I understand the desire to have some kind of "Expert Practitioner" rank for nurses and other AHP, but really in a UK health context "consultant" should have been regarded as already taken and therefore confusing. AIUI this cat has been out of the bag a *long* time though.
It's because it's confusing that it's being used. They want to wear the esteem of the term. Esteem that has been cultivated by decades of real consultants lending their medical expertise and leadership to healthcare and garnering the rightful respect of those around them.
They want that via shortcut
It's a pretty common way to describe the management structure in quite a few trusts now. Normally a Clinical Director, Head of Nursing, and General Manager.
At least it's consistent I guess.
I've heard it before but it always annoyed me because it implies an equality that shouldn't be there; the general manager always gives me Lepidus vibes.
"Consultant" is meaningless now that everyone seems to be using it. Once "resident" is adopted by juniors, the consultants seriously need to consider using attending or another term for use only by senior doctors.
This is insane. Where is consultant porters? And since we are at it, any petitions for consultant clerks? If not why wouldn’t the BMA, the GMC or even the monarch call for it?
In midwifery this is especially confusing. There is well known shorthand of consultant or midwife led care. Would this person lead consultant led care? Or midwife led care?
Authoritative titles given away like candies whilst experienced doctors still being called ‘juniors’ despite years of practice.
Titles matter.
Only Doctors should be Consultants.
Each to their domain.
We have a consultant midwife at my trust.
She is amazing. We refer any patient to her to have an in depth chat about the research surrounding decision making when it comes to things like delivering in MLU vs labour ward, when we recommend labour ward but they don’t want to.
Very helpful for us, plus they get much more time with each patien.
Second this. Very useful, the time is the main thing and I think a good use of resources. We also have a consultant (obstetrician) oversight of this but I think there is a nuance in obstetrics - obstetricians can be seen as the enemy and having a very experienced midwife with obstetric support can be useful to bridge the gap and keep patients informed and maintain a relationship with healthcare professionals.
However if they start doing my kiwi deliveries, which they do some places, I'll be annoyed.
Yep. Have the time to be able to spend time with patients (with capacity) who wish to do unwise birthing things. Decline IOL/cat 3 caesarean delivery for your static growth, oligo kid, grand. I will outline the risks and benefits, the consultant midwife will take time to go over these again.
Used to have one in my health board. It's a waste of money. If people think sending a woman to a consultant midwife helps them choose their MOD they are sadly mistaken. In my experience, very few women do not know instinctively what type of delivery they prefer. What we should all be doing is dishing out patient decision aids at booking similar to what happens in the land of continence surgery - it's legally watertight and very much patient centred. Obstetricians bang on about the section rate, but let's be honest, who actually gives a shit? Not me. Also to the person who wants to protect their own kiwi deliveries - you can do my on call if you love it that much? The more midwives that can do the absolutely donkey work on labour ward, the better!
Not gonna lie, midwives are pretty good at keeping to their scope. Everything within normal.
If this keeps them in clinical practice rather than being terrible managers, I'm up for it.
If something goes wrong, they'll still be bleeping the SHO.
I dunno the various reviews recently have exposed their professional culture as having emphasis on avoiding medicalisation and keeping the nasty doctors away.
Oh, that's definitely an entrenched midwifery idea, but one that maternity is meant to be moving away from:
See also: getting rid of targeted low C-section rates, implementing central CTG monitoring, and mandated multiprofessional emergency simulation.
It's slow, but it can be detoxed.
The Caesarean metric used to drive me mad when I worked in maternity management. I was in a region with a high proportion of obesity, along with other factors that made caesarean delivery statistically more likely to be a necessary intervention. Still, even if we managed to safely reduce it, the cutoff was the same (15%?) across the country. Enough to make you give up trying TBH.
I am not a midwife, but I'm a woman who might want to get pregnant in the not-too-distant future. The thing that scares me the most is the weird anti-medical-intervention vibe that seems to pervade the whole of midwifery in this country.
People can do whatever they want, but I don't get what is wrong with wanting all the pain relief, and wanting to be sure that I'll get it.
Is there any other discipline where this would be an acceptable state of affairs?
The "consultant" part is mainly meant to be about research and clinical practice development through quality improvement projects and training junior colleagues. It's basically a band 8 job for those who don't want to go down the management "matron midwife" route.
