The new MSWs: defined roles, clear careers

on 03 September 2018 Midwives Magazine MSWs - Maternity Support Workers

Back in March, the then-secretary of state for health and social care Jeremy Hunt announced a range of measures designed to boost maternity services in England. The plan to train more than 3000 more midwives over the next four years caught the headlines, but just as important was the proposal to set out a more defined role for MSWs and new training pathways for those who want to move into midwifery.

The measures are intended to support the ongoing drive to realise the vision of Better births, the 2016 national maternity review in England. This envisages more multi-professional working and fewer barriers between midwives, obstetricians and other health professionals, to deliver more world-class, safe and personalised care for women and their babies.

MSWs are a vital part of the maternity workforce that will deliver Better births. They play a key role in supporting midwives, maternity teams, mothers and their babies throughout pregnancy, labour and during the postnatal period. The problem is that, within the current workforce, the actual day-to-day roles and responsibilities of MSWs vary widely.

‘We have MSWs working all over England, doing different things because there is no standardisation of the role,’ says Carmel Lloyd, RCM head of education and learning. ‘We have MSWs working at Bands 2, 3 and 4, but it is all very mixed. We want a clear demarcation between what an MSW working in each band knows and can do.’

A programme to rationalise, develop and professionalise the MSW role is now underway. Health Education England (HEE) is leading it, working closely with partners across the system, including the RCM, NHS England, NHS Improvement, the RCOG, Public Health England and MSWs themselves. The overall aim is to:

  • Develop a nationally defined and standardised MSW role in England, including a national competency and career framework
  • Look at the possibility of a voluntary register for MSWs
  • Introduce new training routes into midwifery through the development of apprenticeships.

The intention is that this programme will provide opportunities for MSWs to strengthen their roles within the maternity workforce and to develop their careers. New access routes will open for those who have their sights set on becoming a registered midwife.  

‘The standardisation will help people on that career pathway,’ says Carmel. ‘Some MSWs take up that role because that’s what they want to do. They like working alongside midwives and being part of the maternity team. They are fulfilled and have no aspirations to go on and do midwifery. But for others, being an MSW triggers their interest, and they feel they have something to offer in terms of being a midwife. They have skills that would be transferable to midwifery training.’

The changes will also mean that employers can invest in developing their current MSWs, helping them not only to retain existing staff but also to attract people who can contribute to delivering the agendas for Better births and continuity of carer.

Sally Ashton-May, regional associate clinical lead at HEE, says the work on the new definitions and career paths is now well advanced: ‘We have regional workshops coming up in the autumn to get input on the proposed framework, and it should all be ready to be launched in January.’

Whatever the final detail of the framework might look like, it will help to improve the standing of MSWs no matter where they work. ‘It will definitely help the status of the MSWs,’ says Carmel. ‘Some of them have done a foundation degree but are working at Band 2, and some are Band 2s doing the work of a Band 4, so I think this will ensure they are banded correctly and paid properly for the work they are doing. From the MSW perspective, this is a move in the right direction.’ 

Making sense of apprenticeships

Jeremy Hunt’s announcement kick-started the development of a midwifery apprenticeship to attract more people into the profession. Skills for Health, HEE, educational institutions and employers set up the ‘midwifery apprenticeship trailblazer’ to develop the standards.

While the trailblazer is still in the early stages, it will have to negotiate a few obstacles. The first is the new NMC standards for midwifery education expected to be published in 2020, meaning that any apprenticeship standard developed now against the current standards will have to be revised in 2020. The second is that apprentices following the new framework won’t be able to apply for recognition of prior learning from courses that are not NMC-approved midwifery qualifications, making the new apprenticeship less flexible than some others.

The possible structure of the apprenticeship is also causing confusion, says Carmel Lloyd: ‘Some people think you won’t need a degree at the end of an apprenticeship, and that you will have two types of midwife, one with a degree and one without. That isn’t the case.

‘Whether you go via the normal university route or the apprenticeship route, you still have to have a degree qualification to get onto the NMC register. A university degree to become a midwife takes three years, but via an apprenticeship it will take longer.’

More information here.

Have your say

HEE recently commissioned the University of the West of England to develop the MSW career and competence framework, which will involve close working with the HEE maternity programme team, MSW implementation group and stakeholders across the maternity system.

The team is holding four regional workshops in October and November to get input and feedback on their proposals.

The events will be open to anybody who works in the maternity system. The organisers particularly want to attract MSWs and midwives – the events will be a great opportunity for them to get involved in helping to inform and develop the final products.

Full details of the events, along with booking information will be announced in the near future. The dates below have been agreed in the meantime, and anybody who wants to register an early interest in attending can contact the team on [email protected] 

London: 9 October
Midlands and East: 19 October (Birmingham)
South: 1 November (Bristol)
North: 7 November (Leeds or Sheffield)