To think if 91 midwives from one trust are under Fitness to Practice proceedings there's a problem with the trust

[JulietteHasAGun]

Rather than the individuals? So work load and staffing, procedures, training?

Nobody wants bad/rubbish staff to go unchecked but I struggle to believe that what must be a significant chunk of the staff are that bad? Scapegoat anyone?

It will suit Wes Streeting, etc to throw individuals under the bus rather than admit that the unit hasn't been staffed sufficiently.

There is currently an investigation ongoing (and a concurrent police criminal investigation) - how many investigations do maternity services need where the results talk about staffing levels and still the govt don't fund maternity services better.

The amount of obs and gynae compensation pay outs is over a third of the total obs and gynae budget and increasing massively every year.

Women need to be up in arms. The NMC are in cahoots with the govt and are doing bugger all about it. The RCM union are useless.

I can bet what;s going to happen now - midwives there will go off sick and/or leave. Who is going to staff the unit then? People will be put off training as midwives - why would you when you see this publicity. Interesting it's the female midwives being thrown under the bus....I don't see anything about any doctors being held to account!

I think this could be the end of Midwifery. These investigations are going to spiral and the blame be put in the wrong place. The govt are not going to admit they should have increased funding, the trusts aren't going to admit they should have employed more staff.

The Nursing and Midwifery Council suspends midwife in maternity probe - BBC News

85 open complaints against Nottingham nurses and midwives

It’s interesting (and sad) that so many people have jumped to the thought of it being to do with midwives being unkind/mean. I think people are right that there may well be this sort of culture in maternity services.

But I doubt any of these fitness to practice cases will be about that sort of attitude. It’s all to do with historical cases, so any allegations have got to be based on tangible, provable stuff which is in the women’s notes.

no midwife is going to write “I was a bitch to bed 4 and rolled my eyes”. It will be about delays, omissions, incorrect decisions. Things done which shouldn’t have been done or vice versa.

which is why I’m surprised that the doctors aren’t equally involved in any reprimands.

However I doubt think if you’re looking after x amount of women and ideally you’d only be looking after a smaller number then care isn’t going to be optimal.

This is what I’m hearing from midwife friends as well. It’s like the air traffic controller yesterday who apparently (if this is true) was doing the job of two people at La Guardia airport. He made a mistake and will get blamed for that but if he was really doing two people’s jobs it’s not really his fault. 🤷‍♀️

I've given birth 9 times and had 5 miscarriages. I've met good and bad midwives; some lovely ones and some good damn horrid ones! However, when it comes to doctors the women ones have been universally absolutely awful. The men have always listened and been led by my own preferences. The women have been obstructive, rude, belittling and resistant.

Previous Ockenden reviews have found some instances of midwives not involving doctors when they should've, so it's possible those might be some of the delays and omissions.

Some of the worst experiences of my life were on maternity wards. Utterly unnecessary and dehumanising. Why aren't we on the streets protesting?? Chained to the hospitals??

Without wanting to detract from the thread, I'm not sure that 91 midwives are undergoing fitness to practise investigations, but more likely that 91 cases are being investigated by FTP investigations. Often a FTP investigation about a single HCP will involve multiple different allegations, so this could be a handful of midwives with many cases each where they are alleged to have failed to meet required standards of care.

I had my first two babies at QMC in Nottingham in the early 00s. Met some nice caring individuals and some downright nasty ones. I will always remember one of them shouting at me when my baby was a few hours old and making me cry. I had terrible PND and this definitely contributed.

I'd say it's more that if there is a culture of disrespect or unkindness towards patients, especially if borne of misogyny, then that is the coal face experience of the patients. Things they will be aware of. Not necessarily the subject of the FTP concerns.

Eg that culture will also manifest in being dismissive of women's concerns, fears about the babies' health/well being, their own health concerns.

It won't be because Sally rolled her eyes at the woman in bed 4 but it might be that the same attitude which caused Sally to roll her eyes at the woman in bed 4 also meant she ignored bed 4s concerns or just didn't do something she should have done.

I wonder if there is also an element of the inverse.

I’m not excusing midwives being actively unkind but I think there is a perception that that female HCPs always have to be motherly whereas male staff don’t.

My ex was a nurse and he was very blunt but he was respected for it. Barring clinical negligence, I wonder how much that is considered “unkind” would have been acceptable if a man did it.