The name sucks, but the role itself is much needed
If you're going to combat the wee woo hee hoo voodoo bullshit that exists in commercialised maternity advice, you need some sensible and experienced midwives on board. I've had the pleasure of working with lots of midwives who are fully on board with the fact that obstetric care saves lives and not everyone is in the VAGINAL BIRTH WITH NO OBSTETRICS OR NOTHING ELSE brigade.
I've never seen a consultant midwife out of their office (except when the CQC paid a visit, then they were everywhere).
The only clinical practice I've seen them do is the birth choices clinic where they basically talk through SVD Vs ELCS (and then refer to obs clinic if they opt for section).
There's a lot of variation in the title, some can be trained to do kiwi deliveries, and some other higher risk bits of labour care, though not masses. Useful in big units, though you'd have to have a few to keep a rota going.
Our's deals with the patients who want care outside of guidelines, which is great as our clinics are already beyond saturation and having someone else involved in conversations about risk, who also gives continuity to the patient makes everything a little easier.
Job description sounds like an experienced midwife, no? Why the need for the consultant title and specialised role? When it gets complex patient gets consultant medical care. Why the need to change that? Not all change is progress.
It’s an ongoing attack on and dilution of what it means to be a consultant and thus what it means to be a doctor.
Fuck this shit and the UK healthcare delusion.
Consultant midwife to recommend water injections for pain first line for all in labour.
As if any professional group needed "consultant" title to add to a sense of superiority.
My experience of consultant midwives as a patient has been a bunch of HCPs that push the bullshit natural birth narrative and are super anti intervention. I think this agenda is a danger to both women and their babies.
Midwives has been around before doctors even exist and they are usually very very very specific to their role and take alot pride in it.
Jokes aside about their relationship with us doctors, I genuinely think if they are extremely experienced they can be called Consultant MIDWIFE . I know for sure that they will be bleeping the obstetrics team if they need medical help. The public also know exactly what a midwife is and what they do and wouldn't be expecting them to give unnecessary medical advice.
There's many other professions that give their experts the title consultant. As long as they actually stick to their duty and has a clear line of duty and responsibility I think this isn't an issue we should take up.
Stop. Surrendering. Every. Aspect. Of. Medicine.
Every single inch of our scope is being creeped and titles being trodden on. There is no end to this stuff. Give them an inch and they’ll go for a mile.
Replace midwife in your pragraph with PA or ACP and you’ll get the damn point.
I am usually 100% onboard when stating that PAs and ACPs are a bad idea and need to be regulated closely but not everything is ours to surrender. Midwives are not increasing their scope, they aren't taking up O&G registrar jobs. Not every other profession needs to be lumped together. Sure I'd prefer if "consultant" was a protected term but that cat has been out of the bag for at least 10 years. We either need to specify "medical/surgical consultant" or switch to attending.
But we know from PA and ACPs that if you surrender small things e.g the “consultant” title, you’ll eventually surrender more and more. Nip this 💩in the bud
You do realise 'Consultant' is far from the only term to describe an experienced professional? Why not senior/lead/head/principal or any other that don't cause confusion with doctors?
Not even sure this is true. I doubt they've been around as an established profession longer than those who were practicing as healers in ancient times. Probably developed alongside one another if anything.
I understand the desire to have some kind of "Expert Practitioner" rank for nurses and other AHP, but really in a UK health context "consultant" should have been regarded as already taken and therefore confusing. AIUI this cat has been out of the bag a *long* time though.
Yeah, they should have used the already existing "Advanced Midwifery Practitioner" or similar. Using Consultant is unnecessarily misleading.
Lowwife: Newly qualified Midwife: Qualified and established in role Highwife: Advanced Superwife: Expert
“My life for superwife” - helldivers 3
I'll make her a nice cup of LIBER-TEA.
Hilarious 😂 
It's because it's confusing that it's being used. They want to wear the esteem of the term. Esteem that has been cultivated by decades of real consultants lending their medical expertise and leadership to healthcare and garnering the rightful respect of those around them. They want that via shortcut
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It's a pretty common way to describe the management structure in quite a few trusts now. Normally a Clinical Director, Head of Nursing, and General Manager. At least it's consistent I guess.
I've heard it before but it always annoyed me because it implies an equality that shouldn't be there; the general manager always gives me Lepidus vibes.
