An “unprecedented” decision by the Nursing and Midwifery Council that a group of independent midwives were using an inappropriate indemnity scheme has sparked criticism of the regulator for causing “maximum disruption” because the clinicians can no longer attend births.
An investigation by the NMC found that around 80 members of the Independent Midwives UK organisation were relying on an insurance scheme that had inadequate funds to settle any potential clinical negligence claims.
“This decision directly jeopardises the health and safety of the women it is supposed to safeguard”
Since 2014 it has been a legal requirement that all registered healthcare professionals have an indemnity arrangement in place.
Following its investigation into the IMUK, the NMC said it wrote to both the organisation and 80 affected midwives in August 2016. It warned them their indemnity cover was not sufficient meet the cost of damages claims.
This could mean that in rare cases where mothers and babies sustain catastrophic injury, such as cerebral palsy due to negligence by a midwife, they would not be fully compensated, said the NMC.
The regulator said it warned the independent midwives they faced removal from the register unless either the IMUK increased its available funds for potential claims or they secured alternative indemnity arrangements.
The NMC said that because the organisation’s funds had not been increased by December it had to take the “unprecedented” step today to announce that the IMUK’s scheme was not appropriate.
But today the Birthrights charity has written to the NMC accusing it of causing “maximum disruption and damage” to independent midwives and the women they care for.
“[The NMC’s] actions appear designed to cause maximum disruption and damage to independent midwives and the women they care for”
It claimed the NMC had only notified midwives of its decision three working days before Christmas, which did not give them sufficient time to make alternative arrangements.
It said the NMC’s decision has led to mothers facing “uncertainty and distress”, because the midwives they had built a relationship with and paid for were now no longer able to attend their home births.
The charity said the decision may mean women were now forced into giving birth in hospital – away from their preferred setting – noting the sometimes limited NHS home birth services in certain regions.
It also raised “urgent” concerns that some women may instead continue with their plan to have their baby at home – but now without any medical or midwifery assistance.
“The NMC has a key role to play in protecting public safety, yet this decision directly jeopardises the health and safety of the women it is supposed to safeguard,” said the letter, signed by Birthrights chief executive Rebecca Schiller.
“To date, it appears that the NMC has shown no concern for the physical and mental wellbeing of pregnant women who have booked with independent midwives,” it said.
”[The NMC has] a responsibility to make sure that all women and their babies are provided with a sufficient level of protection should anything go wrong”
“Overall, your actions appear designed to cause maximum disruption and damage to independent midwives and the women they care for. We do not believe that these are the actions of a responsible regulator,” added the letter.
The charity called for the NMC to guarantee that all women who are currently booked with independent midwives using the IMUK insurance scheme would be able to continue to access their services for the antenatal, intrapartum and postpartum period, and that midwives would not face disciplinary action.
In a statement released today, the NMC noted its decision only applied to around 80 midwives and that more than 41,000 were operating with adequate indemnity cover.
NMC chief executive and registrar Jackie Smith said: “The NMC absolutely supports a woman’s right to choose how she gives birth and who she has to support her through that birth.
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“But we also have a responsibility to make sure that all women and their babies are provided with a sufficient level of protection should anything go wrong,” she said.
“We have been in dialogue with IMUK for some considerable time to try and resolve our concerns about their indemnity provision. Our priority has always been to ensure the safety of women and their families,” she added.
“It is extremely disappointing that the NMC learned today that some IMUK midwives have only just informed their clients of the issues connected with their indemnity cover, despite knowing of the NMC’s concerns for several months,” said Ms Smith.