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Found 223 results
  1. Content Article
    In the UK today, nearly 40% of the population are living in poverty because of low income. This means that nurses and midwives are likely to meet people experiencing poverty and deprivation as part of their everyday work and should be ready and able to help them access the assistance they need to overcome the associated challenges. This article in the British Journal of Nursing examines the link between financial status and people's health and wellbeing. The article includes a case study and suggestions as to how nurses and midwives can promote financial wellbeing.
  2. News Article
    NHS trusts have been given until 2027-28 to employ enough midwives to meet safe staffing requirements, NHS England’s new maternity delivery plan has said. The three-year delivery plan for maternity and neonatal services sets out to “make maternity and neonatal care safer, more personalised and more equitable for women, babies and families”. It says: “Trusts will meet establishment [requirements] set by midwifery staffing tools and achieve fill rates by 2027-28, with new tools to guide safe staffing for other professions from 2023-24.” The plan follows a series of high-profile maternity scandals in the NHS at Shrewsbury and Telford, East Kent, Morecambe Bay and an ongoing independent review by Donna Ockenden into Nottingham University Hospitals Trust. The Care Quality Commission has highlighted a string of other concerns across the NHS. Read full story Source: HSJ, 31 March 2023
  3. Content Article
    In this blog, Sonia Barnfield, Clinical Adviser for Maternity Investigations at the Healthcare Safety Investigation Branch (HSIB), looks at risk assessments during the maternity care pathway, following HSIB's recent national learning report on the same subject. Sonia outlines the need for change in the way that risk during pregnancy is assessed and managed, highlighting that there is currently no single national guidance and that HSIB identified repeated examples of insufficiently robust, continuous risk assessment in the maternity pathway. She lays out six key themes highlighted in HSIB's report and looks at how risk assessments should change to improve safety for pregnant women and their babies.
  4. Content Article
    At least 1 in 5 mothers experience a perinatal mental health (PMH) problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period. This resource was produced by the Institute of Health Visiting (iHV) in partnership with the Maternal Mental Health Alliance (MMHA). It draws together principles collated from a comprehensive desktop evidence review of current policy, research, reports and literature on what good PMH care looks like. It aims to support individuals, services, pathways, multiagency groups and networks across health, public health, social care and non statutory services to consider: Where are we now? Is the care we currently provide good enough? What do families want mental health care in the perinatal period to look like?
  5. News Article
    A trust has been issued with a warning notice after the Care Quality Commission (CQC) raised concerns about parts of its maternity services. Following a focused inspection at University Hospitals Dorset Foundation Trust in September and November last year, the CQC has rated maternity services at Poole Hospital “inadequate”, down from “good”. The service was also rated “inadequate” in the safety and well-led domains. The CQC report warned that Poole Hospital’s maternity unit did not always have enough midwifery or medical staff to keep mothers and babies safe. The inspectors noted this had led to delays to induction of labour and caesarian sections, including emergency sections. A warning notice was also issued over concerns about the unit’s emergency call bell system, which worked “intermittently” due to poor wireless signal, and processes used to summon help during an emergency. The trust said it had since “taken action to address this risk”. Read full story (paywalled) Source: HSJ, 10 March 2023
  6. News Article
    Staff endured a “toxic and difficult working environment” at a maternity unit an employment tribunal has found. The tribunal panel said that the case of a black midwife, Kemi Akinmaji, who partially won her case against East Kent Hospitals University Foundation Trust for racial discrimination showed “there were wider issues beyond the specific allegations before us and which were possibly related to race”. The tribunal judgment said: “The evidence we heard reflected a toxic and difficult working environment generally where the claimant and colleagues were shouted and sworn at over differences of professional opinion. There was some evidence before us that there were wider issues beyond the specific allegations before us and which were possibly related to race… “There is evidence of wider bullying of the claimant in the way the group of colleagues treated the claimant… We’ve also heard that the previous grievance had highlighted risks in respect of unconscious bias and identified recommendations which were not actioned. “The race champion was not appointed and the unconscious bias training not sufficiently followed through. We also heard evidence of staff being wary of further such complaints. These matters were all concerning but we had to limit ourselves to the specific allegations brought by the claimant and which the respondent had been given an opportunity to address.” Read full story (paywalled) Source: HSJ, 1 March 2023
  7. News Article
