This compendium presents the best in our profession, with projects to inspire you and vision for you to emulate. Here are the winners.
Midwives magazine: Issue 1 :: 2012
Wednesday 25 January 2012
Grand Connaught Rooms | Covent Garden | London
I am delighted once again to celebrate with you some outstanding examples of the spirit of innovation and pursuit of excellence to be found in UK midwifery teams. This compendium presents the best in our profession, with projects to inspire you and vision for you to emulate.
Every year, the RCM Annual Midwifery Awards reveal the dedication of midwives and their teams as they deliver outstanding care for women, newborns and their families. These awards showcase the value that midwives contribute through all aspects of their role, whether in the community, in hospital settings or as researchers and educators of future midwives. Through these awards, we share evidence-based innovation and creativity, discover future leaders and reward individual midwives who have gone above and beyond the call of duty. This year, we are also recognising the role of employers in planning and resourcing maternity care.
We could not deliver this awards programme without the invaluable support of our RCM Alliance partners, JOHNSON’S® Baby, Mothercare, Pampers and Pregnacare, and the other companies and organisations that enable us to make this celebration possible, including this year’s headline sponsor, Bio-Oil.
I would like to thank the many midwives who submitted entries for this year’s awards. I am proud that UK midwives still aspire to excellence and for improvement in care, despite the increasing challenges they face. Thank you also to the mothers who nominated their midwives as JOHNSON’S® Baby Mums’ Midwife of the Year. We are also grateful to our judges, who had the challenging task of selecting our winners from an extremely high standard of entries.
I hope you will be as inspired as I am by all the exceptional achievements you will find in this compendium. You will also hear more about the winning projects and individuals through the year in Midwives magazine, on our website and at the RCM Annual Conference. I hope you will be encouraged to develop some of the ideas and vision in your own work and to enter for next year!
Professor Cathy Warwick CBE
THANKS TO ALL OUR SPONSORS
Johnson's baby, Mothercare, Pampers, Pregnacare, the RCM Alliance Programme
NHS Employers, The Maternity Support Foundation, Philips Advent, Thompson's Solicitors
RCM award for promoting normal birth
Midwives making a difference: a novel approach to promoting normality
Alison Fyfe and Donna Burns
NHS Ayrshire and Arran
Donna and Alison held their first HypnoBirthing® - The Mongan Method class in July 2009, with most of the women attending having a fear of childbirth and contemplating an elective caesarean section.
This service hopes to help women find ways to deal with their fears and increase the rate of normal births.
During the first year of classes, 35 couples attended. At the start of the course, all women used words like ‘painful’ to describe birth, however 65.1% got through labour with no analgesia or only used Entonox. All women felt more confident in their ability to birth, saying it was a positive experience, and they all said they would use HypnoBirthing® again. Only two described the birth as painful: one baby was born face to pubes, the other by forceps. All women in spontaneous labour had vaginal births.
Quotes from just two of the women reflect their experience of HypnoBirthing®:
‘It still amazes me that I was able to face the biggest fear of my life in such a peaceful and happy state.’
‘We had the best experience of our lives while using HypnoBirthing®, not just during labour but throughout the whole pregnancy and even after the birth of our baby.’
This is in startling contrast to a pregnancy of fear, a potential caesarean and a difficult start to motherhood.
Promoting normal birth in Barnsley: 'Getting it right from the start'
Susan Cooper and Jayne Shaw
Barnsley Hospital NHS Foundation Trust
The Active Birth project was developed to prepare women for labour and birth, with a focus on normality and learning ‘top tips’ from professionals. The normal birth rate now stands between 68% and 74%.
The maternity support worker’s role in promoting normality in low-risk labour
Rachel Lavelle and Yvonne Regan,
South Tees Hospitals NHS Foundation Trust
This project promotes one-to-one care by training maternity support workers to assist the midwife in labour and, as a second person at delivery, encouraging natural pain relief, particularly massage and water, increasing mobility, and encouraging birth partners in active support.