I was a midwife for 17yrs plus the 3yrs training. On both a personal and professional level, I have experienced the very best and the very worst of staff. Midwifery has the potential for so much good but poor care really does ruin lives.
My feeling is that maternity is run like a conveyer belt, getting people in and out and moving onto the next family. This doesn’t allow for good care, proper relationships or the solving of problems. When I trained, it wouldn’t have been acceptable to not offer a Caesarian section mum a bed bath, tea and toast, help with feeding etc before going up to postnatal. Now it’s up as soon as possible.

There is a huge pressure on beds and moving people through the system. I’ll always remember being told to get women up at 7.30am and out asap (they’d only given birth overnight) as delivery suite was full of women needing to come to and women waiting to come in from triage. I felt absolutely awful doing that but what could be done?

There used to be lots of small community units where women could come to stay for recovery. I even remember newly released from scbu twins coming with their mother at 60 days old for ‘fattening’ before going home! I was able to give far better care in these units than when I had 12 mums and 12 babies to look after on a ward. Even the little things like making hot chocolate in the late evening and bedding everyone down.

The system needs to change so that more midwives can be good at their job and not burnt out. More midwives would then join and the bad ones more easily weeded out.

Yeah, these types of practitioner tend to be neglectful because they refuse to listen to patients. They're also arrogant and this again leads to mistakes by omissions. They often get away with it because other, more conscientious workers will often deal with these omissions thus concealing mistakes. If you get a critical mass of shit workers then mistakes and omissions are revealed.

Having the misfortune to have a chronically ill child and loads of hospital admissions, I found any NHS service focused on caring for women to be generally very poorly run and staff who just didn't seem to care. Post natal was far and away the worst, but peads comes close behind. Any peads ward will usually have 90% mums with their child.

Having now moved to Ireland I'm amazed at the differences in care and attention to detail. I don't know if its understaffed, poor hiring or poor practice, but NHS care isn't fit for purpose too often.

I don’t know what it is with giving birth but there is a general disregard for mothers. Much of this from staff. It’s crazy how you are treated whilst giving birth/after vs having a routine procedure on another part of your body.

We could have a better system if we had widespread insurance and a small fee for hospital and doctors appointments, who would have thought!

I am one of the c2500 people who have given evidence to this enquiry. My experience dates back to 19 years ago and I’m classed as a near miss as thankfully my child was unharmed. As well as the catalogue of errors I experienced with the handling of my maternity care and subsequent birth and hospital stay, I also witnessed blatant racism towards two mothers on my ward (I’m white so this was not directed at me), which I reported in my evidence. I was so grateful to get out of there that I made the decision to stop at 2 children. I felt unsafe the entire time. What you are seeing in the press is the tip of the iceberg and when the report is published I think there is going to be a torrent of horror coming out. This has been going on for decades.

I think you're referring to my story. You don't get it at all. If you're a midwife I wonder if you're a tiny bit part of the culture I'm talking about.

The same midwives who rolled their eyes at me and called me Bed 44:

• didn't report it when I had a further haemorrhage, meaning I wasn't considered for a blood transfusion, with lasting consequences. I lost over 3 pints of blood.
• tried to give me medication I was allergic to, arguing with me about it "you've been prescribed it, are you saying the doctor made a mistake?!" [Yes, they had.]
• earlier in pregnancy, insisted I couldn't possibly have a UTI, refusing to send off a urine sample, meaning it went untreated and I nearly went into premature labour when it triggered very painful contractions at 28 weeks

Shall I go on? Or are you still sure that this is just a case of oversensitive mums fussing over an eye roll??!

Please, please tell me you don't work in midwifery op. You dont get it. And I have more examples.

And by the way I got a formal apology for all of those things. "Lessons were learnt."

So it wasn't just an eye roll. Yours truly, Bed fucking 44.

Op, you seem to think "being a bitch" (your words) is totally unrelated to mistakes, delays, and omissions.

No.

The first leads directly to the next.

When you stop listening compassionately to your patients, when you dehumanise them, you cannot give them good clinical care.

If you're a midwife I really hope you stop and think about this.

Thankfully the NHS mostly recognises this. There is training about introducing yourself tk patiebts, explaining clinical decisions, addressing them by name and so on

Yes. See also failing councils and social workers.

No I do get it and I think you’ve really misunderstood my post. I’m not saying it’s about an eye roll, etc. what I’m saying is surely the investigation won’t be about such behaviour as that would be hard to prove years after the event.

obviously such belittling behaviour is awful and has a big impact on women. Not only on their mental health but on outcomes because yes women who don’t feel listened to are going to stop seeking help. So yes, this sort of behaviour does need picking up and stopping but the investigations and maternity units also need to look at why it’s happening not just blame individuals. If they don’t get to the underlying cause it’ll never stop. It’s too simple to say midwife X was a bitch and strike her off. Why are 91 midwives acting like this? Thats the key question.

