19. Midwifery Matters! - #Intentional coffee with Sarah-Jane Pedler and Gaynor Armstrong

In today’s episode, I’m bringing together 2 people who are literally meeting for the 1st time. 

A world-exclusive #IntentionalCoffee podcast! For those who are old enough, think Cilla Black …

My podcast guests have never previously seen each other or spoken in any way. But they share a passion for midwifery and I think they’re gonna ‘gerralong’. 

Gaynor Armstrong, Director of Midwifery, UHCW in Coventry and Sarah-Jane Pedler, Lead Professional Midwifery Advocate (PMA) in Cornwall will tell you why MIDWIFERY MATTERS.

Their passion for their chosen career/ vocation shines through. Why is being a midwife the BEST job in the world, even in these difficult times? No two days are the same. Every family, every birth is unique. Being there as mums & families welcome their new baby; being remembered for the rest of their lives. The SKY man says so! 😊

Lemon light bulbs  🍋💡🍋

• #IntentionalCoffees are fun & bring great people together!
• These are not unprecedented times – Charles Dickens’ wisdom puts the pandemic in context!
• #MatExp IS a movement for midwifery – let’s tell the international Federation of midwives!
• There are different ways into midwifery – second careers are possible!
•  #NoHierarchyJustPeople - you can influence change at any level
•  We need culture change and sustainability
•  Move away from a culture of stoicism - NHS staff shouldn’t  be expected to grind themselves into the ground
•  Harness cross-generational learning – a mix of fresh eyes & the wisdom from long experience.
•  Midwives have opportunities to stay fresh – to try out new directions
•  Stay in touch with your WHY, your purpose
•  Top tips to stay positive & energised – find your tribe! We are stronger together.
•  The pandemic has been tough for all – let’s support each other. Not us and them between staff & ‘service users’
•  Shine a light like Florence Nightingale but look after yourself & colleagues too.
•  Coping with pressure - we all need headspace
•  Ask “how are you?” –  listen to the answer
•  Communication includes involving people – let them help with the solutions
•  Collaboration is key
• Coproduction is strong – Whose Shoes is ‘brilliant!’
•  Change can be difficult – even when the change is good
• Unlock new knowledge through ‘lemon lightbulbs’!
•  The  new Fab NHS Stuff #MatExp campaign page offers a fantastic way to share all the good stuff – let’s use it!!
•  No more reinventing the wheel!
•  Be generous too - SHARE!
• Tap into individual passions
• Teamwork is beautiful
• It is rewarding to see others succeed
• Cornwall is beautiful too!

Relevant resources
FabNHS Stuff - #MatExp #WhoseShoes campaign page
Whose Shoes - overview
Talking to fab Professor Lesley Page about humanising birth.
Magic Mates - my  episode on the Obs Pod with #FabObs Flo. Check out the whole podcast series, it’s brilliant.
#IntentionalCoffee - here

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I tweet as @WhoseShoes and @WildCardWS and am on Instagram as @WildCardWS.

Please recommend 'Wild Card - Whose Shoes' to others who enjoy hearing passionate people talk about their experiences of improving health care.

Chapters

• 0:40 A world exclusive - an #IntentionalCoffee podcast! Introductions.
• 4:44 "It was the best of times. It was the worst of times ..."
• 5:10 A movement for midwifery - well, there's an idea! #MatExp
• 6:48 Different routes into midwifery - more flexible than you might think!
• 10:29 Wanting to influence change - you can do this at any level!
• 12:54 Sustainability. Culture change.
• 13:40 Care for the carers (staff) - you can't pour from an empty cup. Staffing levels are key!
• 14:48 Fresh eyes and the wisdom and experience which comes with years - harnessing cross-generational learning
• 15:51 Linking back to my conversation with Prof. Lesley Page - humanising birth
• 17:17 Learning from ALL feedback - "why Whose Shoes is brilliant!" :)
• 17:59 Such a special job - the PRIVILEGE of being a midwife
• 18:22 Relationships - continuity of carer
• 19:29 The SKY man says THANK YOU!!
• 20:49 Service to the community. So real and rewarding!
• 21:30 Flexibility and variety - no two days can EVER be the same!
• 22:37 Keeping fresh - so many opportunities to develop and specialise
• 23:10 Stripping back the layers - and re-finding your purpose, your WHY
• 25:08 How do you stay positive and energised when things are difficult?
• 25:28 'Find your tribe' - we are all stronger TOGETHER
• 26:00 WELLBEING. A Whose Shoes event to explore wellbeing. Moving forward from tough times in the pandemic, juggling personal lives and fears, alongside work
• 26:40 Florence Nightingale - shining a light, showing the way with others helping us stay strong
• 27:10 Coping with pressure. Headspace is vital to health and wellbeing.
• 27:32 Key conversations with colleagues. "How are you?" Listening.
• 27:51 Good communications. Being real. Sharing the challenges - and what is happening to address them with the team. Getting people INVOLVED.
• 29:10 Collaboration - central to maternity care, at all levels
• 29:28 Coproduction with women and families - they do it SO well in Cornwall !
• 30:38 BIG changes for staff to cope with - even when it is good stuff.
• 31:40 Sparking lemon lightbulbs through conversations - Whose Shoes approach strong in Cornwall, and has been for years.!) Unlocking new knowledge
• 32:55 Connect with others - share the good stuff.
• 33:36 A practical example - working outside guidelines? There is a 'The Obs Pod'episode!
• 34:28 Maintain energy through making new friends. Magic mates to sound off to! ;-)
• 35:20 NEW! Launch of the #MatExp Fab NHS Stuff campaign page. Now we CAN collect and share the good stuff!
• 35:53 OUR channel. 10 'starters for ten' - Join us and add YOUR fab stuff!
• 36:22 Be generous! Don't start with a blank sheet. See what is out there. And be generous in return.
• 37:29 Let's all share #MatExp #WhoseShoes 'fab stuff'! A fresh way of thinking in the NHS. #NoHierarchyJustPeople
• 39:00 Intrinsic motivation - tapping into what individuals are passionate about.
• 39:14 TEAM work is beautiful - and the satisfaction of seeing others succeed.
• 41:39 A highly succesful #IntentionalCoffee - let's all meet up ... in Cornwall ! :)

