The RCM s Role in Delivering Safe Maternity Care Gill Walton Chief Executive
Overview 2 What is the RCM s purpose? My priorities Safety, Partnership, Leadership Our activity
What is the RCM s purpose? 3 We promote, support & influence on behalf of our members, in their interests and that of pregnant women and their families. We bridge the gap between policy and practice by influencing policy and creating tools to make it easier for midwives and maternity support workers to do the right thing. We believe that leadership, partnership, and safety are key to make Better Births a reality for women and their families, midwives, MSWs and the whole maternity team.
Leadership 4
Leadership why does it matter? 5 it was difficult to identify evidence of strong and decisive leadership. High-quality leadership skills are required in those difficult circumstances. Morecambe Bay Report, March 2015 Leadership is crucial for a safety culture and building high performing teams Better Births, 2016
Building leaders at all levels 6 RCM leadership courses Band 6 midwives Aspiring/new Labour Ward co-ordinators Labour Ward Leaders (finalist for 2017 HSJ award) RCM Career Framework 2018 Describing the myriad of midwifery roles and where midwifery skills can be used NHS, local government, central government, charity and voluntary, education and research NHSI Leadership masterclass for Heads and Directors of Midwifery Isn t it time for Directors of Midwifery to become the norm alongside Directors of Nursing?
Leading safe workplaces 7
Partnership why does it matter? 8 Women and their families at our centre Montgomery v Lanarkshire makes it clear women lead us Serious failures of team-working and the importance of high performing teams Morecambe Bay report and Better Births Influencing on behalf of our members and women Stronger when we work together
Better together 9 Multi-professional working, breaking down barriers between midwives, obstetricians and other professionals to deliver safe and personalised care in partnership with women Healthy culture Strong leadership Working together Training together Clear communication through handover Multi-professional peer review
Safety why does it matter? 10 Too much too soon, too little too late Lancet Series on global maternal health, and the NMPA data shows women are at risk of both We know England can improve Secretary of State s ambition and resolve has grown Multi-faceted safety, for women, for staff Safer care, with professionals working together across boundaries to ensure rapid referral, and access to the right care in the right place; leadership for a safety culture within and across organisations; and investigation, honesty and learning when things go wrong. Better Births Report, 2016
Midwifery services are under the spotlight 11 Maternity Transformation in England Secretary of State for Health s ambition to reduce stillbirth, neonatal brain injury and neonatal death by 50% by 2030 The drive to improve culture and team work within maternity units. Reducing harm through learning from serious incidents and litigation claims Increasing complexity Midwifery and obstetric staffing
RCM Safety offer 12 NHS Improvement Maternal and Neonatal Health Safety Collaborative
RCM Safety offer 13 National Maternity and Neonatal Audit with RCOG Benchmarking services to highlight where we can improve Safety huddles with NHSI Guidance for safety huddles and handover for real-time learning Attain: reducing term admissions to neonatal units, with NHSI Guidance for perinatal review teams, data findings, practice points and system actions Supernumerary status of Labour Ward Coordinators now linked to lower CNST premiums ATAIN positively changing policy New ilearn modules to upskill our members Safeguarding and child protection Promoting Compassionate and Supportive workplaces Saving Babies Lives: addressing stillbirths
14 There is no typical maternity unit 21% of trusts and boards offer the full range of birth settings 77% offer homebirth Two thirds of obstetric units are now co-located with an alongside midwife-led unit 15% of maternity services said they provide continuity of carer through antenatal, labour and postnatal care 97% of providers use electronic systems but half say community midwives can t access the systems and only 10% give women have access to their records
15 Interventions in the care bundle Speaking with the woman about her risk and OASI and communicating with her during the birth to enable a slow controlled birth of the baby, Performing an episiotomy when required, Using the hands to enable perineal protection at the time of birth A thorough examination after birth to detect tears
16 review once, review well Free online tool Facilitate high quality standardised perinatal reviews Four elements The Perinatal Mortality Review Tool Training Involvement of parents National reporting
17 Reducing harm leading to avoidable admission of full-term babies into neonatal units Patient Safety Alert in February 2017 Focussed on hypoglycaemia, jaundice, respiratory conditions and asphyxia In partnership NHSI the RCM are working on the asphyxia workstream to: Develop standards for safety huddles and handovers Develop role descriptor and competency framework for labour ward coordinators Recommend and lobby for supernumerary status of labour ward coordinators Delivering multidisciplinary workshops for labour ward leaders
18 National Maternal and Neonatal Health Safety Collaborative Three year programme quality improvement programme to: improve clinical practices reduce unwarranted variation report on how they are contributing to achieving the national ambition All trusts in England will participate over three years supported by NHSI, first wave ongoing Projects include CTG interpretation Smoking cessation RCM will support by sharing learning
Getting it right for women and babies 19
For further information Website: www.rcm.org.uk Telephone: 0300 303 0444 Email: info@rcm.org.uk www.facebook.com/midwivesrcm @MidwivesRCM