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Vulnerable migrants should not be charged for NHS maternity services, insist Midwives

Research suggests that charging for NHS care is undermining trust and creating a climate of fear.

Chloe Dawson

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Mother baby and Midwife
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The charges for basic maternity care start at £7,000, with complex cases costing substantially more.

The Royal College of Midwives (RCM) is calling on the Government to abolish NHS maternity charges for vulnerable migrants and allow them to access care irrespective of their ability to pay.

Women who are chargeable for their maternity care include destitute women in the asylum system, and women who have escaped sexual exploitation and domestic abuse.

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Maternity Action has published the findings of new research undertaken by the charity that has examined the impact that the NHS charging policy was is having on midwives.

The research, the first of its kind to investigate the impact of NHS charging policy on midwives, found that midwives were concerned that the policy of charging for NHS care was undermining trust and creating a climate of fear amongst vulnerable pregnant women.

The report also highlights concerns previously voiced by the Royal College of Midwives that some women were seeking maternity care late in their pregnancy, missing important tests and treatments, or avoiding antenatal care altogether for fear of charges and Home Office sanctions.

Charges for standard maternity care start at £7,000 and charging for NHS care became a legal requirement in 2015 and upfront charging came into force in 2017.

Charging for care puts vulnerable migrant women at risk.

Gill Walton Chief Executive and General Secretary of the Royal College of Midwives (RCM) said; “The RCM is committed to supporting our members to deliver safe high quality care and cost recovery is a barrier to this. We believe that maternity care should be exempt from NHS charging altogether to protect and promote maternal and new-born health.

“This is why the RCM is calling for the charging regime to be suspended until the government can prove this policy is not doing any harm and jeopardising our shared ambition to make England the safest place in the world to have a baby.

“Women affected by these charges are some of the most vulnerable people in our society. Research has shown us that charging for maternity care reduces the likelihood of vulnerable migrant women receiving care. These women are at greater risk of poor maternal health outcomes, including maternal deaths, and premature birth.

“Midwives should not act as gatekeepers to the maternity services. They owe a duty of care to all pregnant women who seek care from them and they should provide care to all pregnant women irrespective of ability to pay.

“The recommendations from this report, if implemented, will absolutely improve the situation for vulnerable migrant women and the midwives who care for them, and begin to right the wrongs of Cost Recovery. The RCM hopes that NHS Trusts, commissioners and most of all, the Government, listen to the voices of midwives in this report and do the right thing.”

Acute Medicine

Hospital visitors and volunteers help to reduce nursing workloads, survey finds

Nurses believe a lack of visitors is often detrimental to a patients’ health and speed of recovery.

Chloe Dawson

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Patient with visitor in hospitla bed

Two in five hospital patients get no visitors and require additional support from the nursing team.

Nurses working in acute hospitals feel that patients without visitors require additional support from the nursing team, according to a survey by the Royal Voluntary Service (RVS).

The survey also revealed that nurses believe a lack of visitors is often detrimental to a patients’ health and speed of recovery in a number of ways. These include; they are less likely to be mobile (43%), less likely to be stimulated through conversation (56%) and less likely to follow medical advice.

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It is also estimated that around 37% are more likely to have a longer stay in hospital.

The RVS states that volunteers can step in and play a “vital role” in helping to reduce the nursing workload and freeing up staff for clinical care.

Over half of the NHS nurses questioned said a volunteer presence on ward was very important and that volunteers could help with patient care in a variety of ways. In particular, they referenced; providing non-medical support and assisting at mealtimes.

Double the number of volunteers in the next ten years.

Previous research published in a Kings Fund report also found strong support for volunteering among frontline staff.

With approximately 40,000 unfilled nursing vacancies throughout the NHS in England, volunteers are becoming more important to ensure patient receive care in a timely manner.

Following the NHS Long Term plan asking hospitals to double their volunteers in the next ten years and the recognition of the help they can provide by the NHS nursing team, RVS is calling on more hospitals to make the most of volunteers to improve patient health.

Sam Ward, Director of Commissioned Services for the RVS, said; “With results showing two-fifths of patients may not see a visitor during their hospital stay, it is clear that more is needed to be done to support them.

“Volunteers offer a professional support service, encouraging mental stimulation, physical activity, and more that can play a significant role in both mental and physical recovery.

“It is vital that hospitals work together with volunteer service providers to make sure that patients across the country are able to access this support.”

 

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Acute Medicine

‘Harmful’ prescription charges for asthma medication should be scrapped, warn nurses

The majority of nurses want ‘harmful’ prescription charges for people with asthma to be scrapped.

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Asthma Medication Inhaler Nebuliser

Patients are at risk of life-threatening asthma attacks simply because they can’t afford their medication.

Hundreds of nurses called for ‘harmful’ prescription costs for people with asthma to be scrapped after seeing patients have an asthma attack or need emergency treatment because of the high cost of prescriptions.

A report published today by Asthma UK in collaboration with The Royal College of Nursing and Association of Respiratory Nurse Specialists, includes findings from a survey of more than 600 nurses in the UK as well as 150 other healthcare professionals including doctors, pharmacists, and paramedics.

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The research highlights the harmful impact prescription charges are having on people with asthma, putting them at risk of life-threatening asthma attacks because they can’t afford their medication.

Nurses reported patients borrowing inhalers from their friends, relatives or even their own children because they couldn’t afford to buy their own – putting them at risk of taking the wrong medication, or the wrong dose.

‘An outdated and unfair policy’.

One healthcare professional told Asthma UK that she had found the money herself to pay for her patient’s prescription because she was worried about them being unable to afford their life-saving medication.

A majority of nurses surveyed (92%) want ‘harmful’ prescription charges for people with asthma to be scrapped.

Samantha Walker, Director of Research and Policy at Asthma UK and a qualified nurse, said:“It’s really worrying that nurses who are working so hard to help their patients stay well are seeing people with asthma suffer because of an outdated and unfair policy. It is high time the Government took action and urgently reviewed asthma prescription charges so that people with asthma aren’t put at risk of avoidable but potentially life-threatening asthma attacks. No one should have to pay to breathe.”

‘Only making their condition worse’.

Wendy Preston, Head of Nursing Practice at the Royal College of Nursing said: “It cannot be acceptable that some people with long-term conditions are missing out on their vital medication because they cannot afford it.

“Nurses see the impact of this every day of the week and know what happens when people do not take their vital medication.

“This will only make their condition worse and they will end up needing further treatment adding additional pressure the health and care system.

“It is time that there is equity with other long-term conditions such as diabetes where prescription charges are exempt.”

Asthma UK is urging people with asthma, nurses and other healthcare professionals to join its Stop Unfair Asthma Prescription Charges campaign and sign its petition to end prescription charges.

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