Transcript

Sarah-Jane Pedler and Gaynor Armstrong

Sat, 1/22 1:55PM • 43:40

SUMMARY KEYWORDS

people, midwife, midwifery, conversations, role, gill, shoes, nhs, gaynor, women, challenging, maternity, career, important, pledges, team, support, collaboration, service, sarah

SPEAKERS

Gill Phillips, Sarah-Jane Pedler, Gaynor Armstrong

Gill Phillips  00:11
My name is Gill Phillips and I'm the creator of Whose Shoes a popular approach to coproduction. I was named as an HSJ 100 Wild Card, and want to help give a voice to others talking about their ideas and experiences. I'll be chatting with people from all sorts of different perspectives, walking in their shoes. If you are interested in the future of health care, and like to hear what other people think, or perhaps even contribute at some point, Whose Shoes Wild Card is for you.  Today's podcast is quite innovative, I think. I'm delighted to bring together two people who are literally meeting for the first time today. They've never previously seen each other or spoken in any way. But they share a passion for midwifery. A true passion in that they believe being a midwife is the best job in the world! So what a wonderful opportunity for them to meet and tell us why this is true. We're all really excited about it. So this is an #IntentionalCoffee podcast. What is an 'intentional coffee' I hear you ask? Well, last year I launched with Dr. Mary Salama, a wonderful paediatrician in Birmingham, the concept of an intentional coffee and intentional coffee is where you bring people together who you know will simply get on and have that special synergy. One plus one equals so much more than two. Sarah-Jane Pedler is the Lead Professional Midwifery Advocate at the Royal Cornwall Hospitals NHS Trust. I've known Sarah-Jane for many years as the leading #MatExp (that's maternity experience) xx champion who has run wonderful annual Whose Shoes workshops around all sorts of topics using true coproduction from start to finish. She also really impressed me with her innovation during the pandemic, bringing humanity and compassion to both women and families and to the maternity team, to support them. Gaynor Armstrong is Director of Midwifery at my local hospital trust, University Hospitals, Coventry and Warwickshire - equally passionate, equally level headed and practical. I've been working with Gaynor to bring together a truly innovative Whose Shoes event around wellbeing, exploring how both staff and women and families have been affected by the pandemic and providing an opportunity for reflection and a chance to move forward strongly together. So it is my huge pleasure to bring you two dynamos together and see where the conversation might lead. I'm hoping it will have a really long lasting impact, inspiring more people to take up midwifery as a career and also forging some new links between your teams. Perhaps you could start by telling us a little bit more about yourself, and what's important to you. Let's start with Sarah-Jane in Cornwall, and then come back to Gaynor in Coventry, if that's okay.

Sarah-Jane Pedler  03:09
Oh, that's such a lovely introduction to us both, Gill and it's really exciting. I absolutely love the work that you do. I think you're such an innovative, and just really energising for all of us in the NHS, and certainly we've found that in maternity services. When I came into midwifery 19 years ago, it was a second career for me back then. I was in my 30s as a working mum and I worked for a long time as a frontline midwife. During my career I've taken on roles as a supervisor of midwives, have been our practice development midwife. I'm a midwifery ambassador, international leadership management coach and currently our full time Lead Professional Midwifery Advocate and I'll shorten that to 'PMA' - a bit quicker!