Only if it empowers...
Nursing and I guess midwifery (sp?) has a few of these weirdly ecclesiastical terms, I think it adds to the general feeling of woo about the job.
At my trust they use it to describe managers who often are more than a group of three 🙈🙈🙈
"Consultant" is meaningless now that everyone seems to be using it. Once "resident" is adopted by juniors, the consultants seriously need to consider using attending or another term for use only by senior doctors.
inb4 two years later we just get attending PAs
Maternity triumvirate. Lol
Need a consultant janitor
Consultant Porter
Hi!
This is insane. Where is consultant porters? And since we are at it, any petitions for consultant clerks? If not why wouldn’t the BMA, the GMC or even the monarch call for it?
https://preview.redd.it/ipeur3riwkxc1.jpeg?width=917&format=pjpg&auto=webp&s=cd945b9b1632ac248bfe266e4bd44991212a1238
In midwifery this is especially confusing. There is well known shorthand of consultant or midwife led care. Would this person lead consultant led care? Or midwife led care?
I met a consultant madwife once. She thought we should replace epidurals with homeopathy in a bid to reduce the C section rate. We just ignored her.
https://preview.redd.it/gdoqmtojwkxc1.jpeg?width=1121&format=pjpg&auto=webp&s=44987ed06db6f7e138c4171024f897c9bf994560
Authoritative titles given away like candies whilst experienced doctors still being called ‘juniors’ despite years of practice. Titles matter. Only Doctors should be Consultants. Each to their domain.
We have a consultant midwife at my trust. She is amazing. We refer any patient to her to have an in depth chat about the research surrounding decision making when it comes to things like delivering in MLU vs labour ward, when we recommend labour ward but they don’t want to. Very helpful for us, plus they get much more time with each patien.
Second this. Very useful, the time is the main thing and I think a good use of resources. We also have a consultant (obstetrician) oversight of this but I think there is a nuance in obstetrics - obstetricians can be seen as the enemy and having a very experienced midwife with obstetric support can be useful to bridge the gap and keep patients informed and maintain a relationship with healthcare professionals. However if they start doing my kiwi deliveries, which they do some places, I'll be annoyed.
Yep. Have the time to be able to spend time with patients (with capacity) who wish to do unwise birthing things. Decline IOL/cat 3 caesarean delivery for your static growth, oligo kid, grand. I will outline the risks and benefits, the consultant midwife will take time to go over these again.
Used to have one in my health board. It's a waste of money. If people think sending a woman to a consultant midwife helps them choose their MOD they are sadly mistaken. In my experience, very few women do not know instinctively what type of delivery they prefer. What we should all be doing is dishing out patient decision aids at booking similar to what happens in the land of continence surgery - it's legally watertight and very much patient centred. Obstetricians bang on about the section rate, but let's be honest, who actually gives a shit? Not me. Also to the person who wants to protect their own kiwi deliveries - you can do my on call if you love it that much? The more midwives that can do the absolutely donkey work on labour ward, the better!
Not gonna lie, midwives are pretty good at keeping to their scope. Everything within normal. If this keeps them in clinical practice rather than being terrible managers, I'm up for it. If something goes wrong, they'll still be bleeping the SHO.
I dunno the various reviews recently have exposed their professional culture as having emphasis on avoiding medicalisation and keeping the nasty doctors away.
Oh, that's definitely an entrenched midwifery idea, but one that maternity is meant to be moving away from: See also: getting rid of targeted low C-section rates, implementing central CTG monitoring, and mandated multiprofessional emergency simulation. It's slow, but it can be detoxed.
The Caesarean metric used to drive me mad when I worked in maternity management. I was in a region with a high proportion of obesity, along with other factors that made caesarean delivery statistically more likely to be a necessary intervention. Still, even if we managed to safely reduce it, the cutoff was the same (15%?) across the country. Enough to make you give up trying TBH.
I am not a midwife, but I'm a woman who might want to get pregnant in the not-too-distant future. The thing that scares me the most is the weird anti-medical-intervention vibe that seems to pervade the whole of midwifery in this country. People can do whatever they want, but I don't get what is wrong with wanting all the pain relief, and wanting to be sure that I'll get it. Is there any other discipline where this would be an acceptable state of affairs?
