listened to and found it hard to raise concerns.
Yes, some staff felt their concerns weren’t being listened to. All staff should feel able to speak out, if they feel undermined or bullied or see behaviours that put colleagues or women at risk without fear of retribution. The RCM developed Standing Up for Higher Standards which is a step-by-step guide for our members about how they can raise concerns about poor behaviours in the workplaces. Everybody working in maternity services has a responsibility to create an environment where issues and concerns can be raised without fear. That starts with chief executives and flows down through leaders and managers to clinical teams.
Does the RCM support the recommendations in the report?
Yes, we fully support all the 32 recommendations within the report. The recommendations are measurable and sensible and reflect what the RCM has been calling for over recent years.
Are there any recommendations for the RCM?
While there are recommendations within the report for the Department of Health and other relevant stakeholders, there are no specific recommendations for the RCM. We are committed to working in partnership with those at the highest level to improve services for the women that access them and the staff that work in them. Within the report there are named persons and organisations responsible for each recommendation. It will be up to them to work on delivering the change we need to see, but we as midwives are central to those changes and the RCM will support its members throughout.
What can I do as a midwife or MSW to support the implementation of the recommendations?
Midwives and MSWs are essential to the delivery of safe women-centred care. You can help by familiarising yourself with the report and its recommendations and understanding them. That includes being aware of new protocols, guidelines and areas of improvement that have been recommended within the report and continuously improve your professional development through training and education. The RCM has a wealth of resources to support you with professional development. Everything from ilearn courses to ‘How to’ guidance.
How soon we will see recommendations actioned?
The recommendations are to be phased over five years with specific strategic actions identified from year one to year five. The RCM will be following the implementation of actions closely and monitoring the impact of them. We will do this by listening to the experiences of our members and the women they are caring for. We will also hold those who are responsible for implementing and driving the actions for change to account.
Are there any immediate implications for practice?
Yes, there were three main areas that have been identified for immediate action. These include postnatal care in hospital and community settings, improved interdisciplinary working for women requesting care ‘outside of guidance’ and psychological safety for all staff working within the maternity service.
How can I better promote, and support women-centred care in my service?
Women-centred care is crucial to improving maternity outcomes as it ensures that care aligns with the women’s values, preferences and specific needs. As midwives we can promote this by listening to women’s concerns and involving them in decision making. This includes providing clear accessible information, respecting cultural, emotional and individual preferences, especially in birth plans, advocating for women’s preferences in multidisciplinary discussions and ensuring her voice is heard in all her maternity care decisions.
Useful support and guidance for RCM members:
- RCM member guide for raising concerns
- How to stand up for higher standards
- RCM Solution Series – Learning from reviews of maternity services
- Rebirth guide for midwives to support women
- More on the Rebirth project
- i-learn is the RCM’s e-learning platform. It has modules to support your practice as a midwife, MSW or student midwife – access our modules here
- You can read the full report ‘Enabling Safe Quality Midwifery Services and Care in Northern Ireland’ here
This content is for RCM members only
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