Johnson’s® Baby award for Excellence in Midwifery Education
Sharing the success of the first work-based (distance learning), pre-registration, shortened midwifery programme
Francesca Entwistle and Dee Campbell
University of Hertfordshire
In January 2009, the first cohort of students
started the first work-based (distance learning), pre-registration,
shortened midwifery programme in the UK, which includes a full-time (78
weeks) and part-time (two years) route. Students spend 60% of their time
in practice and 40% of their time studying, with learning primarily via
an e-learning portal, bespoke to the University of Hertfordshire,
called StudyNet. Students also attend the university for a one-week
block each semester, have support from a personal tutor at their
practice site, attend site-based trigger and reflective sessions and
engage in various discussion groups and student-centred activities via
StudyNet. Their first placement is in community midwifery, where there
is continuity of mentors and a focus on normal midwifery.
The course is commissioned by two strategic health
authorities, supporting three NHS trusts. The first cohort of students
qualified in July 2010 and are now practising midwives in local teams.
The second cohort have been interviewed and posts are being held for
them following completion of the course. Recruitment to the programme is
buoyant, with low student attrition levels and lots of positive
The development of a virtual learning environment
Jenny Bailey, University of Nottingham
has developed an innovative approach, using the Second Life virtual
world tool to create a virtual midwifery unit, where situations can be
simulated and unique learning opportunities generated.
Maternity REACTS (Recognition, Evaluation, Assessment, Critical Treatment and Stabilisation)
Helene Marshall and Catriona Connelly, Scottish Multi-professional Development Programme
REACTS was developed to provide maternity staff with the skills and
knowledge to help with early recognition and treatment of critically ill
women, who require increased support, but do not meet the intensive
Philips Avent Award for Innovation in Midwifery
The development of a virtual learning environment
University of Nottingham
Jenny has taken an innovative approach to learning,
using the Second Life virtual world tool to create a virtual midwifery
where everyday situations can be simulated and unique learning opportunities generated.
It is intended to enhance clinical practice, rather than replace it.
Student midwives need to develop excellent
communication skills when dealing with people in their care. But, in
real life, caring for women in labour on a busy unit does not always
afford the chance for discussion and questioning of clinical practice.
By simulating practice in a virtual environment,
students can immerse themselves in clinical scenarios and practise
communication skills and explore management of care issues in a
practically and ethically safe environment, without fear of
repercussions or clinical harm.
Students and the midwife teacher roleplay using
avatars, which can remove some of the embarrassment experienced in real
Now that the virtual maternity unit is almost
completed, Jenny is organising trials with students and has started
using it as a demonstration aid in lectures.
She hopes to introduce it into the curriculum for normal labour scenarios.
Improving maternal health in NHS Lanarkshire
Jacqueline Holmes and Susan Short
questionnaire completed by pregnant women and discussed with the
midwife ensures that the time midwives have to discuss diet is as
effective as possible. It is available in English, Polish, Urdu and
Right first time! Improving detection of perineal trauma
Julia Sanders and Laura Mundy
Cardiff and Vale University Health Board
innovative programme to improve midwives’ knowledge and skill in
assessing women for anal sphincter injury, using female pork bottoms to
illustrate degrees of tear, and pig heart muscle to practise repair.
Pampers Award for Excellence in Postnatal and Newborn Care
The Kangaroo care project
The kangaroo care research team Maidstone and Tunbridge Wells NHS Trust
The Kangaroo care project on the postnatal ward at Pembury Hospital, Kent, has transformed the experience of women with pre-term and small babies. It empowers them to feel more confident in caring for their babies and has resulted in shorter hospital stays and more exclusive breastfeeding on discharge. This was true for the 107 women who participated in the study and also for an estimated further 200 women who have enjoyed Kangaroo care as routine practice across the trust since the research ended a year ago. For many years, Kangaroo care has been known to have significant benefits for pre-term and small babies both in resource-poor settings and in neonatal intensive care units.
