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A RECENT RCM survey of Heads of Midwifery across Britain found that almost three quarters are relying on a significant or moderate level of goodwill from their staff, including working extra hours to give high quality, safe care. Midwives are worn out and stressed; workplace culture is significantly affected by demands on staff and how staff are treated has a direct effect on patient care. Equality in the workplace is fundamental to reducing inequalities in care.
An RCM member survey that accompanied the launch of our Caring for You campaign found over half had experienced harassment, bullying or abuse from service users or their families in the last 12 months and a third reported being on the receiving end of this from a manager.
However, this is not a problem isolated in maternity units, the most recent NHS Scotland staff survey revealed this is a widespread issue. A third of staff said they do not have confidence and trust in senior managers responsible for the wider organisation and one in 10 do not feel appreciated.
In Scotland we have the advantage of strong negotiated procedures in the NHS due to the hard work of trade unions and a strong tradition of partnership working. We believe that a coordinated national approach to address negative workplace cultures across NHS Scotland is now required.
The RCM’s Caring for You campaign asks heads of midwifery to sign up to a charter to commit to work in partnership to improve the health, safety and wellbeing of staff, foster a positive working environment, nurture a compassionate workforce and ensure NHS staff have access to occupational health and other policies for their mental and physical health, safety and wellbeing. We know that trade unions are key to positive change in the workplace and we need to come together to tackle this nationally through STUC and locally through staff-sides working together.
While we acknowledge the laudable aims of programmes such as the “I Matter” approach to team building in the NHS in Scotland, we have to hold employers to account to ensure words are turned into action and bullying and harassment are eradicated from the NHS.
The RCM’s second STUC motion is focused on “Best Start” which is the five year plan for improving maternity and neonatal services in Scotland. We welcomed this policy, it is groundbreaking and if implemented correctly could improve care and outcomes for women and their families. It is, however, a major shift in maternity services and in how midwives and maternity support workers work. The proposed new model of maternity care in Scotland is built around “Continuity of Carer.”
This means that a woman receives their care from a midwife who they know, from antenatal right through the birth and the early days of parenting. RCM Scotland have argued over the last two years that we need the right conditions and staffing levels for these changes to be safely implemented. Our lobbying has led to £12 million of ring-fenced funding, increased student midwife numbers and a review of the midwifery workforce planning tool.
As implementation of the Best Start recommendations gathers pace across Scotland, the RCM wishes to ensure that the Scottish government and Health Boards approach this process in the spirit of true partnership working, collaboration and co production.
While many of our members are keen to work in this way, a significant number of our members are concerned about the demands of being on call and the potential impact on their work life balance of this model of care. Midwives will need time, training and support to feel confident to work in different ways. Midwives’ needs for adequate rest and time off must be respected in any model of care.
The pace of change should not be forced, implementation of such a significant change must be undertaken in a measured way, ensuring that lessons from early adopter sites are heeded. Managers must evaluate to ensure that new models of care work for our members as well as the women and families we care for.
As a trade union we will support all our members, our Workplace Representatives are involved in local implementation boards and advisory groups, supporting members both individually and collectively. Essentially both our STUC motions are linked, when staff feel appreciated and organisations work in partnership with them and trade unions, change is viewed more positively and patient care improves.
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