Gill Phillips  03:52
So PMA, because we need an acronym here. We don't like acronyms, but we need one here!

Sarah-Jane Pedler  03:57
It's a bit of a mouthful otherwise, isn't it? And I'm also in my final year doing my dissertation for my MBA in senior  leadership and healthcare. As a midwifery advocate, I put a lot of consideration into what it means to advocate for midwifery, both in terms of midwifery as a career choice but also in terms of retaining midwives in this amazing profession that we are. So just as a very momentary thing, just to anchor for me where I am, I've got two direct quotes that I'd like to read befor e we move on to listen and hear  from Gaynor. They're both direct quotes, one is from Charles Dickens, and from A Tale of Two Cities and one's from the International Confederation of Midwives. It's from their strategic plan, 2021-23.  So Charles Dickens first. "It was the best of times. It was the worst of times. It was the age of wisdom. It was the age of foolishness. It was the epoch of belief. It was the epoch of incredulity. It was the season of light. It was the season of darkness. It was the spring of hope. It was the winter of despair. And then my other quote is, as I said, from the International Confederation of Midwives. And they've said that we need to foster and build the next generation of midwives, while leveraging the knowledge and the wisdom of older generations, fostering cross-generational learning. And their Strategic Priority 3 is to foster a movement for midwifery, enabling and strengthening partnerships, advocacy, communication, and women's voices at the centre. So for me advocating for midwifery is about seeking authentic hope, and seeking the synergy of new knowledge and the wisdom of experience.

Gill Phillips  05:52
That's brilliant. And it's definitely the first time we've had Charles Dickens on the podcast. What an amazing start. And I love those quotes. And I love the idea of building a movement of midwifery because hey, that's what we're doing with #MatExp isn't it?And for the people that the midwives serve, and the whole maternity teams because everybody's got to work together. So thank you for that powerful start Sarah-Jane. Hi, Gaynor, say hello to Sarah-Jane - you haven't met before now!

Gaynor Armstrong  06:20
Hi, Sarah Jones really nice to meet with you. And Gill's told me so much about you already. I do feel like I already know you. Besides, Gill was sharing some of the experiences that she's had of working with you and felt that we'd get along. And it sounds to me like we already have quite a lot in common. 

Sarah-Jane Pedler  06:40

Absolutely.

Gill Phillips  06:42
Gaynor, It wasn't the first career for you either, was it?

Gaynor Armstrong  06:46
No, that's what I mean. So, before becoming a midwife, I very much had a career in the financial services industry where I'd worked for 13 years, whilst having my children during that time as well. So, you know, I'd had the opportunity of joining a very well known building society that was local to me. And yeah,  being supported very much so in that role, but then realizing it really wasn't something that I'd planned to do, but more stumbled across. So then I went in search of my dream after having my second daughter, and I said ... I think my husband thought I was having some sort of midlife crisis ... because I decided then to undertake an 'Access to health care' course, having left school with GCSEs back in the 1980s. And similar to yourself, I had two young children then, but I decided to join a hospital as a healthcare support worker, because I felt that I needed to understand how working in health care would fit with having a very young family, with my daughter being only 18 months old at the time. So I worked firstly, in  ... just outside critical care, actually, on a very heavy ward. And I very quickly learned how hard nurses work and worked there for a very short time before I was offered a post in maternity. Obviously, this was my ambition and dream to go and work in that department. And I think the team felt I had very rose-tinted glasses, because it was a real dream of mine to work there. And I loved going to work every day, always with a smile on my face and a skip in my step. So I then kind of thought, right, this is the next step to take and obviously was in contact with universities to get a placement and was very fortunate to be supported with secondment from that trust to undertake my midwifery training. And then I had the opportunity to have some wonderful mentors, who one of them Sandra, who always tells me now that she taught me everything I know. And she really did, and some great midwifery experience. So yeah, started on my journey very much like you and I've had various different experiences throughout my career as well. So having been my first 12 months as a hospital midwife, then was asked to go out into community as an integrated midwife. So very much delivering continuity of carer. I had my own caseload two days a week community, and two shifts in the hospital and I saw, probably about 75% actually, throughout the hospital experience for those women. And I did that for about five years before realising I wanted to do more and influence change a little more. So I left that trust to go to another to work as a Labour Ward Co-ordinator, which was a huge step. And I really loved what I did, and felt that I could support midwives as well as supporting the women and their families to get their birth choices but also for midwives. To succeed and become the midwives that they wanted to be with training and support, and then realised, again that that wasn't enough and felt I needed a new challenge. So I left that role to go into patient safety, where I remained for about five years before coming into this role. So I joined UHCW as the Women's and Children's Risk Manager before then taking on the role as the Interim Head of Midwifery and subsequently obviously Director of Midwifery. So I think the thing for me, my biggest passion has always been that I wanted to influence change. And I've done that on an individual basis with women and with midwives as a mentor, as a coach, and also as an advocate for both women and for staff. But then, I don't see my role any different now. It's just I'm doing it on a bigger scale. So I can advocate for more women in this role. And that's my honest belief. And that's why I do this job. And that's what helps me sleep at night as well. So yeah, very similar stories that we ... our career journey has been quite similar in that respect, which is, it's just so heartwarming for I think, then others to see that ... it might not have been your profession of choice when you left school or education. But actually, that doesn't stop you. And I've done a talk to maternity support workers only last year. And I said, the thing for me was actually realising that you should never accept no as the first answer.