Despite this, it has not been studied or used in the postnatal/transitional care ward environment in UK maternity services, where well premature and small babies are cared for with their mothers. This was therefore the purpose of the study, which took place from November 2009 to August 2010.
Parents’ comments regarding Kangaroo care were overwhelmingly positive, highlighting the care as a simple, cost-effective intervention.
‘Cwtch’ – transforming postnatal experience
Julie Austin and Carol Bowman, Abertawe Bro Morgannwg Health Board
Cwtch, which is Welsh for hug, is based on Caring staff, Welcoming environment, Team approach, Confident women and Happy babies! As a result, direct care time has increased to 53% and discharge documentation is completed over 50% faster. More time for a cwtch!
Improving bladder health in childbearing women
Julie Gough, South Eastern Health and Social Care Trust
After a number of women were identified with postnatal voiding dysfunction, Julie carried out an audit to examine practices and establish contributory factors. She then formulated guidelines and produced a booklet for mothers, which has significantly improved care and outcomes.
National Maternity Support Foundation Award for Supporting Training and Rewarding Excellence in Bereavement Care
Forget Me Not
South Eastern Health and Social Care Trust
As a midwife working on labour wards for 16 years, Hilary recognised the need for dedicated bereavement support for grieving families and trained as a bereavement counsellor before establishing the bereavement support midwife post in December 2003 – the first of its kind in Northern Ireland. The service provides confidential support for couples grieving the loss of their baby, following miscarriage, neonatal death or stillbirth, or the loss of an older child. Care is coordinated from the moment the bad news is broken and throughout the bereavement process.
The service also provides support to the multidisciplinary team within the directorate via staff training in communication skills, breaking bad news and care of the bereaved. Bereavement care pathways have been developed in each area, providing a framework of choice for parents, based on local and national guidelines and policies.
In 2007, Hilary established the ‘Forget Me Not’ committee of bereaved parents at the Ulster Hospital, to improve the experience of parents who have been bereaved. The group, which has an invaluable role in educating staff, meets regularly and was consulted in the production of regional postmortem leaflets.
The TLC (tender loving care) clinic, a subsequent pregnancy support clinic, for women who have had a pregnancy loss
Julie Key, Bradford Teaching Hospitals
For the past eight years, Julie has been heavily involved in the TLC clinic offering emotional, psychological and social support, as well as some of the more routine aspects of antenatal care, for women who have had a previous pregnancy loss – in an area where the mortality rate is twice the national average.
How early bereavement care can influence grief
Daryl Mallis, NHS Tayside
Since 2005, Daryl has been employed in the specialist role of providing maternity and neonatal bereavement support and counselling. She has developed and expanded this service throughout the trust, making it easily accessible and tailored to individual needs.
Mothercare Award for Supporting Families in the Community
Providing an enhanced midwifery service to vulnerable families in Knowsley
Allison Wright and Gayle Woods
St Helens and Knowsley Hospitals NHS Trust
The appointment of two public health midwives was
commissioned to provide an enhanced community midwifery service for NHS
Knowsley/St Helens and Knowsley Hospitals NHS Trust, from January 2010.
The trust provides services for St Helens, Halton and Knowsley Primary
Care Trusts. Our posts were commissioned by Knowsley Primary Care Trust.
Part of our remit is supporting vulnerable families.
Knowsley is the eighth most deprived local authority in England, with
58% of children living in poverty. The female population of Knowsley
have high levels of smoking (28.5%), binge drinking (31%) and obesity
(20.5%), all of which could contribute to an increase in maternal and
When we receive a referral, we carry out a full
needs assessment with the woman and her family, and put a package of
support in place. In some cases, we provide their antenatal and
postnatal care and smoking cessation support.
As a result of the service, we have documented a
number of cases where the outcome has been significantly improved for
both mother and child.