    A criticised maternity service needs 37 more midwives, about a fifth of its total midwifery workforce. The Care Quality Commission has said Northampton General Hospital did not always have enough qualified and experienced staff to keep women safe from avoidable harm. Figures obtained by the BBC show that 49 serious incidents have occurred in its maternity services in four years. The hospital said it had undertaken "a lot of work" in the past 18 months and a recruitment process was under way. According to a Freedom of Information Act response, between November 2018 and November 2022, the hospital had 278 serious incidents, with the highest level coming across maternity services, including gynaecology and obstetrics. There are currently 37 vacancies for midwives but the trust said it manages staffing levels "closely and ensure that all shifts are covered by bank or midwives working altered shift patterns, to ensure that we are able to provide a safe maternity experience". Read full story Source: BBC News, 27 February 2023
  8. News Article
    Two health watchdogs have issued safety warnings after junior staff were left to work unsupervised on maternity wards previously criticised after a baby’s death. Training regulator, Health Education England (HEE), criticised the “unacceptable” behaviour of consultants who left junior doctors to work without any superiors at South Devon and Torbay Hospital Foundation Trust’s wards. The maternity safety watchdog Healthcare Safety Investigation Branch (HSIB) also raised “urgent concerns” over student midwives and “unregistered midwives” providing care without supervision. The latest criticism comes after the trust was condemned over the death of Arabella Sparkes, who lived just 17 days in May 2020 after she was starved of oxygen. According to a report from December 2022, seen by The Independent, the HEE was forced to review how trainees were working at the trust’s maternity department after concerns were raised to the regulator. It was the second visit carried out following concerns about the department, and reviewers found there had been “slow progress” against concerns raised a year earlier. Read full story Source: The Independent, 16 February 2023
  9. News Article
    The Royal College of Midwives (RCM) has not met thresholds required to strike in its vote, it announced today, but physiotherapy staff are set to strike at more than 100 trusts in their first ever action ballot over pay. The trade union announced this afternoon that its ballot had not reached the turnout required to take strike action. 88& of those who voted said they supported strike action, but only about 47% of eligible members voted. Law requires a turnout of at least 50%, the RCM said. It comes as nurses prepare to take industrial action on 15 and 20 December, over pay and safety concerns, with ambulance staff across the GMB Union, Unison and Unite set to walk out on 21 December (and GMB also on 28 December). Read full story (paywalled) Source: HSJ, 13 December 2022
  10. Event
    until
    Interested in sustainability and a Greener NHS? Join the Nursing and Midwifery Sustainability Network and help improve health now and for future generations. Nurses, midwives and care staff have a unique role to play in supporting the NHS’ net zero goal. They are already making tangible changes to tackle climate change while improving care. And together, we can achieve even more. That’s why NHS England is launching a Nursing and Midwifery Sustainability Network. The network will create a space and opportunity to share ideas, successes, and innovative practices and it will help us to address barriers and discuss challenges in order for our professions to make a real impact. Nurse, midwives and care staff prove every day that that they are adept at identifying issues and creating solutions – skills that are immensely valuable in reducing the NHS carbon footprint and delivering the NHS’ net zero goal. Come along to the online launch event and first network meeting to find out more about the network and how you can get involved. Open to all nurses and midwives working within the NHS in England, please sign up using your NHS email. Further information
  11. News Article
    Mothers are being offered water injections by the NHS to relieve pain during childbirth, while in some hospitals midwives are burning herbs to encourage breech babies to turn in the womb. Safety campaigners have dubbed the practices dangerous and say that they amount to “pseudoscience” being offered by the health service. They have called on the chief executive of NHS England, Amanda Pritchard, to ban their use in a letter published over the weekend. At least three trusts in England offer water injections for pain relief, including Newcastle upon Tyne Hospitals Trust, United Lincolnshire Hospitals Trust and North Tees and Hartlepool Trust. Information on the Newcastle trust’s website describes the injections as an “alternative form of pain relief” while in Lincolnshire patients are told the body’s response to the injections “prevents pain signals from reaching the brain.” The National Institute for Health and Care Excellence (NICE), which is responsible for setting out which treatments patients should receive, has said the NHS should not use injected water for pain relief. Read full story (paywalled) Source: The Times, 27 November 2022
  12. Content Article
    This article for Vogue explores the experience of a midwife working in an overstretched maternity unit in England. Melissa Newman, who has been a midwife for nearly six years, highlights the impact of staff shortages on midwives—she describes how she does not have time to eat, avoids drinking because she will not have time to go to the toilet, and sometimes works fifteen hours without any break. She calls on the Government for more funding to fix the crisis facing NHS maternity services, and the NHS more widely.