 Gill Phillips  11:32
Just find a different way.

 Sarah-Jane Pedler  11:33
It's so interesting, isn't it? Because I think for a while midwifery stopped having lots of different ways that people could get into midwifery. And we're gradually opening up in different ways now, aren't we way, the only route isn't just that you have to go and do a full time degree in midwifery. I think that's so important. Because although there's plenty of people who would want to do it that way, that isn't the right way for everybody. And that isn't actually sustainable and possible for everybody. So one of the things for me that I'm so excited to see that we're looking back at getting people who are nurses being able to train as midwives, people being able to become a maternity support worker, and then get funded to train as a midwife. I think it's a real barrier for people who have families or who can't afford to go to university without working alongside it. So I think it's really exciting to see that that's been recognized, because that's how we're going to move forward, isn't it? When I look at so many of our problems at work, so much of it is down to staffing, there will be obvious other issues, but staffing is such a huge crux of everything, isn't it? If you don't have enough midwives, everything else cannot fall into place, you can't create that people-centered ethos that we want to create you. You can't create that culture that we're really looking to create where people are cared about their well being that really matters. It creates issues for people on the frontline, it creates issues for everybody who's line managing, and it creates issues for leadership all the way up. So I think that's one of the most essential things that I can see gradually shifting and changing in terms of that kind of recruiting people in and it's something I'm really passionate about. Anyway, it's part of that journey that I've taken, I came into midwifery. So women and people-centered thinking that I would always really want to be that frontline midwife. And as my career went on, I think particularly when I became a supervisor of midwives, I started to get more and more passion for well, actually, we don't get it right for our workforce, then they cannot get it right for those that they care for. You know, we rightly put women and people at the centre of our care. But if someone isn't then stepping back from that, and putting the workforce at the centre of their care, then you get this kind of domino effect, I think of things gradually being displaced, and a sense of real complexity in how we provide the care that we want to provide. And I think in terms of really maintaining and holding on that sort of sustainability of those who we do manage to recruit into the role. We're lucky we you know, now we're working for an NHS that's really looking to shift and change its culture, but that's deeply entrenched, isn't it? That very strong sense of being stoic, of working hard of not taking a break, of not saying that you're struggling? That's a big thing to shift. And I think the more we get that combination of people who are fresh from school, with their lovely fresh approach that they have, but also combined by that - people who have life experience coming into it as a second career and that combination, I think that's where we start to unlock the ability to have a much wider view on what it's like to be a midwife and what it's like to be in a different role. And we've got so many different roles that we can have, and be, and do, far more than I think, certainly, that I've ever seen. And I think that's, you know, partly down to the leadership as well, isn't it where I am, we've been really lucky to have leadership that is really looking to build more interesting roles to create those kinds of specialist roles. And that obviously, gives its complexity because you're taking frontline staff out of the frontline working to do that as well. So you've got to be able to keep replenishing them. So bringing people into this as a career, it's where it all starts, isn't it?

 Gill Phillips  15:50
And I think this is where this episode is exciting for me in terms of building really strongly on the fantastic chat that I had with Professor Lesley Page, humanising birth. Now for me with Whose Shoes you know, people can think that Whose Shoes is about - and it is - getting people to think more what it's like to be, in the context of maternity, the women and families or in the wider work that we do, perhaps the people in the community or the patients and so on. But coming back to Gaynor's point, unless people have got that skip in their step, unless they actually want to join the profession in the first place, and then stay engaged, stay innovative, you know, the love and the lemons and all the reasons that you came into the profession in the first place, wanting to be women-centered ... not just being ground down. So it's trying to build those conversations. We're calling this episode 'Midwifery Matters'. I can see that both of you are passionate about being midwives. Let's get some of that energy in terms of stripping away all the 'stuff'. And Whose Shoes tries to strip away the stuff. We can do  plenty of 'stuff', can't we? Guidelines, targets, and all the things that are really, really important, but which can change the focus in a way, and start to move away from what really matters to people. You can move away from just the central, the midwife, the mother, the baby... what is so awesome about that?

