A reflection on the #MaternityReview & #NHSStaffSurvey

I just wanted to take an opportunity to reflect upon the Maternity Review published this week by Baroness Julia Cumberlege, Chair of the National , and colleagues. I will also couple this with a reflection on the NHS Staff Survey in England, also published this week 

See the full NHS Staff survey here

See the full Maternity Review report here


Overall, I think the National Maternity Review report, ‘Better Births’ was received very warmly by all, including the  community. You can read the #RCOG response to National Maternity Review here. I certainly welcome the core recommendations as listed below:

Recommendation 1: Personalised care, centred on women and families. Genuine choice, unbiased info.

Recommendation 2: Continuity of carer: safe care, a relationship of mutual trust and respect

Recommendation 3: Safer care, working together across boundaries, leadership for a safety culture.

Recommendation 4: Better postnatal and perinatal mental health care – funding and provision

Recommendation 5: Multi-professional working, breaking down barriers to safe and personalised care

Recommendation 6: Working across boundaries to support personalisation, safety and choice.

Recommendation 7: A fair and adequate NHS payment system for high quality NHS care

Also, please see  for a great summary of  here-> 

However, there were a few sentences which had me a little worried, and helped me to reflect on my own work.

Firstly: “Providing health care is by nature demanding and stressful, but the NHS Staff Survey provides evidence that this affects maternity staff more than most.”

Here, it is wonderful to see the emotion/stress work done by midwives being acknowledged. It is recognised, and so we can now begin to respond to this. Also, the evidence that maternity staff are affected more than most highlights that perhaps the midwifery workforce is more in need of support than others? or at least that we should support the midwifery workforce as a priority group? It was always my vision that the work I would do would start with midwives, and then disseminate to other staff groups….Now we have evidence that this could be a wise choice.

The report also states that:

“Midwives are more likely to report feeling pressured at work than other NHS staff, with almost half recording having suffered from work-related stress”

Does this mean that more midwives are coming forward and reporting the consequences of these pressures? Psychological distress too? At the very least, we are seeing more recognition of the reality of midwifery work environments.

Lastly, we see that:

“More midwives and trainee obstetricians report feeling unsupported in the workplace compared with other clinicians, although midwives report feeling slightly more supported by their managers than in previous years”

This tells us that midwives are in need of support. The question remains to be what type of support is required? wanted? needed? By the sounds of things, any intervention of support could complement the current systems, as long as it is there!

This reassures me that I am working towards at least one sound solution to support midwives in psychological distress. An anonymous, online intervention…. In future, we may have more opportunities to illuminate how midwives are really surviving, thriving or diving in an evermore challenging profession.

We all want to put women at the centre of maternity care. However,  I remain convinced that this can only happen if the well being of midwives is also made a top priority.

Also this week, an annual staff survey answered by nearly 300,000 people

I was delighted to hear that in response to this survey, NHS England’s chief executive, Simon Stevens had said that “The best NHS employers know that staff well being and high-quality patient care are two sides of the same coin,” he said. How refreshing 🙂

Sadly,  about a quarter of the total NHS workforce found that a third felt they had experienced work-related stress. Yet there were also many encouraging improvements noted.

Danny Mortimer, chief executive of NHS Employers, said: “The variation in staff experience across the NHS remains a real concern for employers and boards will want to do more to address this.”

Chris Graham, director of research and policy at the Picker Institute and the survey’s chief investigator, said: “Too many staff complain about inadequate resources, staffing shortages, and the deleterious impact of their work on their own health and wellbeing. We call on all employers to closely review their results and take action to ensure staff are supported and listened to.”

With these new learnings in place. Lets hope that we can all create new narratives where the staff experience is prioritised alongside the patient experience. My intervention cannot come soon enough…I just need to finish this PhD first!

In terms of my own practice. I continue to reflect upon the same part of the NMC code in that we must all “be supportive of colleagues who are encountering health or performance problems”. The staff experience falls in line with this, in that we must all support staff well being in order to promote excellence in healthcare.

So until next time. Look after yourselves, and each other.


A reflection of #CBCIDH16 & designing new innovations in health care


This week the  was a great way for me to learn more about how I can develop new ways to support NHS staff, network and share ideas about future healthcare change. I always find it so inspiring to be among driven people who are passionate about what they do. It drives me to want to do better, and gives me hope for the future. Another reason to !



The conference began waiting for  to get the party started -> See the full programme here

Keynote speakers were so inspiring, asking us all to review the way we design and develop interventions for healthcare. Such insight into innovation makes me want to champion more amazing ideas and people to make great things happen. Such talent in our field.


