Neighbourhood Midwives; The John Lewis of midwifery?

When my colleagues and I first conceived the idea of Neighbourhood Midwives it was driven by the necessity of the looming threat of the EU Directive requiring mandatory insurance for all health professionals. As independent midwives we were affected by this and had each been advised that self-employed midwives would be unable to obtain the required cover.

So, here were four strong-minded independent midwives who had chosen to be self-employed and who had vowed never to work for someone else again. Having to create an employing organisation that would meet all the necessary governance standards, to obtain insurance and CQC registration, but still allow us to feel and work as autonomous practitioners was a huge challenge.

Midwifery has a proud tradition of autonomy; we do not need to be supervised by a medical practitioner and we have our own Code of Conduct and supervisory system. It was therefore vital to us that our new organisation provided midwives with as much freedom over their daily working lives as possible whilst still meeting the necessary governance standards.

The obvious answer soon emerged – employee ownership.

Of course not all EO organisations are non-hierarchical, with the degree of freedom that our midwives enjoy, but the partnership ethos and culture of employee ownership businesses we researched seemed to fit us perfectly.

Neighbourhood Midwives formed with a completely flat structure; there’s no hierarchy here. We all earn the same salary, even our CEO. Our midwives work from home and manage their own caseload of women, organising their working day to fit themselves and the women. They are all on call 24/7 so this imposes limits on their freedoms but if they have no visits or appointments they are free to pick up the children from school, go shopping or have a coffee with friends. In reality each of the midwives works more than the average 5 day week but it is spread out to suit them.

We are a relatively paperless organisation with the midwives using smart phones and a virtual desktop to work from home (or in the car). We meet frequently, have a weekly conference call and all decisions affecting the midwives are discussed and agreed by them as a whole. Recent issues that have arisen are how to deal with travel expenses, caring for friends and family who are pregnant and how to calculate holidays when we don’t work a simple 5 day week.

As a new organisation we are just about to commence our Share Incentive Scheme and we have an elected Employee Director on the Board. All of the Central Management team carry out clinical work and therefore work alongside the midwives helping to ensure that there are no ‘us’ and ‘them’ barriers.

So whilst we are in a different sector of the economy, we do share many of the same characteristics as other EO businesses and EOA members; effective internal communication and engagement, giving staff a voice in the decision making; transparency and openness to ensure there is a strong sense of shared endeavor; and a structure which allows everyone to share in the ownership of the business.

Neighbourhood Midwives – a unique midwifery organisation; a social enterprise; 100% employee owned – created by women for women.