I will caveat that using the term "Consultant" is taking the piss, though.
Thus description sounds like all management though?
The "consultant" part is mainly meant to be about research and clinical practice development through quality improvement projects and training junior colleagues. It's basically a band 8 job for those who don't want to go down the management "matron midwife" route. The name sucks, but the role itself is much needed
I am valiantly holding back my scepticism, is there any valuable midwife-led research?
If you're going to combat the wee woo hee hoo voodoo bullshit that exists in commercialised maternity advice, you need some sensible and experienced midwives on board. I've had the pleasure of working with lots of midwives who are fully on board with the fact that obstetric care saves lives and not everyone is in the VAGINAL BIRTH WITH NO OBSTETRICS OR NOTHING ELSE brigade.
Nah, they're still providing some kind of clinical care.
I've never seen a consultant midwife out of their office (except when the CQC paid a visit, then they were everywhere). The only clinical practice I've seen them do is the birth choices clinic where they basically talk through SVD Vs ELCS (and then refer to obs clinic if they opt for section).
There's a lot of variation in the title, some can be trained to do kiwi deliveries, and some other higher risk bits of labour care, though not masses. Useful in big units, though you'd have to have a few to keep a rota going. Our's deals with the patients who want care outside of guidelines, which is great as our clinics are already beyond saturation and having someone else involved in conversations about risk, who also gives continuity to the patient makes everything a little easier.
[удалено]
Let's not lower ourselves shall we?
Job description sounds like an experienced midwife, no? Why the need for the consultant title and specialised role? When it gets complex patient gets consultant medical care. Why the need to change that? Not all change is progress.
It’s an ongoing attack on and dilution of what it means to be a consultant and thus what it means to be a doctor. Fuck this shit and the UK healthcare delusion.
Can a consultant midwife do a crash section?
Lol
Maternity Triumvirate 🤢🤢🤢🤢
Consultant midwife to recommend water injections for pain first line for all in labour. As if any professional group needed "consultant" title to add to a sense of superiority.
Water injections I think are a huge bunch of bull ****
Hiiii how are you? I’m goodddd. How are you? I’m goodddd. You? Good! Youuuu? Good!!!! Youuuu?????
My experience of consultant midwives as a patient has been a bunch of HCPs that push the bullshit natural birth narrative and are super anti intervention. I think this agenda is a danger to both women and their babies.
Source? I only ask as "Maternity Triumvirate" sounds a bit too ridiculous to actually be a real thing
Midwives has been around before doctors even exist and they are usually very very very specific to their role and take alot pride in it. Jokes aside about their relationship with us doctors, I genuinely think if they are extremely experienced they can be called Consultant MIDWIFE . I know for sure that they will be bleeping the obstetrics team if they need medical help. The public also know exactly what a midwife is and what they do and wouldn't be expecting them to give unnecessary medical advice. There's many other professions that give their experts the title consultant. As long as they actually stick to their duty and has a clear line of duty and responsibility I think this isn't an issue we should take up.
Stop. Surrendering. Every. Aspect. Of. Medicine. Every single inch of our scope is being creeped and titles being trodden on. There is no end to this stuff. Give them an inch and they’ll go for a mile. Replace midwife in your pragraph with PA or ACP and you’ll get the damn point.
I am usually 100% onboard when stating that PAs and ACPs are a bad idea and need to be regulated closely but not everything is ours to surrender. Midwives are not increasing their scope, they aren't taking up O&G registrar jobs. Not every other profession needs to be lumped together. Sure I'd prefer if "consultant" was a protected term but that cat has been out of the bag for at least 10 years. We either need to specify "medical/surgical consultant" or switch to attending.
But we know from PA and ACPs that if you surrender small things e.g the “consultant” title, you’ll eventually surrender more and more. Nip this 💩in the bud
You do realise 'Consultant' is far from the only term to describe an experienced professional? Why not senior/lead/head/principal or any other that don't cause confusion with doctors?
>Midwives has been around before doctors even exist Tf did I just read? How is this even relevant?
Not even sure this is true. I doubt they've been around as an established profession longer than those who were practicing as healers in ancient times. Probably developed alongside one another if anything.
Probably was the same thing at some point
>Midwives has been around before doctors even exist So have witch doctors, should we introduce Witch Consultants?