Local midwives overcome legislative barriers to ensure continuity of care for mothers-to-be
Local midwives, Rene Bozier (Schwencke) and Sally Harley, explain how they and their colleagues overcame barriers to their work environment, presented by recent changes to EU law, to ensure they can still offer full continuity of care to women with "a midwife she knows and trusts" throughout pregnancy, birth and the postnatal period.
Independent midwives have for many years had great difficulty in finding insurers willing to underwrite the professional negligence risks associated their profession. It has until recently been the case that as midwives are unable to secure this cover, they should declare this fact to the women in their care.
However, new EU rules come into force this Autumn and will require all health professionals to have insurance cover. Furthermore, it will become the regulator's responsibility to gain assurances that this cover exists.
This has meant that midwives have to find a solution to this rather tricky quandary. Sadly, some have not been able to continue their work and so have ceased to assist women in childbirth.
Rene Bozier tells us how she and her colleagues have approached the new requirements asked of the profession and what she thinks about how this has affected women's choices when giving birth.
Questions:
How was the new legislation approached?
Independent Midwives have been aware for many years that this problem was looming. I was involved with a group within IMUK to seek a solution, and which would also provide our model of care for all women. The hope was that we could develop a Community Midwifery Model that could gain NHS contracts to provide care and allow midwives to contract into the model. It soon became clear to us that the difficulty lies in the self employed model. Insurance companies are most unwilling to provide cover for, say, 30 individuals, but will provide cover for one organisation employing 30 individuals. Even if the model of care and guidelines are the same, the insurance industry sees the risk differently. So we took the difficult decision to set up an employing organisation; It's a Social Enterprise with the long term aim of providing the service free at the point of delivery and it is 100% employee owned to ensure that the midwives felt as empowered as possible. Neighbourhood Midwives was born.
Have you obtained insurance and if so, how?
Yes, we have full insurance for the full care pathway including birth and we are CQC (Care Quality Commission) Registered. The insurance was obtained by setting up a credible well structured organisation with good governance which meets all the required regulations.
Although Neighbourhood Midwives was created in response to the insurance issue, we now believe that it could change the way maternity services are delivered in the UK as it is a sustainable caseload model that can be replicated throughout the NHS.
Has this been a difficult process?
Incredibly difficult. At times we wondered whether a solution really existed. The founders have worked virtually full time for the last 18 months on this but have acquired some wonderful supporters along the way. Business advisers, lawyers, accountants, PR people, learning from them all. There have been terrible obstacles but the one thing learnt is to be flexible and not give up, it is too important.
How has this made you all feel?
Exhausted, despairing and exhilarated in equal measure, but we all have daughters and we know so many women who have benefited from this type of care that we could never give up.
Has this improved or detracted from the experience of pregnant women?
The recent period of uncertainty has, I think, been very unsettling for women but now we are up and running we know that we can make a difference to women's experiences. At the moment we have to offer the service as self funded for women who wish to pay for their midwifery care but ultimately we will obtain NHS contracts so that any woman can choose us or a similar provider.
Being a social enterprise is vital to us and this means that any surpluses are ploughed back into improving the service or for community based projects for childbearing women.
What does this means for women who want more choice?
Ultimately it will mean that a woman can choose full continuity of care with a midwife she knows and trusts regardless of where she gives birth or her level of risk. In the short term women can buy parts of their midwifery care, e.g. postnatal care or the full care package but we work together with the NHS to ensure all of the woman's needs are met? The NHS also benefits as we can ease some of the pressure.
Does this protect or harm women? Is it a sensible approach?
It can only benefit women. Research shows that continuity of care is the gold standard offering a wide range of health benefits. Also these benefits continue into parenthood and for many years.
It is also good for midwives offering them more choice and freedom over their working life but with the benefits of security, holidays, pension etc. The employee ownership model is really important to us, we have been described as "the John Lewis of midwifery" and all of our midwives will be partners with equal votes in determining the course of business.
Sensible? To me it's a no brainer.
Neighbourhood Midwives offer FREE consultations in the comfort of your own home.
