In March 2017, due to the vision of then Head of Midwifery Mary Armitage, Airedale NHS Trust pioneered a new way of working collaboratively with the independent midwives (IMs) of Yorkshire.
Independent midwife Claire explained, “In January 2017, the UK’s independent midwives
had been prevented by the NMC from using our bespoke indemnity arrangement, leaving us temporarily unable to attend the births of already booked clients. By offering us bank contracts with the Trust, Airedale supported the Yorkshire IMs to continue to attend the births of our clients by providing the legal indemnity cover required by all registered midwives practising in the UK.”
This arrangement saw IMs being able to continue to provide ‘Gold Standard’ support to
women across Yorkshire and beyond, and resulted in an increased home birth and continuity of carer rate for Airedale, inline with NHS England Better Births (2016). The collaborative arrangement was popular with both independent midwives and clinical staff at Airedale.
“We have built warm, supportive, and mutually educational and beneficial relationships, as well as working arrangements, with each other over the three years,” said IM Deborah. “I gained so much from working [together], by sharing our collective midwifery wisdom and experiences. I have loved getting to know you all and learning from you. I have huge admiration and respect for all of you,” said Airedale midwife Susan, of her IM colleagues.
Airedale Trust were able to claim the maternity tariffs for each of the IMs’ home-birthing
clients which had previously gone unclaimed by the NHS. IMs contributed by working bank shifts to cover staff shortages in the hospital and by providing a lot of ‘on call’ cover for the home birth service, keeping it open and available to Airedale’s own home birth clients.
NHS midwife Laura said, “the IMs covering the homebirth service facilitated women on my caseload to have homebirths that would have not been available otherwise! I have equally had the pleasure of attending homebirths with IMs which I found to be a reassuring and learning experience. I have been in awe of the care you provide and I would have no hesitation in booking my own care with you.”
The IMs’ passion for informed choice, individualised care, and facilitating physiological
approaches to childbirth was incorporated into study days, and they also became involved with guideline writing. “I have particularly enjoyed the study updates and feel that these were a huge enhancement to my practice… and my confidence in supporting women to make informed choices, and supporting women who want care outside of hospital and national guidelines,” commented Laura. “I have always been inspired by the work of independent midwives, the commitment to normality, provision of truly informed choice and family centred care.”
“Through both discussions and working alongside each other, we IMs were able to benefit from the experience of the Trust midwives; this broadened my understanding of hospital based complex care and associated options,” said IM Sharyn. “It also reminded me how challenging advocating for women can be, within the NHS, and how much I respect midwives who face up to this challenge. There are so many amazing Airedale folks I will really miss working with.”
Despite being a successful working arrangement for three years, with IM clinical care
leading to no adverse outcomes, and with a great deal of positive feedback from both IM
clients and Airedale clinical staff, the collaborative working arrangement has now come to an end, after changes at Airedale Board level.
“I can’t tell you how sad I am about this partnership ending, for the women and for the
staff. I was slightly apprehensive at first how things would work, but I can say hand on
heart it has been a pleasure, both to work alongside and to have learnt a lot from all of
you,” said NHS midwife Alison.
Women booked under the scheme prior to 16th March 2020 will have their birth indemnity cover honoured, but the arrangement is now closed to new bookings. Chelsea & Westminster NHS Trust continue to successfully move forwards with a very similar agreement in place. Ideally other NHS Trusts may wish to take advantage of the opportunities of working with independent midwives to continue supporting women’s choices and rights in pregnancy and childbirth.
This statement was written by
Deborah Rhodes IM
Deborah Neiger IM
Claire Harbottle IM
Hannah Beatty IM
Amanda Wardle IM
Sharyn Lock IM