 Gaynor Armstrong  17:17
I think the thing for me as well as I think about conversations that I've had with midwives before and when we look at, in particular, where we have positive or negative feedback from women about the care that they've had, and I think this is where Whose Shoes is brilliant, because getting feedback, it doesn't matter in what context. But that feedback is so important for us to shape, what we do and how we improve. Whether that is that we continue because we found a good way of doing it or whether it's that we need to make a change, because it doesn't work in that way. And I think how I've then always said to midwives, when I've had those one to one conversations, is that we have to remember, we are so privileged to be involved in this part of a woman's life and family's journey into parenthood, that that might only be maybe once, twice, three times for some women in their entire lifetime. So how lucky we are to have been a part of that. Now when we provide really good care, and we are advocates and supporting women, they never ever forget their midwife, their relationship with that person. And when we talk about continuity of carer, it is all about the relationship of care, isn't it? And I think that's the bit for me that is so precious about being a midwife and what makes it so different from some other health care professionals, that we have this very intense period of time that we spend with the woman, her partner and her extended family. And I remember being a community midwife and starting off by seeing one lady one partner, and then by the time that I finished, it will be that it was five years later, they were embarking on their third pregnancy when you then get to meet baby number one or baby number two in a very different way. And they are there talking about this - "This is the lady who looked after mummy when you were in her tummy" and having those conversations and the sense of pride that they describe you. And I know I told you Gill about having recently had Sky installed when I'd moved house, and the chap said to me, "what is it you do for a living?", and I thought, why is he asking that, that's really strange. And I said ooh, I'm ... because I'd said I work for the NHS. And I said ooh, I'm a midwife and he said I looked after my wife when she had a baby and "I knew it was you but I didn't want say" he said she absolutely thought you were great. I was, I was so touched and that actually meant so much to me. And then he told me that his daughter was now 13 years old, then realised that realisation of how families move on, but we don't necessarily because this is our day to day, what we do and who we are. And I do think it is who we are. I do think that is part of it, that when I describe myself as a being a midwife, I forget that its a role - it is who I am. And I'm still as passionate as that first day when I say, you walk into work with a smile on your face and skipping a step. Despite the challenges that we currently have, I absolutely love what I do and wouldn't change that.

Sarah-Jane Pedler  20:43
And how many careers can you have such a multitude of different aspects to it? 

Gaynor Armstrong  20:49
Yeah

 Sarah-Jane Pedler  20:49
As a midwife, you, you have this opportunity to  ... you're in service, you are able to completely serve your community, which for me, was a massive part of it. And certainly in the conversations I have with so many of my colleagues, that service element, that being such an integral part of the community, is  really important. And I think community during COVID has really taught us more and more, brought home that sense of community and how important it is to feel part of your community, and that you're doing something of real value for your community. So I think that's an amazing thing that we do. But also we've got all of these different skills that we have to develop as a midwife, you're looking after, on the whole 40 weeks of pregnancy, and then the birth, and then the beyond. And all the different things. You could have somebody coming to you who's really fit, healthy and well ... you've got somebody who has all sorts of complications in their own wellbeing before they became pregnant, people who have lost pregnancy and have had to cope with all of the myriad of the distress of losing their pregnancy, there are so many different elements to what we do, and the skills that we have to develop. And it's a constant, constant evolving learning. And that's one of the things I think that it keeps it so fresh, and so constantly challenging, but in a wonderful way, challenging. You know, we talk a lot about the complex challenges of midwifery. And I think it's very vocal in the press around that complexity of maternity services. But it's also really important that we focus on the complexity of midwifery in the most wonderful sense. All the different things that we have to learn and do and develop, and also the way that we can shift and change. So if you feel that you need refreshing in some way, then you're suddenly able to think, "Okay, well, I'm gonna develop skills in a whole different direction". And the fact that every day something is gonna happen, it's completely different, you will never be able to turn up and just give exactly the same as you did the day before, you've always got something that you need to find within yourself, that refreshed energy. It's interesting talking with colleagues of mine, and also a bit involved in a few groups that are a national group. So we have some really interesting conversations nationally as well around ...how do you stay refreshed? And what do you do? how to keep that kind of appreciative inquiry? Or the 'what if it DOES work out'? approach, which I think I sense in so many people that are still in love with their career, or the years later, there are people who have that ability to, to think well, okay, well, what next in the best possible sense? Or how do we make the best out of this, but in a genuine way, because, you know, we have to be really genuine, it is a challenge. It's a challenging time in NHS services as a whole. But there are always ways and forms and one of the things that I love is that in my role, and I feel so lucky to work with people who, if they're starting to feel like "I don't know how to look at it through that lens that I've always looked at it through" then you can start to strip back with people and start to really get down to "what's your sense of purpose? What brought you to it in the first place? Where's your' what matters to me', where's your sense of purpose as to why you want to be a midwife now in everything that's going on, and I love that when you start to strip the layers back of everything that's going on and everything that's challenging?" And when you get somebody to that core of what they feel their purpose is , you can just see it, you know, you see their posture change, their voice shifts, their eyes lighten up. It's just that - how do you strip that away and keep people at that stage when it you know ... not just people who've been in it for a long time, you know, we have people who are in their vocation for one or two years who find it challenging and maybe not exactly what they thought it would be to, especially if they come into into a pandemic which is, you know, nothing at all that any of us could ever envisage. And it's taken energy away from where we were going, we've all had to put this huge amount of energy in a completely different direction. And what from your ...  both ...because I know Gill, you always seem to manage to keep incredibly energised and upbeat. You know, what do you do? How do you ... how do you keep that going for you? is not always easy. Is it? And like you say, it has to be genuine, I can see that Gaynor has got a really good answer. Have you Gaynor?