Telephone 0208 874 6624
or e-mail: info@neighbourhoodmidwives.org.uk
or contact one of our midwives directly on:
Rene Bozier 07585 129 055
Sally Harley 07952 653 482
Visit their website HERE
Local midwives, Rene Bozier (Schwencke) and Sally Harley, explain how they and their colleagues overcame barriers to their work environment, presented by recent changes to EU law, to ensure they can still offer full continuity of care to women with "a midwife she knows and trusts" throughout pregnancy, birth and the postnatal period.
Independent midwives have for many years had great difficulty in finding insurers willing to underwrite the professional negligence risks associated their profession. It has until recently been the case that as midwives are unable to secure this cover, they should declare this fact to the women in their care.
However, new EU rules come into force this Autumn and will require all health professionals to have insurance cover. Furthermore, it will become the regulator's responsibility to gain assurances that this cover exists.
This has meant that midwives have to find a solution to this rather tricky quandary. Sadly, some have not been able to continue their work and so have ceased to assist women in childbirth.
Rene Bozier tells us how she and her colleagues have approached the new requirements asked of the profession and what she thinks about how this has affected women's choices when giving birth.
Questions:
How was the new legislation approached?
Independent Midwives have been aware for many years that this problem was looming. I was involved with a group within IMUK to seek a solution, and which would also provide our model of care for all women. The hope was that we could develop a Community Midwifery Model that could gain NHS contracts to provide care and allow midwives to contract into the model. It soon became clear to us that the difficulty lies in the self employed model. Insurance companies are most unwilling to provide cover for, say, 30 individuals, but will provide cover for one organisation employing 30 individuals. Even if the model of care and guidelines are the same, the insurance industry sees the risk differently. So we took the difficult decision to set up an employing organisation; It's a Social Enterprise with the long term aim of providing the service free at the point of delivery and it is 100% employee owned to ensure that the midwives felt as empowered as possible. Neighbourhood Midwives was born.
Have you obtained insurance and if so, how?
Yes, we have full insurance for the full care pathway including birth and we are CQC (Care Quality Commission) Registered. The insurance was obtained by setting up a credible well structured organisation with good governance which meets all the required regulations.
Although Neighbourhood Midwives was created in response to the insurance issue, we now believe that it could change the way maternity services are delivered in the UK as it is a sustainable caseload model that can be replicated throughout the NHS.
Has this been a difficult process?
Incredibly difficult. At times we wondered whether a solution really existed. The founders have worked virtually full time for the last 18 months on this but have acquired some wonderful supporters along the way. Business advisers, lawyers, accountants, PR people, learning from them all. There have been terrible obstacles but the one thing learnt is to be flexible and not give up, it is too important.
How has this made you all feel?
Exhausted, despairing and exhilarated in equal measure, but we all have daughters and we know so many women who have benefited from this type of care that we could never give up.
Has this improved or detracted from the experience of pregnant women?
The recent period of uncertainty has, I think, been very unsettling for women but now we are up and running we know that we can make a difference to women's experiences. At the moment we have to offer the service as self funded for women who wish to pay for their midwifery care but ultimately we will obtain NHS contracts so that any woman can choose us or a similar provider.
Being a social enterprise is vital to us and this means that any surpluses are ploughed back into improving the service or for community based projects for childbearing women.
What does this means for women who want more choice?
Ultimately it will mean that a woman can choose full continuity of care with a midwife she knows and trusts regardless of where she gives birth or her level of risk. In the short term women can buy parts of their midwifery care, e.g. postnatal care or the full care package but we work together with the NHS to ensure all of the woman's needs are met? The NHS also benefits as we can ease some of the pressure.
Does this protect or harm women? Is it a sensible approach?
It can only benefit women. Research shows that continuity of care is the gold standard offering a wide range of health benefits. Also these benefits continue into parenthood and for many years.
It is also good for midwives offering them more choice and freedom over their working life but with the benefits of security, holidays, pension etc. The employee ownership model is really important to us, we have been described as "the John Lewis of midwifery" and all of our midwives will be partners with equal votes in determining the course of business.
Sensible? To me it's a no brainer.
Neighbourhood Midwives offer FREE consultations in the comfort of your own home.
Telephone 0208 874 6624
or e-mail: info@neighbourhoodmidwives.org.uk
or contact one of our midwives directly on:
Rene Bozier 07585 129 055
Sally Harley 07952 653 482
Visit their website HERE
This article was first written by Helen Smith PR - helenpatriciasmith@gmail.com
