Midwives and disciplinary proceedings

By Julie Griffiths on 08 November 2012 Equality and Diversity Midwives

Amy Leversidge reports on the surprising findings of recent research into disciplinary proceedings and ethnicity, outlining possible underlying factors and the RCM’s commitment to equality and fairness in the workplace.

There is an uncomfortable and difficult issue that we rarely talk about publicly – what happens when midwives are subject to disciplinary proceedings and, when this happens, do trusts treat all staff fairly regardless of ethnicity? The RCM submitted a Freedom of Information (FOI) request last year to investigate the number of midwives involved in disciplinary proceedings, broken down by ethnic group, and the results proved to be quite shocking.

Some of you may have been subject to disciplinary proceedings; it can be a very stressful and emotional time. Some of you will have joined the RCM for the very reason that, if you are in that position, you will be represented by a midwife. RCM stewards are the first port of call, but sometimes cases are escalated to a regional officer, who are all midwives and have vast amounts of experience in representing midwives.

Of course, the RCM can never condone bad practice, however, there are many times when mistakes or errors can be dealt with through training and development. Ultimately though, the workplace representative or regional officer is there to ensure that the midwife involved is treated fairly.

If you are ever seeking representation from a regional officer, you will be asked to complete an anonymous equality monitoring form. These are collected and analysed to investigate any equality issues there may be with members seeking representation.

Unfortunately, during the analysis of these forms we have found that in London, there has been a disproportionate amount of black or black British midwives who seek representation.

This is not unexpected. In 2004, the Institute of Employment Studies found that midwives report more incidents of harassment, including verbal and racial abuse, than any other group in the NHS (Robinson and Perryman, 2004). Moreover, in 2009, a report from Aston Business School (Dawson, 2009) linked NHS staff survey data to patient survey data that found high levels of bullying, harassment and abuse against staff, particularly on the basis of ethnic background, related to negative patient experience.

In March 2010, the University of Bradford published its report, The involvement of black and minority ethnic staff in NHS disciplinary proceedings, which found that black and minority ethnic (BME) staff were almost twice as likely to be disciplined in comparison to their white counterparts (Archibong and Darr, 2010).

Following on from this research and the findings of the RCM’s equality monitoring forms, we sent a FOI request to the 24 trusts in London that provide maternity services, to gather information about the number of midwives subject to disciplinary proceedings broken down by ethnic group.

The FOI request revealed that while 32% of midwives in London were black or black British, 60% of the midwives disciplined were black or black British. Furthermore, the outcomes of the disciplinary proceedings appeared to be harsher – notably, 10 midwives were dismissed during the time period and every midwife dismissed was black or black British.

Unfortunately, numbers can only tell us so much. On their own, the numbers do show that black or black British midwives in London are not being treated equally or fairly, but we believe that the reasons for the numbers are likely to be complex.

It is probable that part of the reason for the stark difference will include organisational culture and poor management practice, not just in maternity but across the trust. There could be issues in human resources departments where there can be a real lack of understanding and awareness of equality and diversity.

We also have to look at the issues of leadership and culture, including a lack of diversity among leaders.

The NHS has almost 1.3 million employees and nearly 15% of these come from a BME background, which equates to around 200,000 employees. However, there are currently only five chief executives from BME backgrounds (NHS, 2009). The NHS has developed a programme called Breaking Through, which seeks to identify talented individuals who have the potential to become senior leaders and develop their skills and confidence so they can go further in the NHS. This is an excellent move, as it will ensure the talent pool that senior leaders are selected from covers more diverse backgrounds.

NHS Employers have also developed a campaign to ask staff to be ‘equality champions’. The role doesn’t take up a lot of time and there are no requirements in terms of expertise or experience. All you need is to be passionate about the NHS and care that diverse workplaces make organisations better. You can find out more and sign up to be a champion by visiting the NHS Employers website.

The RCM has a commitment to equality and diversity and ensuring that midwives are treated fairly and equitably at work, and we want to make sure that maternity leaders are diverse, inclusive and reflective of the workforce and show a commitment to equality and fairness.

The RCM has published the report, which is available to download from the website. We have not identified individual trusts, preferring instead to work with them along with other stakeholders to find solutions to this very serious issue. We are already working with the London Local Supervising Authority and some trusts and we will continue to do so as part of our commitment to ensure that all midwives are treated fairly and with dignity at work.

Amy Leversidge
RCM Employment Relations Advisor

► For details of the NHS Breaking Through programme, please visit: nhsbreakingthrough.co.uk
► For the NHS Employers website, please see: nhsemployers.org


Archibong U, Darr A. (2010) The involvement of black and minority ethnic staff in NHS disciplinary proceedings. See: http://www.nhsemployers.org/SiteCollectionDocuments/Disciplinary%20Report%20Final%20with%20ISBN.pdf (accessed 17 October 2012).

Dawson J. (2009) Does the experience of staff working in the NHS link to the patient experience of care? An analysis of links between the 2007 acute trust inpatient and NHS staff surveys. See: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_111827.pdf (accessed 17 October 2012).

NHS. (2009) An introduction to the Breaking Through Programme. See: www.nhsbreakingthrough.co.uk/Breaking-Through-programme/Introduction.aspx (accessed 17 October 2012).

Robinson D, Perryman S. (2004) Healthy Attitudes: quality of working life in the London NHS, 2000-2002. See: www.employment-studies.co.uk/pubs/summary.php?id=404 (accessed 17 October 2012).