 Gaynor Armstrong  25:29
I was just gonna say I think the thing is, you know, it's really important, isn't it? In order for you to remain positive, it's, it's good to have people of a similar nature around you as well. So surrounding yourself with people who also have those similarities in our personality types. Because I think when you are trying to be supportive of your colleagues, your team, your family, as well, who are really anxious at this difficult time. And I think ... I know Gill, we've had a conversation because one of the things we wanted to do with the Whose Shoes is actually bring together the staff and the women so that there is a shared understanding of the pressures that that has placed upon us, when we have got worries about what's going on at home as well as at work. And I think, in order for us to support people, that does require for us to be energised, isn't it because I think that's where ... if we are not able to show them the way through some of these challenging times. That thing with Florence Nightingale and the lamp with the shining light, you know, that sometimes we have to be that person, don't we, so that we can support others and lead the way to continue with that. And I think it is that we have to have people around us that are like minded. And if there aren't people around us, then it's to seek those people out through whatever means we can, both inside and outside of our working life. For me, it's really important that we have what we call headspace. We were in a discussion with our senior team yesterday, and saying that sometimes the pressures placed upon us ... in particular, when you get into any management role within healthcare or industries at the moment. Headspace is so important, isn't it and our health and well being. And it's about having those key conversations with our team, even if it is on a very ad hoc basis. "Hi, how are you today?", you know, "how's things going?" but genuinely then having the time and opportunity to be able to hear what's being said? I'm not saying that you always have the solution. And obviously, I think at the moment with the challenges that you've already mentioned, Sarah-Jane, about the staffing. And I know this has been discussed on national, regional as well as local levels. And we can't get away from that. But it's actually letting the team know what we're doing about it and how we're trying to address some of these challenges currently. It's not to say that we will always have the answer either. But I think being honest, being open and sharing that, but also engaging and asking people to get involved with you. So if any way that they want to get involved in the recruitment process, and share their passion and dedication for the role as well. It just reinforces how they're feeling. And that then has that knock on effect for others as well. And I think that's the bit that's important for me is we have got so many people that work with us, as our colleagues and friends and peers that do feel still so passionately and strongly about midwifery. And I think sometimes this is the reason why it then can be quite distressing. And, you know, it's so disheartening currently, isn't it with the challenges that we face?

 Sarah-Jane Pedler  29:09
And I think it's in that collaboration, isn't it Gaynor, or that  we get our thanks? And I think it's one of the things I love about midwifery as a profession because the collaboration is always there. When I look back you know, we talk about collaborating now very much like kind of nationally across different services. We talk a lot about collaborating with our service user voice, and we've got we're lucky in Cornwall, we've got an amazing Maternity Voices Partnership.

 Gill Phillips  29:38
Oh, wait, where did that come from?

 Sarah-Jane Pedler  29:42
Well, it would have always come, but we did launch it, didn't we Gill, at our Whose Shoes.

 Gill Phillips  29:47
We did! That's exciting.