  13. News Article
    The death of a three-day-old baby could have been avoided if medical professionals had acted differently, a coroner concluded. Rosanna Matthews died three days after being delivered at Tunbridge Wells Hospital in Kent in November 2020. The hospital trust apologised, saying the level of care for Ms Sala and her daughter “fell short of standards”. Ms Sala told the inquest midwives were "bickering" and appeared confused during her labour. She claimed that if she had been allowed to start pushing when she wanted to, instead of waiting as midwives advised, Rosanna would have lived. Rachel Thomas, then deputy head of gynaecology and midwifery, said there had been "errors in communication". Following the conclusion of the inquest, the coroner ruled Rosanna died following a “prolonged period of avoidable hypoxia”, which led to brain damage. The coroner, sitting in Maidstone, also found midwives at the hospital failed to recognise that Rosanna was already unwell with congenital pneumonia. Ms Sala said her daughter could have lived had medical professionals acted differently on the day of her birth. Read full story Source: BBC News, 8 November 2022
  14. Content Article
    Racism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
  15. Content Article
    This analysis by The Health Foundation looks at NHS staff pay over the ten years to 2021. During those 10 years, there was very little change in overall average basic pay for NHS staff, after accounting for inflation. However, the analysis found considerable variation in how pay has changed across different NHS staff groups over the same period. After accounting for inflation, pay declines are particularly visible for nurses and health visitors, midwives, and scientific, therapeutic and technical staff.
  16. Content Article
    In this article for The Times, Deborah Ross describes her negative experience of NHS maternity care during and after labour, and how this has put her off having more children. During her 72-hour labour and subsequent hospital admission, she was denied pain relief, did not feel listened to and was not informed as to why her baby had been transferred to NICU.
  17. Content Article
    Appreciative Inquiry (AI) is a research approach that aims to create practical and collaborative change by taking participants through an in-depth exploration of their organisation, team or role. This article in the European Journal of Midwifery reflects on the process of using AI in a study that explored staff wellbeing in a UK maternity unit. The authors share key lessons to help others decide whether AI will fit their research aims, and highlight issues in its design and application.
  18. Content Article
    Reports showing that babies and mothers died or were harmed as a result of failures by, and sometimes heartless cruel treatment in, NHS maternity units are becoming worryingly common. Dr Bill Kirkup’s just-published 192-page exposé of an appalling catalogue of failings at East Kent NHS trust between 2009 and 2020 is the second in the last 12 months. As many as 45 babies and 23 mothers in East Kent died avoidably during that time because their care was substandard, his inquiry found. March brought Donna Ockenden’s grim findings about poor maternity care at the Shrewsbury and Telford trust. And Kirkup produced the first detailed exposition of what inadequate care of women and their offspring during childbirth looked like when in 2015 he laid bare “serious and shocking” lapses in care at Morecambe Bay trust. A fourth official inquiry, again being led by Ockenden, is under way into death, brain damage and other horrendous outcomes at the Nottingham trust. Families affected claim that, despite coroners’ findings, close scrutiny of the trust by regulators, media coverage of lapses in care and pressure for change, “babies, mothers and their families continue to be harmed”. No wonder Rob Behrens, the NHS Ombudsman, says: “The phrase ‘never again’ is starting to ring hollow.”
