Midwives magazine: Issue 3 :: 2012
The RCM wanted to create an environment to encourage dialogue between itself and its MSW members. To this end, it has embarked on a pilot initiative in a number of London trusts delivering bespoke workshops, with a view to rolling it out to the rest of the UK. Here are the key issues that have been raised so far…
Training: what’s happening nationally?
The impact on MSWs
It was announced in November 2011 that the government was to commission work to develop a code of conduct and minimum training standards for healthcare support workers. Currently there is no minimum standard of education for MSWs, with some undertaking a foundation degree, a diploma or an apprenticeship programme, but a significant number receive very little training. Where training is provided by the employing trust, it is often not transferable to a subsequent employer. Skills for Health and Skills for Care have been commissioned to carry out this work. A steering group has also been set up, of which the RCM has membership. It is envisaged that the work of NHS Wales and NHS Scotland, who already have a code of conduct for support workers, will be heavily drawn upon.
The importance for MSWs
The RCM has developed a bespoke workshop on numeracy for MSWs. Numeracy skills are essential in securing employment and training. For example, to access an MSW apprenticeship, a learner will need to be at level one (equivalent to GCSE grade D to G) in numeracy. The workshop uses an audience participation system similar to the television programme Who Wants to be a Millionaire? so that participants can remain anonymous as to how accurately they answer the question. This provides a safe environment to assess one’s skills.
Midwife → MSW
Delegation in midwifery
The delegation of tasks to an MSW by a midwife can be cause for concern for both parties. If a midwife asks an MSW to undertake a task, which the MSW wrongly carries out and causes harm, who is responsible? The midwife is responsible for the delegation of an appropriate task to a competent MSW, but it is then the responsibility of the MSW to carry out the task. The midwife, while remaining accountable for the overall management of the client, will not be accountable for the decisions and actions of the MSWs. However, if a midwife delegates a task to an MSW that requires midwifery training, this would be an inappropriate task and the midwife will remain accountable with possible consequence for her continued registration. The midwife will also be accountable if she delegates the task, but does not establish that the MSW has been trained and assessed as competent to carry it out.
The wide variations
The banding of posts is often an area of contention for MSWs, particularly if they are on different bands, but it is not transparent as to how the banding has been applied. MSWs can be banded 2, 3 or 4 using the national job profiles for healthcare support workers at bands 2 and 3 and the maternity care assistant at band 4. The RCM has identified that there is a wide variation in how MSWs are banded in what are very similar roles. This can cause acrimony among MSWs, which can impact on the delivery of care.
► Inform MSWs of the national position in respect of their developing role
► Consider the tasks and responsibilities of MSWs and the process of delegation
► Provide the opportunity to discuss and celebrate the MSW role.
Where have they been held?
► Lewisham Hospital NHS Trust
► Whipps Cross University Hospital NHS Trust
► Whittington NHS Trust
► Imperial College Healthcare NHS Trust
► Kingston Hospital NHS Trust
► Chelsea and Westminster Hospital.
In a video interview, an MSW detailed how she has progressed in her role. As an HCA working in a maternity unit, she felt unchallenged in her role and frustrated that she was unable to offer more support to her midwifery colleagues. She was offered the opportunity to undertake a foundation degree and having completed her degree she now works as breastfeeding advisor.
► Watch the interview at: www.youtube.com/watch?v=aBS3vNJcCso
The workshops provided the opportunity to discuss the RCM’s The Roles and Responsibilities of MSWs guidance document, which was launched in November 2011. This document details those tasks that the RCM believes are appropriate for MSWs to undertake and those that they shouldn’t.
The RCM is developing guidance on the banding of MSW posts to support its position that ‘job evaluation principles must be adhered to when banding MSW posts’. This guidance should be available in early summer.
RCM employment relations advisor
RCM. (2010) Position statement: maternity support workers. RCM: London.
RCM. (2011) The roles and responsibilities of maternity support workers. RCM: London.