 Sarah-Jane Pedler  29:48
And you know, we've just done ... Georgie Watson and Nicki Burnett, who are just absolutely phenomenal, leading Maternity Voices Partnership ... it's now Nicki Burnett has taken over the chair there. And actually, we have our Maternity Voices Partnership as a kind of thread through everything we do, you know, they are involved in our guidelines, in the language that we use, in our interviews, involved in every project where there needs to be any kind of service user voice. For example, at the moment, we're developing a pathway for people who choose ... their birth choice falls 'outside of guidelines'. But you know, we look at that from both perspectives. So we want to get it right for our service users. So we've got to have our service user voice in there. So our Maternity Voices Partnership is massively part of that. But also, we're trying to get it right for our workforce, because for them that we're in this constant shift andchange, aren't we ... how we would have spoken to our service users, how we were encouraged to speak is so different when I came into the profession 19 years ago, compared to now. And I love the direction that it's going. But the fact is, it is a shift and change for people. So we're developing this pathway together so that we kind of make sure that we look at education for our frontline staff as well, so that they feel they've got the skills that they need. And it's in that collaboration for me, I think is so wonderful. And we see it in every different stage, we see it on delivery suite in the conversations that you might have when you come out of your room, and you just kind of run it by one of your senior colleagues like "this is what my plan is, what do you think? what would you do?", so the simplest of collaborative conversations. And I think, again, it's one of those careers, one of those vocations that really empowers us, and also demands us to be highly highly collaborative, which ... as soon as you get into collaboration, and you get that energising, and you get that ... get someone else's view. And I think that that really helps us to stop us from kind of getting stagnant in what we do and stagnant in our view, or, "but I always do it this way". And that's essential, I think, to keep that refreshed energy. That's why I love working with people as well who, when people come from another trust or when they're newly qualified, or when they're students, or when they've gone into a new role and had to develop new skills. I love that, because the conversation starts to really shift and change. And you can see people sparking off each other. And it's that kind of ... that Whose Shoes approach as well, isn't it Gill, you know, where you're instigating things at all times, you're looking for that collaboration, but you're looking for people to not just teach each other something you already know. But when you get that third aspect where you both plan your view in, and then suddenly there's that lightbulb moment of actually there's something else that neither of us would have considered without talking to each other that wasn't even there that you didn't know. It's that unlocking of, of knowledge, I guess within us, and I think midwifery is one of those careers that really enables us to do that.

 Gill Phillips  30:37
But ... it's lovely that you say that. And I know I've found one thing that I really, really love is the point at the live ... particularly the live ... I mean, virtual has been different ... the  face to face Whose Shoes events, where we've sown the seed all the way through for people to make pledges. Now I've found now ... it's like you really, experience builds ... and someone will come up with an idea. And I can pretty much guarantee that I'll be able to add to the idea, either by, it might be easy, there might be somebody else in the room that pops up and says, "Hey, that was my idea!" And you think, well do it together then! But in terms of the collaboration and the network, and what you're both saying about that, find your own people, there will be somebody that's already doing that work. So it's less lonely. I mean, it's just so practical, because it saves time to find out what's already happening. Because you link with other people who've got the same passions as you and you can talk and you can develop together. So immediately when you were talking then, Sarah-Jane about developing a toolkit about working with women who want to have a birth that's perhaps outside formal guidelines. Now Flo. This is Florence Wilcock and the ObsPod has done an episode around working outside guidelines. So immediately, I can recommend a resource that you can listen to. And it will add to that conversation because it will be things that you've thought of, things that you haven't thought of, things that you think differently about, perhaps have a chat with Flo. And I think that's what's so special. So your earlier question - and I thought Gaynor's answer was brilliant ... You know, how do you keep going with energy? Well, of course you can't. And some of it might be a perception, you know, my lemons on Twitter, and sometimes you're really frustrated about something and I've had some big frustrations over the last couple of weeks when my emails weren't reliably arriving. And just, you know, we all have the stuff, but I think is the human approach and the connections - and I use the word 'friendships', not just colleagues - and you develop proper friendships through these things. Flo and I have done a 'Magic mates' podcast together. And that's how we feel. And you find people who add, coming back to my introduction when I thought two would be more than '1+1=2' and I almost feel I can back out of this now and just let the two of you run with it! Because that's, you know ... you just bring people together and connect. And the other really, really fantastic thing that we've got that I wanted to share with both of you... So last Sunday, we've launched the #MatExp campaign page on Fab NHS Stuff. Now that's been overdue for years, really, you know, we've looked for a platform whereby ... supposing from either of your work, whether it's a toolkit that you're developing, or whether it's a pledge that's come from a Whose Shoes workshop, which might be a little thing, or it might be a big thing, or it might grow into a bigger thing, you know, to have somewhere to regularly be able to collect stuff. That's what we're now doing. So take a look, they literally put it together last weekend, and they've got 10, 'starter' things. Well, all of the 10 Starter things are fantastic. But we've now got a channel, all of us, and this belongs to all of us, that we can add little bits of good practice. And it could be the first place that you look, not just to find out a resource, but also a connection, someone who's the person behind it, who's the person who's passionate about that. So it's a very exciting time, I think. 