What I’m trying to say (and possibly explaining badly) is will the investigation actually be able to look at such behaviour though due to a dearth of evidence. A woman says well 3 years ago, xyz happened, it won’t be documented and the midwife denies it 🤷‍♀️. So I’m not at all saying this is about over sensitive mums. There is something very rotten about maternity services and I’m worried nothing will change even after this report.

So what is the investigation actually finding which is leading to 91 midwives on fitness to practice. It’s more likely to be something which can be evidenced through notes. Not attitudes. And if it doesn’t look at everything including attitudes it won’t get to the bottom oF It and nothing will change,

I completely agree with you. 🤷‍♀️

I'm glad you agree, I didn't get that from your previous comment.

I disagree with your hypothesis that systemic understaffing is more at fault than individual cruelty or cruelty in the culture.

When you come across that kind of dehumanisation, you can see it's not from understaffing. I've seen busy, but lovely and well-meaning, HCPs. They're the ones who don't respond to the buzzer immediately, but when they do, they listen. They're the ones whose eyes flicker to the name plate above the bed and say "how are you feeling - um - Jane?" They're the ones who believe you when you're worried.

Actually it's often the busiest ones who are the most competent

With that number of people being investigated yes it is an endemic, systemic problem. Now clearly it is possible to do the job in that trust, in a way that doesn’t invite an investigation or they would have 100% of midwives being investigated so there is an element of individual poor practice at play too but it certainly appears that the environment or couture has allowed or encouraged bad practice too.

My personal experience of midwifery care was that I was induced at the city hospital due to Gd and being under consultant led care. I mainly just felt like I may as well have been at home by myself. I was checked on very infrequently and generally left to it. When I felt like I needed to push I tried to get someone attention and was told that they would be there to check in a bit when they’d finished their paperwork. I loudly told my husband to get ready to catch and the MW sighed loudly, came over, took one look, pressed the call button and ran into the corridor to get help becuse I was crowning and needed to be moved to delivery.

i gave birth in the corridor as the bed was being pushed along.

Afterwards I had to push the crib with baby in it to the ward myself, then I was left to it overnight and in the morning I had to make my own breakfast while holding my newborn. They let me leave at 8am because I’d been asking anyone who made the mistake of walking near my bed when I could leave since 4am. No one helped me to leave I literally put DD in her car seat and carried it and my bags out, propping the door open with my foot and loaded her and my stuff into the taxi, didn’t have to sign out or have anyone check that she was being taken home safely.

Expectations are just so bloody low in midwifery.

I'm a teacher and we're understaffed, overworked, underpaid too. But if we're anything other than Little Miss Sunshine at every single moment, that's unacceptable. Even when pupils are being objectively very trying.

But if a midwife is "being a bitch", we'll that's just because they're understaffed don't you know. The vibe in the postnatal ward is begging for a glass of water as if for a great boon. I honestly felt a bit like I was in a prison asking for favours off the prison wardens.

Just to be clear I had some very nice ones too and they outnumbered the horrid ones. There was one called Patience and I remember telling her over and over how perfectly named she was. If you're reading this Patience the midwife, thank you!

(And I know being a midwife is a much harder job than teaching)

That’s not the case. There was a story about this recently, 33% of newly qualified midwives cannot find roles. There is a shortage of midwives, but the vacancies aren’t there.

I think I just feel pessimistic that nothing will change. They haven’t changed after previous reports. we’ve been here before, even going back to the Mid Staffs hospital enquiry (nursing rather than midwifery I think) where they said the culture turned previously compassionate individuals into un compassionate ones.

Midwives who are unkind or incompetent, staff who don’t listen to women need rooting out. I just find it hard to believe there’s over 90 midwives like that in ne trust. But maybe it is a culture there. 🤷‍♀️ I wouldn’t like to see a member of staff who has missed something/made a mistake due to rushing/overworked be struck off.

When I had my daughter the day after my section I pulled the buzzer in the toilet on the postnatal ward as a large lump of flesh had landed on the floor. I thought my liver might have fallen out my vagina. Was the size of my fist. Midwife looked and said it was a clot and then told me to pick it up and bin it! 12 hours post section. I remember being a bit surprised but did as I was told. I sometimes wonder why she thought that was appropriate….was she lazy, was she uncaring, maybe she didn’t realise I’d had a section. I guess she had no gloves with her but i wasn’t far from the midwives desk….she could have gone and got some gloves. I mean it was a minor incident but it makes me wonder how she treated women generally.