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Midwives call for common sense on maternity visiting guidance

on 15 December 2020 Maternity Services Maternity Safety covid-19 Covid-19 NHS NHS England NHS Staff RCM RCM CEO

The Royal College of Midwives (RCM) today has called on NHS Trusts in England to exercise common sense when considering whether to increase attendance of supporters and visitors at maternity services. The call comes as NHS England publishes new guidance which urges Trusts to do all they can to open the doors of maternity services.

Responding to the new rules in an open letter to all maternity staff in England, Gill Walton, Chief Executive of the RCM, said:

“We support and trust local maternity and midwifery leaders to make decisions in the best interest of the women in their care. We trust them to work with health and safety representatives and to follow NHS England’s own risk assessment process, which enables maternity services to make decisions about visiting and access for partners and families that are based on current, local information. With more areas moving into Tier 3 restrictions, many will question the common sense of releasing this new guidance now.”

The RCM, along with the Royal College of Obstetricians & Gynaecologists and the Society and College of Radiographers, was consulted on previous drafts of the guidance and gave feedback based on 10 principles. However, not all of these principles were adopted by NHSE and so the RCM is unable to endorse this new guidance.

The RCM believes that these common sense principles, alongside health and safety legislation and the Nursing and Midwifery Council Code, should be applied to decisions about opening up access so that maternity staff are able to carry out their work as safely as possible, while ensuring that the women in their care receive the support they want and need from partners, friends and family.

The 10 common sense principles are:

 

  1. Safety must be the paramount concern.

  2. It is vital that respect for, and trust in, those taking evidence-based decisions around care and access is reflected in the tone and language of this and any future guidance.

  3. Recommendations made by local decision makers to mitigate risk should be supported.

  4. Attendance of partners during labour and at birth must be the priority.

  5. Reliable testing should be available for all women and partners attending maternity services.

  6. Appropriate PPE should be available for all partners and visitors, and must be worn.

  7. NHS England should use its channels and platforms to share good practice around access and safety.

  8. Decisions made based on risk assessment should be simple and robust and clearly communicated to women currently using the service.

  9. The approach taken around access to maternity services is proportionate to the policy used in the rest of the Trust.


  10. Individualised risk assessments are undertaken for individuals with special requirements, including women who have previously experienced or are currently going through pregnancy loss, difficult pregnancies or birth trauma.

 

The RCM’s greatest concern, though, is that safety is being sacrificed in favour of popularity. Gill Walton continued:

“We have made it clear to NHS England that we will use these principles to shape our ongoing response to the new guidance, responding to changes in local circumstances, including shifts in the Government’s Tier system. We will not hesitate to raise concerns where we believe non-application of these principles is putting our members’ safety – and that of the women and families in their care – at risk. We know that doing the right thing is not always popular and that there will be some who do not agree with our stance. We have been clear throughout the pandemic that keeping our members and the women and families in their care safe is the right thing to do. Safety, not popularity, is our priority.”

 

ENDS

 To contact the RCM media office call 020 7312 3456 or email media@rcm.org.uk.


Notes to Editors

 

  • The RCM common sense principles when considering whether to increase attendance of supporters and visitors at maternity services are as follows:
  1. Safety must be the paramount concern.
    Any consideration of the needs of women and their partners to attend maternity appointments, including scans, prior to labour and birth should be balanced against the need to protect the safety of women, hospital patients, staff and the wider community.

  2. It is vital that respect for, and trust in, those taking evidence-based decisions around care and access is reflected in the tone and language of this and any future guidance.
    The significant steps maternity services have taken – and continue to take – to ensure women and their partners have as positive a pregnancy and birth experience as possible should be recognised.

  3. Recommendations made by local decision makers to mitigate risk should be supported.
    Where potential risks to safety are identified, there should be senior support to ensure that risk is mitigated, including but not exclusive to limits on visiting or attendance.

  4. Attendance of partners during labour and at birth must be the priority.
    While the presence of partners at antenatal appointments are important, where difficult evidence-based decisions around access have to be made, the priority must be for partners to attend labour and birth.


  5. Reliable testing should be available for all women and partners attending maternity services.
    NHS England’s recommendation that rapid testing is made available for all women and partners attending maternity services, whether for appointments, scans or birth, will improve confidence around COVID safety. However, the significant logistics of applying this to all maternity services may include a significantly increased workload for staff in managing the testing process, which could take them away from their key role of providing care to women.

 

  1. Appropriate PPE should be available for all partners and visitors, and must be worn.
    Once a negative test has been received, partners and visitors should be given appropriate PPE and be required to wear it to ensure their, and staff, protection.
  2. NHS England should use its channels and platforms to share good practice around access and safety.
    Adaptations could be rolled out to other Trusts more quickly and effectively if good practice were shared through existing channels and platforms.

  3. Decisions made based on risk assessment should be simple and robust and clearly communicated to women currently using the service.
    Local maternity leaders should be trusted to take the right decision for their service, based on clear risk assessment criteria. Clear communication with women using the service will improve engagement and adherence to the rules put in place.

  4. The approach taken around access to maternity services is proportionate to the policy used in the rest of the Trust.
    Difficult decisions are being taken across NHS Trusts around access for patients and visitors. The approach taken within maternity services must be in line with those in place elsewhere in the Trust, and particularly on the same site.

  5. Individualised risk assessments are undertaken for individuals with special requirements.
    Women who have previously experienced or are currently going through pregnancy loss, difficult pregnancies or birth trauma may require additional support. Individualised risk assessments to allow compassionate visiting should be instigated in these cases.

 

 

 

 

 

 

 

The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit the RCM website at https://www.rcm.org.uk/.

 

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