Quality and Standards
Quality and standards refer to the principles, practices and guidelines that ensure the care provided to women and birthing people, and their babies is safe, effective, and of the highest possible standard.
The quality of midwifery care reflects the overall effectiveness of the care provided and is based on the principles that care is safe, person-centred, timely, equitable, evidence-based and efficient. The aim is for high quality care that achieves optimal health and wellbeing for women and babies, and thereby our society and future population.
Standards set clear expectations for how midwives and the wider maternity team ensure high quality care can be consistently achieved. Standards include guidelines, regulations, competencies and national policies. They cover education, research, clinical practice, professional regulation and employment laws. Standards define our role, our working environment, and the expectations of those in our care. Standards are also crucial for benchmarking and encouraging a quality improvement process. They thereby ensure that both personally and as a profession we seek to continually improve and enhance the care provided.
The RCM meets with the national independent health inspection organisations to ensure your concerns are shared and to provide constructive challenge and expert insight into maternity care issues. In England this is the Care Quality Commission (CQC), in Scotland it is Healthcare Improvement Scotalnd, in Wales it is Healthcare Inspectorate Wales (HIW), and in Northern Ireland it is the Regulation and Quality Improvement Authority.
The Healthcare Quality Improvement Partnership (HQIP) is an independent, not-for-profit organisation. Their primary aim is to support improved health outcomes through evidence-informed, patient-centred quality improvement. This is achieved by commissioning national clinical audits and outcome review programmes, registry data, resources, and other quality improvement and patient engagement activities.
The RCM represents members and provides expert knowledge by sitting on HQIP project boards and planning meetings, including MBRRACE-UK, the National Maternity and Perinatal Audit (NMPA) and the National Child Mortality Database Programme.
The NHS Race and Health Observatory (RHO) is an independent expert body established to identify and tackle inequalities experienced in health and healthcare by Black and minoritised ethnic patients, communities and workforce.
The RCM works closely with NHS RHO as a member of the neonatal and maternal health advisory group, contributing to their strategy, sharing members’ workplace issues, and promoting strategies and solutions that seek to tackle health inequalities.
NHS Resolution is an arm’s length body of the Department of Health and Social Care (DHSC) that provides expertise for the resolution of patient concerns and disputes regarding care. They are integral to safety and improvement work in maternity services and oversee the Maternity Incentive Scheme (MIS). This is a financial incentive programme which rewards the NHS Trusts in England which demonstrate yearly achievement of ten safety actions.
The RCM provides expert advice and represents member views to NHS Resolution on a range of collaborative projects.
The National Institute for Health and Care Excellence (NICE) support clinicians and organisations to deliver evidence-based care through the development and maintenance of indicators, quality standards and national guidance.
The RCM regularly contributes to consultations on guidelines relevant to maternity care to make sure our members voice is heard. For example, in 2021 the RCM reached out to our networks and members to reject some of the proposed amendments to the NICE Induction of Labour guideline. As part of a national midwife-led campaign, NICE retracted some of the proposed amendments.
The Nursing and Midwifery Council (NMC) is in the independent regulator for UK midwives. Their core role is to regulate through higher education and professional standards. They maintain a national register of those eligible to practice and monitor revalidation. They also investigate concerns raised about those on the register.
As a key stakeholder, the RCM is consulted by the NMC on a range of topics relevant to midwifery practice including updates to regulation, education standards and advanced practice. As well as representing members reported to the NMC, we seek to amplify your voices by advising the NMC on a range of issues, such as concerns about freebirth and non-registered birth attendants.
The Royal College of Obstetricians and Gynaecologists (RCOG) supports the training and assessment of doctors around the world in the field of obstetrics and gynaecology. They work to improve women’s healthcare globally and have around 17,500 members. Unlike the RCM, they produce clinical guidelines, deliver assessed training programmes for the specialism, and publish information for the public. They are also not a trade union.
In our commitment to making maternity services safer through strong multiprofessional leadership, the RCM and RCOG are partner organisations. We collaborate on multiple projects including the Avoiding Brain Injury Programme (ABC) and the Tommy’s Clinical Decision Tool. We represent our members at RCOG committees and societies where we input into guidelines and policies, including the Clinical Quality Assurance Group and the British Maternal and Fetal Medicine Society. We even share the same London headquarters!
SHOT is the UK’s independent, professionally led hemovigilance scheme. SHOT collect and analyse anonymised information on adverse events relating to blood transfusion and blood products. This includes errors relating to anti-D immunoglobulin.
The RCM represents members at the SHOT Steering Group, providing expert midwifery input into findings, reports and recommendations.
The UK Health Security Agency (UKHSA) provides specialist advice and support to the emergency services and NHS. They prevent, prepare for and respond to infectious diseases, and environmental hazards, to keep communities safe, save lives and protect livelihoods.
The RCM is a stakeholder on UKHSA committees relevant to maternity care, such as vaccination, ensuring members voices are represented and providing members with information regarding changes that affect practice.