  19. News Article
    Two out of five maternity units in England are providing substandard care to mothers and babies, the NHS watchdog has warned. “The quality of maternity care is not good enough,” the Care Quality Commission (CQC) said in its annual assessment of how health and social care services are performing. It published new figures showing it rated 39% of maternity units it inspected in the year to 31 July to “require improvement” or be “inadequate” – the highest proportion on record. Ian Trenholm, the CQC’s chief executive, said maternity services were deteriorating, substandard care was unacceptably common and failings were “systemic” across the NHS. Its latest state of care report said: “Our ratings as of 31 July 2022 show that the quality of maternity services is getting worse, with 6% of NHS services (nine out of 139) now rated as inadequate and 32% (45 services) rated as require improvement. “This means that the care in almost two out of every five maternity units is not good enough.” The report said: “The findings of recent reviews and reports … show the same concerns emerging again and again. The quality of staff training, poor working relationships between obstetric and midwifery teams and a lack of robust risk assessment all continue to affect the safety of maternity services. These issues pose a barrier to good care.” Staff not listening to women during pregnancy and childbirth is a recurring problem, Trenholm said. Their concerns “are not being heard” by midwives and obstetricians “in the way that they should”. Read full story Source: The Guardian, 21 October 2022
  20. Content Article
    This article by Carrie Murphy looks at the practice of inserting a 'husband stich' or 'daddy stitch', where midwives or obstetricians make an unnecessary extra stitch when repairing episiotomies or tearing from birth. The belief is that it will make the vaginal opening tighter and therefore increase pleasure for the woman's sexual partner. The author highlights that this is a real practice that has been carried out on women for many years, and describes the ongoing impact it can have on women affected, many of whom don't realise they have been given too many stitches. This misogynistic and unethical practice can cause additional pain for women during sex. The women featured in this article state that they did not consent to the practice, being vulnerable after childbirth and in many cases unaware of what a 'husband stitch' was. Angela Sanford reports only finding out that she had a 'husband stitch' five years after birth at a cervical screening appointment where the nurse expressed concern. Murphy expresses her concern that the practice may still be carried out without women's consent, leaving them feeling violated and in pain.
  21. Content Article
    This joint report by the APPG on Baby Loss and the APPG on Maternity is a culmination of over 100 submissions to an open call for evidence from staff, service users and organisations, on the maternity staffing crisis. It paints a picture of a service that is at breaking point and staff that are over-worked, burnt out and stressed.
  22. Content Article
    This article in the Manchester Evening News details the experience of Amy, whose daughter Harper was stillborn following failings in Amy's care. After being induced, Amy was left on her own in a room at the Royal Oldham Hospital's maternity unit overnight, without any monitoring. She had raised concerns about her baby's reduced movements but was denied additional checks. When Amy was finally checked in the morning, Harper had no heartbeat. An internal investigation conducted by The Royal Oldham Hospital found that if Amy had received appropriate monitoring, CTG abnormalities would have been noticed. This would have led to an escalation in her care, earlier delivery and Harper is likely to have been born alive.
  23. Content Article
    This framework from NHS England supports nurses, midwives and care staff in ensuring care remains at a high standard, as well as demonstrating the contribution to the Long Covid response. It aims to give the opportunity to embrace collective leadership in supporting people and communities served and showcase good practice as it emerges across England.
  24. Content Article
    This article tells the story of Baby E, who died two hours after delivery following issues with the management of her labour. The maternity unit was short-staffed on the night of Baby E's birth and there were delays in getting her mother to theatre for a caesarean section. Baby E's parents felt that the hospital withheld information from them, failing to inform them of internal investigations that had taken place following Baby E's death. At the inquest, the coroner concluded that errors had been made, including the fact that Baby E's low heart rate had been missed. She also criticised the decision-making process in the management of labour, but concluded that she was unable to say whether this had made a difference to whether or not Baby E lived.
  25. News Article
    NHS England has this week told trusts it is abandoning a patient safety target ‘until maternity services in England can demonstrate sufficient staffing levels’ to meet it. The Midwifery Continuity of Care model was designed to ensure expectant mothers would be cared for by the same small team of midwives throughout their pregnancy, labour and postnatal care. It was a key recommendation of 2016’s Better Births review of English midwifery services. NHSE’s chief midwifery officer for England Jacqueline Dunkley-Bent championed the policy and guidance on its implementation was issued in October. However, in her report on the care failures at Shrewsbury and Telford Hospital Trust’s maternity department, Donna Ockenden said the Midwifery Continuity of Care model should be suspended until more evidence was gathered about its effectiveness and there were enough midwives to meet minimum staffing requirements. Ms Ockenden said patient safety had been “compromised by the unprecedented pressures that Continuity of Care models of care place on maternity services already under significant strain”. Read full story (paywalled) Source: HSJ, 23 September 2022
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