Named midwife for child protection
Elaine Smith, Epsom and St Helier University Hospitals NHS Trust
introduced a simple Parenting Capacity Assessment Tool, used at booking
and follow-up appointments, which helps midwives identify families in
need of additional services so that assistance/protective measures are
put in place in an effective and timely manner.
Pre-birth planning service
Valerie Arbuckle and Robbie Duffy, NHS Forth Valley
was identified that there was a group of pregnant women considered
vulnerable, although not to child protection level, whose needs were not
being met. A specialist midwife post was created to lead the service,
which offers support such as maternity care assistants, family support
and community child care.
Thompsons Solicitors Members’ Champion Award
Betsi Cadwaladr University Health Board
Kath Jones is one of only a few RCM stewards in North Wales and is always available to talk about practice or workplace issues. Any time a colleague has a problem, the first person we think of is Kath; her knowledge and support is an assurance for us all.
Kath is a wonderful role model and is highly regarded by her colleagues and the women she cares for. Kath is passionate about what the RCM can offer members. I cannot think of anything more she could do as a workplace rep; the RCM should be proud to have such a fantastic, caring and dynamic midwife representing them.
Kath supports midwives across three hospitals, but she is always available, never complaining when she is contacted by distressed midwives at any time of the day or night.
Kath has successfully represented midwives at supervisory, disciplinary and NMC cases. Yet she has also developed excellent relationships with managers and HR, always emphasising the importance of working together.
Kath appears fearless, but is always calm and reassuring, and her recruitment skills meant that a maternity care assistant (MCA) from our unit became the first MCA to join the RCM. She is our champion.
Nominee: Annemieke Koper, Maidstone and Tunbridge Wells NHS Trust
Nominated by: Aine Alam and Barbara Weekes
Annemieke has worked diligently as an RCM steward for over two decades. As staff-side representative, she often leads stewards from other unions in negotiations.
Nominee: Annette Lobo, NHS Fife
Nominated by: Aileen Lawrie
Annette always champions initiatives to promote normality and the role of the midwife.
Nominee: Jill steer, Weston Area NHS Trust
Nominated by: Christina James
Jill is a lasting example of what a good midwife should be, even after 50 years in the profession.
Pregnacare Award For Excellence In Initiatives In Improving Public Health And Reducing Inequalities
Improving safeguarding practice
Sue Hancock and Nicola MacPhail
Plymouth Hospitals NHS Trust
In November 2009, the safeguarding midwifery team was introduced. The vision was:
✲ A robust system with clear pathways to identify, assess and refer families identified as vulnerable in early pregnancy
A shift of focus from child protection to family support and improved
parenting, with early intervention by midwives and other services
✲ Better integration of health, education and social care.
Prior to implementation, there was not a clear
process. Families with vulnerabilities were often identified late and
referred late to social care, resulting in distress.
The implementation of a clear pathway/guidelines
when vulnerabilities are identified has resulted in a universal
documentation system; ongoing assessment of need; improved communication
between agencies and early referral to support services; and greater
The process centres on unborn baby hospital records
for any family where vulnerabilities have been identified and has
improved practice significantly. Families are much better supported, and
child protection proceedings are often avoided.
Health in pregnancy support service (HIPSS)
Stephanie Mansell and Sally Cornfield, Dudley Group of Hospitals NHS
An integrated obesity and stop-smoking service that offers antenatal support.
Setting up an aquanatal and parenting education service
Natasha Carr and Maggie Prain, Birmingham
A weekly lunchtime service, integrating parent education and aquanatal exercise.
Knowsley smoking-in-pregnancy pathway
Allison Wright and Gayle Woods, St Helens and Knowsley NHS Trust
post for a smoking-in-pregnancy coordinator was created to develop
pathways and an ‘opt-out’ scheme that incorporates routine carbon
RCM Award for Excellence in Maternity Care
Getting it right at the heart of the matter
Kathryn Murphy and Claire Stanley
Central Manchester University Hospitals NHS Foundation Trust
The service was set up in 2004 to offer multidisciplinary, tertiary care for women with complex heart disease in pregnancy, the leading cause of maternal mortality. To promote a positive, woman-centred approach, Kathyrn and Claire then employed a specialist midwife and moved the clinic from the hospital outpatients department to the antenatal clinic, where there is an ethos of promoting health and wellbeing. All the women attending felt this had shifted the focus from their cardiac problem to their pregnancy, birth and preparation for parenthood.
