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Independents' Day

Midwives duck out of whooping cough campaign

Exclusive: GPs are being dumped with the lions’ share of the whooping cough vaccination programme in pregnant women after midwives said they did not have enough capacity or training.

LMC leaders in many areas midwives are refusing to take part in the programme and have warned that uptake of the vaccine may be affected.

The Department of Health said it was up to local NHS organisations to make arrangements to involve midwives, but Pulse has learnt that this is not happening in many areas.

The DH announced last month that all pregnant women are to be offered the pertussis vaccine as part of a £10 million temporary programme being rolled out across the country by GPs and midwives.

The move is designed to counter a major surge in whooping cough cases with 4,791 cases so far this year - more than four times higher than the total number of cases reported for the whole of 2011.

But Dr John Grenville, Derbyshire LMC secretary said they were frustrated that the task of vaccination had fallen entirely on GPs who do very little antenatal care.

He said there was a danger that women receiving most of their routine care from would fall between the cracks when they were not regularly visiting the GP.

He said: ‘They say they’re not trained but we are not sympathetic to that argument. We are trying to put pressure on for this to be a service commissioned from them.’

Dr Rob Barnett, Liverpool LMC secretary, said midwives in his area were not administering the vaccine due to lack of training.

He said: ‘These are competent, intelligent individuals who deal with women at a precarious stage of their life so they should be able to do this.

‘On the one hand the Government is saying we’re going to try to hammer you into the ground while on the other they’re saying we need your help. The good will in all this is ebbing away faster than some people might think.’

Dr Nigel Watson, chief executive of Wessex LMCs, also said GPs were doing most of the immunisation, but that midwives were best placed to do the vaccinations because they had built up the relationship with the pregnant woman.

He said: ‘One problem is that GPs no longer do much antenatal care so haven’t built up that relationship with the patient when talking to them about the benefits of the vaccine.’

RCGP immunisation lead Dr George Kassianos agreed that midwives needed to be more engaged in the immunisation programme: ‘The only way we are going to deliver high pertussis immunisation rates for pregnant women is if GPs and midwives work together.’

A Department of Health spokesperson said: ‘It is up to local NHS organisations to make arrangements to involve midwives or other suitably qualified and experienced providers in delivering the programme, based on the need in their area.’

Louise Silverton, deputy general secretary of the Royal College of Midwifery, said midwives could only carry out immunisations if they had the capacity.

She said: ‘The GPs keep saying they are very busy, but so are midwives as they have had a 40% increase in births.’

A spokeperson from NHS Derby City and NHS Derbyshire County said midwives were not able to offer vaccines ‘especially at such short notice’. 

She added: ‘Midwives from one provider are also providing opportunistic vaccination for those attending delivery suit. Midwifes from a second provider are administering the vaccine in GP clinics as required.’

Readers' comments (27)

  • Same is happening on the Fylde Coast. My Practice Nurses opinion of midwives not being trained to vaccinate not only pertussis but influenza as well is not printable but I'm sure you get the idea!

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  • Peter Swinyard

    no doubt GPs will soon be performance managed to reduce the 40% increase in births with which the midwives are coping. Antenatal care was taken away from us - was one of the more satisfying aspects of general practice as built family relationships - but of course when a midwife goes on holiday or off sick we are expected to do their clinics. Even with good local working relationships - we are looking to the midwives at least to counsel their patients - our patients - so they come and ge the jab. And since when are midwives not trained to give injections? Monday morning ramble over. Better now.

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  • Once again a new project gets dumped on GPs Nothing we can do about it without damaging patient care. At least we are not dying on the battlefield like the soldiers who are being shafted gy this government also

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  • Same has happened in ABMU Health Board area, with patients reporting that their enquiries and concerns about the vaccine have been met with "see your GP". Officially, we have been advised that midwifery staff have not had immunisation update training. Perhaps this should be included in their CPD as routine

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  • I'm afraid this attitude rather undermines their desire to be seen as independently practising professionals leading the care of women through pregnancy and child-birth.

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  • Yet again the midwives want to be part of the team when it suits them and not when it doesnt. (See my comments t the Commons select Committee on Science and technology 20 October 2010.)

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  • As a Practice, we accepted that we would have to be responsible for these vaccinations, however a call to our local birthing centre with suggestions to work together to raise awareness, fell on stony ground when the lead midwife didn't even return my call!

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  • So when you GPs become commissioners next April, this is somewhere where you should use your new powers.....

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  • Mark Struthers

    Is it possible that midwives are less wedded than GPs to the idea that pertussis vaccination in pregnancy is both safe and effective?

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  • Vinci Ho

    You have DoH organisation of this whooping cough campaign was very poor as people remembere that GPs were informed until the last minute . The campaign is no doubt necessary and you just midwives understand that . As the antenatal care is no longer in our hands , midwives have to at least promote the vaccines to women . Practically , the vaccines can be given there and then , hence saving the patients' extra journey to see GPs. Common sense needs to pervail.

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  • Vinci Ho

    Apology
    '.... and you just hope midwives understand that.'

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  • I think that a major part of this problem is the farce of the ever escalating retraining that professionals need to do. It is the fear of jab being given without the backup of a certificate, that means managers prevent their staff giving either flu or pertussis vaccination.

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  • Aneurin Bevan Health Board
    I am totally dismayed that midwives are not being pro-active. Lack of training is a poor excuse, as is the "time " factor. Practice nurses are rising to the occasion to protect babies, so why can't midwives?This is a public health issue which needs engagement. Shame on the midwives.

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  • I am afraid that Midwifes have let themselves down here. They campaign for autonomy of their services but when it comes to the wire they back off. HCA’s give immunisations after training so where’s the problem for Midwives.

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  • Interesting. Midwives are not trained to give flu and pertussis vaccinations but are able to administer pethidine.... where is the logic.

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  • I do not think this is a 'training issue'.../ or even a capacity issue- it is a payment issue!- midwives will not come into practice and help with these patients, as GP's get the income from flu and whooping cough.

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  • I'm sure that the issues are more complicated than this. Can we hear from the midwives, please.

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  • talk about midwifes taking responsibility and their training.i had a 26 w pregnant patient with uterine pain and she was told to put her feet up!! abruptio placenta it was!!

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  • Midwives are so lazy...

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  • I agree with Tom Inskips comments. It reminds me of working in the hospital wards not too long ago.
    Doctor: why did you bleep me at 3am
    Nurse: Mr Smith needs his troponin bloods doing
    Doctor: you are a nurse, surely you can do the bloods
    Nurse: sorry doctor i don't have the certificate yet
    The usual fragmentation of services here has been left to us to sort out

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