Recommendation 1

HM Government Accepted

The government recognises that cultural competency is a critical skill for all maternity staff, including midwives. The government is clear that demonstrable progress on reforming midwifery education must be made, to reflect modern maternity care needs. The Nursing and Midwifery Council (NMC) is the independent regulator of nurses and midwives in the UK, and nursing associates in England. It sets the standards that registrants must meet to demonstrate that they are capable of practising safely and effectively, which includes a standards framework for midwifery education and training. Since the publication of an independent report into NMC’s culture in July 2024, NMC has undergone a series of leadership changes (including appointing a new chair and chief executive) with increased external monitoring through the Professional Standards Authority’s Independent Oversight Group on which Department of Health and Social Care (DHSC) officials sit. NMC has also undergone significant cultural changes to address these concerns. NMC has developed a 3-year Culture Transformation Plan, which began earlier this year. This includes: • embedding equality, diversity and inclusion throughout the organisation • ensuring values-based decision-making that puts patient safety and modern care principles at the centre • creating an environment where staff can challenge outdated practices Cultural competency training for maternity services staff is part of the core competency framework, which sets out clear expectations for NHS trusts. It ensures that training to address significant areas of harm is included as a minimum core requirement and standardised for every maternity and neonatal service. Over 20,500 maternity staff have completed the e-learning module to date. While this training is not mandated, NHS trusts are expected to cover the training from a list of topics included in the core competency framework, identified from: • unit priorities • audit report findings • locally identified learning Ensuring staff are providing culturally competent care requires a range of initiatives and responses, including but not limited to training. To address more systemic issues such as institutional racism, unequal access to care and biased policies, NHS trusts also need to ensure they are: • listening to feedback from service users and their communities • reviewing and updating guidelines • tackling workforce issues Some of this has been tested as part of the Race Health Observatory’s Maternity and Neonatal Learning and Action Network programme. We are ensuring learning from this programme informs all our work going forward. NHS England has also committed to better involving service users and ensuring service user voice is at the heart of decision-making in maternity and neonatal services. To achieve this, integrated care boards (ICBs) are expected to commission and fund maternity and neonatal voices partnerships (MNVPs) to cover each trust within their footprint, reflecting the diversity of the local population. MNVPs are there to listen to and reflect the views of local communities, including seldom-heard groups. To support this, NHS England provided additional funding to ICBs for their MNVPs in 2024 to 2025 and 2025 to 2026. Providing culturally competent care will also form a core component of NHS England’s Perinatal Equity and Anti-Discrimination Programme. The aim of the programme is to equip staff with the knowledge, skills and tools they need to bring about the behavioural, cultural and organisational changes required to tackle racism and discrimination, and sustain an inclusive culture. The programme has several elements, including: • webinars to raise awareness and name racism • support to identify specific local challenges • engagement with senior leaders around how to lead an anti-racist and anti- discriminatory workplace • empowerment for clinical leaders to act as role models and tackle poor behaviours • guidance in co-creating policies through an anti-discriminatory lens More generally, work is underway in NHS England to draft a new statutory and mandatory training competency framework for all NHS staff, which will replace the Core Skills Training Framework. This will set out all nationally recommended subjects to be mandated and is due to go live by April 2026.