Running the obstetric anaesthetic clinic at the same time as the fetal medicine and echocardiography clinics has improved communication and means women can have different aspects of their care managed at one visit. Kathryn and Claire have also improved their high dependency facilities on the labour ward, which will enable some women, who require critical care, to be looked after on the labour ward and stay with their baby, instead of being transferred to the intensive care unit, aiding bonding and breastfeeding.
As a result of the initiative, the vaginal delivery rate is high at 68%. But, more than anything, there are women with severe heart disease who now have children but who, without our service, would not have embarked upon or survived pregnancy.
Supervision in line with the QIPP agenda
Amanda Lucas and Elaine Alston, East Cheshire
The supervisors of midwives at East Cheshire Trust decided to challenge themselves by setting a formal work plan aligned to the Quality, Innovation, Productivity and Prevention (QIPP) programme, with impressive results.
Basildon Birth Afterthoughts Service (BBATS)
Jennie Ponting and Liz Carpenter, Basildon and Thurrock University Hospital NHS Foundation Trust
Women who have celebrated
a birth at Basildon University Hospital now have direct
access to a midwife for a postnatal debriefing service
to help them understand their birthing experience.
Pampers Student Vision Award
Elective visit to Kandy, Sri Lanka
University of Surrey
Rachel is a second-year midwifery student and has found a placement in Kandy, Sri Lanka, through Work the World. This includes a three-week placement at an obstetric and gynaecological ward in a local hospital, allowing her to discover how environment and culture can impact midwifery and affect client care throughout pregnancy and birth. Another opportunity will be to work in a Northern village, learning about Ayurveda medicine, a 5000-year-old alternative therapy.
This elective will offer an insight into a different system of care to that in the UK. In Sri Lanka, pain relief in labour is unusual, making support for women particularly important. Infection control is hampered by lack of resources; understanding how this may affect a woman’s care would be a key learning experience, as would overcoming language barriers working in a non-English-speaking environment.
The Safe Motherhood Initiative, launched by WHO, UNICEF and UNFPA, highlighted significant maternal death rates in Sri Lanka. This initiative expresses the importance of skilled care during pregnancy and delivery. According to WHO, 96% of deliveries in Sri Lanka are now attended by a qualified practitioner. Rachel will be able to find out how this has developed in Sri Lanka, and whether there are any parallels with midwifery elsewhere in the world.
Maternity care and breastfeeding practices in northern Argentina
Aongola Ngenda, University of Bradford
Aongola hopes to undertake a three-week placement to Hospital Lagomaggiore, Argentina. She has been involved in a voluntary project that highlighted maternal and child health and education issues affecting developing Latin American countries, including illegal abortions and socio-economic disparities.
Affecting midwifery change: gaining a political voice
Julie Haigh, Salford University
Julie is planning an elective placement in New York to help her understand birth within a financially driven and medicalised environment.
NHS Employers award for Maternity Employer of the Year
Hugh McCaughey, chief executive
South Eastern Health and Social Care Trust
Nominated by: Elaine Madden
Our executives unanimously and wholeheartedly support maternity staff to affect real change by hearing our visions and proposals. They have facilitated new posts in theatre care, bereavement support, practice development and research, allowing those postholders to go on to win awards for the changes they made.
In Northern Ireland, we are the only trust to have standalone birth centres and a stand-alongside unit, where all rooms have an ensuite birthing pool. We were supported to truly embrace midwifery-led care and are delighted that a quarter of women in our care are labouring and delivering in water. Both midwives and users had a strong voice on the design of all our buildings and were able to ensure maternity services that are truly women focused.
