inflexibility of midwife appointments

[Waggamamma]

I've always been really happy with the care I've recieved from midwives and the nhs. Bee treated with empathy and respect but...

The inflexibility of the system has really annoyed me today. My surgery only offers appointments with a midwife between 10 and 12:30 on Wednesday and you don't get a choice over what time this is (first come first served). I work an hour commute away from my surgery and on a Wednesday work 8am-2pm. This is going to make attending appointments difficult and involve a whole day off everytime because I can't get to work either side of the appointment iyswim.

The next appt is booked on a day that I have something really important on at work but the GP receptionist wouldn't let me postpone to the following week. She also said it's not possible to attend a different surgery closer to work.

Has anyone else had problems with such inflexibility? Why do they make clinics right in the middle of the day? The beginning or end of the day would be far easier. I can't be the only person who's going to struggle to attend due to work.

If you are based in the NW you can switch to 1-2-1 midwives at any point (no charge) and you get appts as regularly as you like, at home and times that suit you. I have done this myself due to difficulty contacting my midwife and sorting out appts.

That sounds like a great service but I'm not in the NW. I'm in Scotland.

The receptionist gave me the date and time of my next appt and said it's not negotiable or changable. Obviously I will go because it's important for mine and baby's wellbeing but its going to cause difficulties for me and cost me a days work (so well over £100 or a days annual leave but I was saving this to start mat leave early).

Work have to give you time off for ante-natal appointments. It's the law.

I agree that the inflexibility is unhelpful though. I'm the SE and have opted to use an independent midwife to get the kind of flexibility that 1-2-1 offers.

I'd be tempted to try holding your ground. Don't let the "it's for the baby's wellbeing" line scare you too much. You're not refusing to attend appointments: they are not offering you appointments you can make consistently. Their move.

You may well find that if you speak to the midwife rather than the receptionist you might find that there is some flexibility in the system.

I am a nurse practitioner and I prefer to make my own appointments because they are based on clinical criteria. I ask the receptionists not to change any appointments, but to get the patient to speak to me first. It is part of risk management.

Your employer HAS to give you paid time off for antenatal appointments. But yes, that sounds really irritating.

It sounds like you are having community appointments? Is there a base hospital that you could go to? Or move gp to access a different clinic? Nuts that you would have to do those things though. Some teams do all appointments in your home if you are home birthing.

Are you self employed? Otherwise you are legally entitled to paid time off.

However, yes, it is frustrating. But you have to remember that midwives are fitting their clinics around all their other duties, including in many cases visiting mothers post natally, time at the hospital, shifts at the hospital, etc. It is a pain in the arse, but it isn't just them being awkward.

I don't quite understand why the receptionist told you you couldn't wait a week for your appointment though. It isn't her job to decide your schedule of care? How many weeks are you? In your position I would be inclined to phone up and say you've been asked to book for X date (a week later). Then separately ring up and cancel the one you have booked in now. For most of the appointments a week won't matter if it is something really important at work you'd rather not miss.

Also, have you tried speaking to the midwife? I have clinic on a Wednesday afternoon 12.30 until 3.30, but they are always running at least half an hour late meaning I have only a few slots I can make and still collect DD1 from school on time. I've explained this to the midwife who has said that, if I ever have dire problems, she can squeeze me in at one of her days up at the hospital or make other arrangements for me.

If you work an hour's commute away, I can understand why you can't see someone near work, it's probably a whole other area administratively. Would an IM be a financial option?

Yes our were Tues pm only and they always filled them up from the first slot.

I understood that there was only 1 afternoon as the midwives from the hospital had a session at lots of go practices and that made sense.

I also understood they wanted to fill up consecutive slots in case the list wasn't full so they finished earlier rather than having gaps then a late finish (as they were often back in the hospital after).

However I got really fed up with often getting the appointments that clashed with school pick up and complained and after that there was a not more flexibility.

I'm not sure how you could get round the middle of the day clinic (unless you could ask for appointments at the hospital?) but deferring by a week seems like a reasonable thing to ask.

Do you have drop in midwife sessions? We have them at our local sure start centre twice a week.

As others have said work have to give you paid time off for appointments which includes travel time.

Thanks everyone. This is for my 16week appointment so I didn't think it would make a big difference to have it a week later.

My work are very good about time off for appoints. But I only get the half hour appointment time, not my travel etc and right in thr middle of the day I can't make it to work either before or after the appointment. This particular week I have something on I really shouldn't miss if I can help it.

I understand midwives have lots of commitments and people to see, it's just frustrating from my point of view. It sounds like other areas offer a bit more flexibility. I will speak tp the mw when I see her to double check their are no other options.

Does sound inflexible and a bit of a pain, but as someone has pointed out, your work are lawfully obliged to give you time off for antenatal appts, although this might effectively mean you are absent the whole day.

Appts aren't that frequent though until the latter stages unless you are having extra monitoring, so I think you're going to have to suck it up and get used to it. Just wait till you're back at work an have to deal with calls 'cos your LO is ill or take emergency time off to look after sick kids. It'll make your me appts seem very straightforward!

I'm in Scotland too and only had a choice of a Thursday morning and just had to squeeze in wherever. It's just the way it is afraid. My mw was always on the go, if she wasn't going me appts at the doctors, she was up to her eyes in admin or out doing community visits. They have a very heavy workload.

midwives arent based at gp surgeries all the time.
one midwife can have 10 gp surgery clinics plus drop in clinics plus home visits. so Thats why its a specific day and time period.

your work are legally obligated to give you time off work for appointments. alternatively most areas run drop in clinics on different days of the week. in my area they have morning, afteenoon and evening drop in clinics. in my last pregnancy i didnt visit the gp midwife once i went to the evening drop in clinics instead

Your work aren't 'good' if they are spinning you the line that you only get the time of the actual appointment. You are entitled to ' be permitted by her employer to take time off during the employee’s working hours in order to enable her to keep the appointment'. That is time off to keep the appointment, not just the duration of the appoint. You may want to point this out to HR. They can ask you to try and make it convenient, but if you can't, you can't.

I'm self-employed - I work as a contractor that supports a team for a company back in the US. I know if I have to take too much time off, the US company will just sack me. They don't give a rats' behind about UK law. I didn't realize just how inflexible the appointments might be here. Thankfully it hasn't been a problem yet, and I hope it remains that way.

Definitely try speaking to the midwife instead. I'm also in Scotland and my midwife lets me choose the time and date (although restricted to Mondays and Tuesdays) of my next appointment before I leave.

When I couldn't see the midwife due to there being no appts left I saw my GP, would that be possible?

There should be drop in clinics local to you,in my area they are normally held in sure start centres.My work were really flexible but because I didn't drive and my gp surgery was a bus ride away it was sometimes more convenient.
Just take your notes with you and it should be fine.

Work have to give you the time off including travel time etc.
I see a hospital midwife as only some GP surgerys have midwives if you discuss it with the midwife she may be able to refer you to the hospital for future appointments.