As the conference moved on, it became clearer and clearer to me that we need to think of new ways to support people and tune in to their own motivations for engaging with health interventions. In my own work, I started to think about how and why NHS staff would engage with an online intervention designed to help them. Would they misuse the very thing designed to support them? Do they want to be supported? Will they accept help and engage for the right reasons?

This video below aptly captures my own fears as to what could go wrong in designing healthcare interventions for those in need:

Also at the conference, we discussed how we might evidence and evaluate digital interventions to either be commercialised or developed further. This was done in a very ‘researchy’ way, and went very much against my Healthcare Leadership background. Don’t get me wrong, I really value research and evidence based approaches to change.

However, one of the sessions by focused upon ‘How to get digital intervention development taken seriously without RCTs is a scientific and political issue’ and this really grabbed my attention, as I believe that sometimes, if the evidence base is there…you just need to give it a go! This takes me back to my MSc in healthcare leadership, were we learnt how to turn visions into practice.

As I continue to attend the School for Health and Care Radicals, and the latest module ‘Making change happen’ I will be sharing these thoughts,learnings and ideas via Lets continue to work together and learn how we can really make behaviour change happen in the NHS…. together.

Check out this #SHCR module here:

Thank you to  for a great conference.   has opened my eyes to the wonderful opportunities out there to implement change and improvement in health and social care, through digital technologies.

Thank you also to everyone who came to see my research poster, presented during this conference. Your feedback was extremely productive and helpful to my PhD project.

Until next time, be kind to yourselves, and each other.






A summary of the #MaternityForum 2016 London Conference

Yesterday I had a wonderful time (as always) at the   Maternity, Midwifery and baby regional professional development forum in London (4th February, 2016).


You can view all recorded video sessions from the day here

Firstly, I was struck by the session on cultural competence by Professor Irena Papadopoulos, Professor of Transcultural Health and Nursing, Middlesex University London.

In healthcare, cultural competence is the ability of systems to provide care to patients with diverse values, beliefs and behaviors. This means that we all need to tailor the delivery of our care to meet patients’ social, cultural, and linguistic needs. This is crucial, as when we ensure that cultural competency is embedded within our service, we may see increased access to quality care for all. As we adopt the principles of both patient centeredness and cultural competence jointly, our healthcare services may also align to meet the needs of all patients, including those whose needs may otherwise be overshadowed.

cultural competance

I was also enthralled by the powerful session given by Lindsey Ahmet, Senior Lecturer, Middlesex University London – The FGM challenge.

This session was incredibly well delivered and focused upon the duty of us all to identify, safeguard and report those women/girls at risk of harm. There was a specific focus on prevention, and I do still find it difficult to know that there is seemingly so little progress being made in some areas.

FGM in public health

A special shout out goes to Shawn Walker, PhD student, Centre for Maternal and Child Health Research, City University London for her presentation on a Clinical focus – New reflections on breech birth. I was especially interested in her new paper ‘Standards for maternity care professionals attending planned upright breech births: a Delphi study‘. Shawn’s slides and videos showed us how the intuitive movements of the labouring woman can be magically successful in delivering babies safely and effectively. This reinforces our belief and faith in the human bodies’ ability to birth babies if they are left alone to listen to their instinctual birthing cues. I think we will all be taking this in to midwifery practice and sharing our learnings with women and colleagues alike.

Equally, Dr Gloria Esegbona, OBGYN, Midwife and Winston Churchill Fellow 2015, Kings College Learning Institute demonstrated in her seminar ‘OBSTRACT and the art of delivery – how to prevent trauma to the obstetric tract during childbirth’ demonstrate that when we allow the perineal muscles to adapt and stretch in tune with a mothers natural urge to push during labour, we are in turn optimising the health of the newborn at birth. We are also informed about supporting the perineal muscles during birth so that trauma may be reduced or even prevented where possible.

Then it was my turn to present my research work. I wanted to thank this lovely audience for their warm and kind words in response to my presentation. It was wonderful to hear your support for my project and evoke some really interesting conversations and ideas with you all. Thank you. I hope you will all continue to follow this project as it continues…(I already have some contacts to keep in touch with – great to network!)

Below is the poster I presented should you want to read the full results:

Sally Pezaro - Research Poster for Delphi Results 2016.jpg

In terms of new evidence for practice – it was great to see a new government publication advocating the safety of eating running Lion eggs!  Great news for pregnant women and toasted soldiers alike!

Runny eggs OK in pregnancy!

I can see this #MaternityForum becoming a staple part of my conference calendar!…

Until next time – be kind to yourselves…and each other.

Click here to see all abstracts from this conference