Lastly, when we requested to pilot the ‘lean’ NHS toolkit, midwives were invited to sit at executive management meetings, where directors listened and applauded change at real and meaningful levels.
We feel embraced by a strong circle of support that has facilitated us to achieve a service of which we are all very proud and which inspectors have commended.
Abertawe Bro Morgannwg Health Board
An organisation that values its employees; facilitates, encourages and celebrates innovation; and offers excellence in clinical care. A workforce proud of the care we give!
Johnson’s® Baby Mums’ Midwife of the Year Award
South and East
Midwife Debbie Oram and mum Olwen Mayes
guided me through both my pregnancies, the first being a wonderfully
calm waterbirth at home, but my second pregnancy was a very different
I was in hospital with
placenta previa, where I stayed until my baby was delivered by caesarean
at 38 weeks. Debbie knew I hadn’t wanted this and did everything to
make sure things were as natural as possible, despite the clinical
surroundings, and I was able to have skin-to-skin contact and establish
breast-feeding within an hour of delivery.
were some desperate moments for both myself and my baby, but, thanks to
Debbie’s skills and professionalism, I knew nothing of the dangers that
we faced, and overcame, until we were safe after the event.
I am eternally grateful to Debbie for her time, knowledge, dedication and her kindness.
Midwife Jessica Hughlock and mum Jackie Johnson
Jessica managed to calm me, take the fear away and help me give birth with no medication.
Midwife Marie Allsop and mum Emily Jones
Without Marie, my immediate recovery and bonding with my newborn baby would have been completely different.
Midwife Diane McInally and mum Louise Morris
Diane was my rock! She made my pregnancy possible and had me strong, confident and ready to be a wonderful mother.
Midwife Emma Mills and mum Diana Lewis
Emma is a wonderful midwife – she made me feel confident that I could manage a fearless labour.
Unfortunately it has not been possible to choose a
winner from the Northern Ireland regional category for this year’s award
due to insufficient nominations.
Bio-oil Team of the Year
Maternity support workers: pivotal team players in a successful birthing centre
The Oasis Team, South London Healthcare NHS Trust
The Oasis Midwifery-Led Unit opened on 8 December 2010 and we are very proud to have supported the arrival of 721 babies, to date. The unit is staffed by a dedicated team of midwives and maternity support workers (MSWs) who are passionate about normality and whose ethos is to offer women care in an environment that is conducive to achieving physiological birth.
Our birth centre consists of five birth rooms and one four-bedded bay. Our MSWs are pivotal to the efficient running of our birth centre and enable the midwives to provide one-to-one care in labour. The unit is fortunate to benefit from MSWs who have recently completed the foundation degree programme, giving them the theoretical knowledge and confidence to underpin their clinical practice. During the past six months, 98% of women described themselves as ‘extremely happy’ with the care that they received. In addition, we are proud of our exceptional clinical outcomes – although 50% of the women using the unit are first-time mothers, we have an intrapartum transfer rate of only 15% and an average labour length of less than eight hours.
Whether it’s caring for women or assisting the midwives, our MSWs play a central role in a multi-disciplinary environment. They are a respected, appreciated and much-needed part of a cohesive team. Without their ongoing assistance and support, the Oasis would not be such a tranquil place to give birth.
Public health midwives integrated health team
The public health midwives, Wrightington, Wigan and Leigh Foundation Trust
The team aims to encourage vulnerable women, and their families, to make significant changes in their lives to improve health outcomes for their newborn baby and their own long-term health.
Teenage pregnancy team
Chris Hilton and Sue Horne, East Kent Hospitals University NHS Foundation Trust
Kent has a higher than national average of teenage pregnancy, with Thanet having the highest rates and suffering significant deprivation, unemployment and social exclusion. A dedicated team aims to reduce teenage pregnancy by reducing subsequent unplanned pregnancies.