Most midwives cannot access bereavement care training during working hours

Pregnancy and baby loss charity Sands has published the results of a survey, which found the majority of midwives working in NHS trusts and boards are expected to complete vital bereavement care training in their own spare time. [1]

Good quality bereavement care is vital for parents who have experienced the loss of a pregnancy, or whose baby has been stillborn or died in hospital during the first weeks of life.[2]

Although just over three quarters (77%) of trusts and boards reported that bereavement care training was accessible to their midwives, only a third of trusts and boards (33%) said that those midwives were given time during working hours to attend it.

Sands believes that high quality bereavement care training must be prioritised within all NHS health trusts and boards. The charity is now calling for all healthcare professionals in contact with bereaved parents, to have dedicated time for this essential training during working hours.

Sands is urging everyone to raise this important issue with their local health trust or board chief executive. The charity has launched an e-action as part of its latest campaign, Together, we are Sands, that asks NHS leaders to ensure that their frontline staff are given time in working hours to attend this vital training.[3]

Clea Harmer, Chief Executive of Sands, said: “Every parent whose baby has died, equally deserves excellent bereavement care. It’s the very least we can do for them. So it is simply not good enough that so many midwives and other healthcare professionals either don’t have access to this training, or are expected to do this in their own time outside of work hours.

“Bereavement care training is essential to ensure the immediate and long-term wellbeing of families affected by pregnancy loss or the death of a baby. Sands can offer support and training to midwives, and other healthcare workers, to ensure they have the skills they need to both care for bereaved families, and to look after their own wellbeing.

“Nothing will ever be able to take away the grief parents suffer when they lose a baby, but ensuring the right care and support is in place can help them come to terms with their tragic loss. Poor bereavement care can exacerbate a parent’s grief and have an immediate and long term effect on their mental wellbeing, but good care can and does help them on their painful journey.”

More findings from the Sands survey

Overall the survey found wide variation between different professional groups in the provision of bereavement care training; midwives, obstetricians and gynaecologists having the best access, and A&E staff or paramedics having the least.[4]

For example, only 39% of trusts and boards said this training was accessible to ultrasound practitioners, who may be the first person to spot that a baby has died, and only 4% were given time to attend during working hours.

Across the UK, an average of 49% of trusts and boards said that bereavement care training was available to staff across the range of healthcare professionals, but only 12% said time was given in working hours to attend.

Why bereavement care training is so important

Thousands of parents experience pregnancy loss or the death of a baby every year. It is estimated in the UK that one in four pregnancies end in miscarriage, 5,000 wanted pregnancies are terminated for medical reasons every year, and 13 babies are stillborn or die shortly after birth every day.

Caring for parents whose baby has died can be challenging for professionals, who may feel unprepared and daunted. Specialist training is therefore vital to boost their confidence, skills, and their own wellbeing, which in turn enables them to provide excellent care for families.

Earlier this year, Donna Ockenden noted the devastating effect lack of compassion had on a whole community in her report into failings in maternity care at Shrewsbury and Telford Hospitals NHS Trust. The Immediate and Essential Actions in the report highlighted that staff “should have been trained in dealing with bereavement”.[5]

Sands working to improve bereavement care

Healthcare professionals are an important part of the Sands community, and we work to support them to deliver good bereavement care.

The National Bereavement Care Pathway (NBCP) which is currently being rolled out in England and piloted in Scotland, clearly sets out what good bereavement care training for staff should look like. Bereavement care training is one of the nine NBCP standards central to high quality bereavement care.[6]

Sands offers evidence based training from experienced trainers to build the confidence knowledge and skills of staff to support families through pregnancy and baby loss.7 Anyone interested can find more information at www.training.sands.org.uk

References

1. In spring 2022 Sands conducted a survey to better understand what is happening in bereavement care following pregnancy loss or the death of a baby in NHS Trusts and Boards across the UK. The survey was open between 25 February and 4 April 2022. 117 NHS trusts and boards across the UK completed it, which we estimate to be 74% of trusts and boards delivering care to families who experience pregnancy loss or the death of a baby. The full survey report will be published on Sands website from 9 June.
2. Bereavement care training in this context is specific to pregnancy loss or the death of a baby, helping healthcare professionals improve their skills and knowledge and increasing their confidence to hold difficult conversations in a sensitive way.
3. When someone loses a baby, it is an isolating, devastating and life-changing experience. This is why the Sands community is so important – to support families through their loss and to grow around grief. This June, Sands wants to bring people closer together. To help everyone to know that they have an important role to play as part of that Sands community. Find out more: www.sands.org.uk/we-are-sands
4. The healthcare professions we asked about in the survey were: midwives, obstetricians, gynaecologists, neonatologists, paediatricians, neonatal nurses, early pregnancy nurses, ultrasound practitioners, student midwives, student neonatal/paediatric nurses, A&E staff/paramedics, and NHS support staff.
5. The Immediate and Essential Actions in the Ockenden report highlight that staff “should have been trained in dealing with bereavement”, and be able to deliver “Compassionate, individualised, high quality bereavement care… for all families who have experienced a perinatal loss”.
6. To ensure bereaved parents and their families are supported in the best way possible, the National Bereavement Care Pathway (NBCP) was launched in 2017 and has been rolled out across all NHS Trusts in England. The NBCP helps professionals to provide families with a greater consistency and quality of bereavement care after pregnancy or baby loss. More about the National Bereavement Care Pathway in England More about the National Bereavement Care Pathway in Scotland.
7. From free access webinars on bereavement care and engaging parents in a review of their care, to bespoke webinars and full and half day face to face bereavement care training tailored for a specific, unit, hospital or university. More information at: training.sands.org.uk

Staff Writer