Sarah-Jane Pedler  36:21
I LOVEthat idea, Gill, and also, because there's so many people doing amazing things isn't there, you know, across the whole country. And also, I mean, I don't know whether it's just particularly true of NHS services. I mean ... I'm studying an MBA, and because it has that business aspect, we're always been encouraged to look outside of the NHS and to look at business and what we can bring into the NHS from business thinking. But one of the things that I see so much in the NHS is this generosity of sharing knowledge, there's not a, "I'm holding on to that! That's my idea, I don't want to share that, we want  want the credit for that!". I know that that, of course still exists. But the people I talk to, they're so generous with their knowledge, and they're so generous with wanting other areas to grow and share and develop. I think that comes back to that whole thing that of course, because we're in service, because if you help other people to grow, then really all you're doing is making sure that the people in their community get a much better service. So maybe, and that's underpinned by that kind of whole altruistic attitude that we have underneath it all. But the idea that you could just go on to a platform, and that you can think well, who's come up with something brilliant, I can see and then talk to, I think that's a wonderful idea. And I think, because you have so many people who were doing so many different projects, and certainly from Whose Shoes perspective, it generated so many different, you know, a very different and fresh way of thinking in the NHS, a very different way. Again, it's that collaborative thinking, isn't it, but in that very non-hierarchical way. And it's one of the things that I loved about Whose Shoes because it has, you know, we have done several ... we're a bit a bit stunted due to COVID, but we'll continue on. But that's about taking the hierarchy out of it so that people feel the freedom and they're not afraid to speak up and they're not afraid to share their idea. Well, of course, if you've got a platform like that, then anybody who maybe would feel intimidated to share, can maybe feel "well, I've got a voice, I can share that too".

 Gaynor Armstrong  38:25
I was gonna say I mean, again, you know, another similarity that we have i said that on Friday, I've got my last exam for my MBA. It's been dragged out because of COVID. But thankfully, it's the very last one, but doing Healthcare Management and I was thinking when you were talking earlier, Sarah-Jane, some of this with collaboration really is around actually the different motivational factors, what makes people want to make these changes whether that's a service user or whether it is a member of our team or whether it's us personally as individuals, we all have different intrinsic factors that make us then think ..."well actually, I'm really going to run with this and I'm going to do it because actually it's so important to me". But on the other side of that is the fact that the feeling it gives you when you see others achieve and I know we often use, don't we, the acronym for TEAM, you know "together everybody achieves more". And I think there is that thing that when it is that you're in these positions, whether it is like yourself as a PMA, whether it's in line management or whether it is as that midwife supporting the woman in a room, but we do it collectively as a team approach don't we? But we feel so much better when we've empowered others to do that as well. So you know everything that you've just said, I think is so absolutely right but different reasons why people will be motivated to do different things. And I think what the Whose Shoes has done for us before here at UHCW is actually bring all those ideas together, isn't it? And actually, it then gives us ... as part of the pledges at the end, you know, we all have that same commitment to make that change, and to make a difference. And I think that is so important for us in our roles for the women, the service, but also for the team that we're supporting as well.

 Sarah-Jane Pedler  40:23
And I think saying that we're a team, that's a huge part of what we do, isn't it and for me, it's one of the hugest privileges is that sense of team, when you're a midwife. When you work in maternity services, you're working in the most incredible partnership as a team, in so many different ways. It might be the team, on the day out in the community, or in the hospital, it might be within a leadership team, it might be across a national team, who are looking to create direction, we have the ability to have these highly functioning teams. And I think that's one of the most beautiful aspects for me, and I know beautiful is a strange word to use. But for me, team working is one of the most beautiful things you can ever, ever bring to your life. That ability to be able to be shoulder to shoulder with people, to still challenge each other and challenge each other's thinking. But in a way that you bring alongside, that we're bringing people along with us when we challenge them, getting them to ... or you don't need to bring them along, because there's so on that page with you already, which is just how I feel having a conversation with you Gaynor and Gill today. It's just such a privilege.

 Gill Phillips  41:34
So I think that's brought us to where we need to get to because I know people have got to go. But where are we? We've got curiosity. We've got listening, we've got teams, we've got collaboration, we've got pledges, so I'd like to think you two will pledge to speak to each other again after our initial #IntentionalCoffee. And we've got so many different aspects we could have talked about, but I think we've got through a lot really in terms of what matters and why midwifery matters. Final word, Gaynor or Sarah Jane?

 Gaynor Armstrong  42:04
Yeah, can't wait to come and see you Sarah-Jane, I shall be down in Cornwall this year. I come every year, bring the dogs on their holiday.

 Sarah-Jane Pedler  42:13
Oh wonderful. It would be nice to meet you and do this in person.

 Gaynor Armstrong  42:18
Absolutely. So I'll have to let you know when I'm down. We're coming down at the end of June. So I'll let you know when I'm down. And if you are around, and if you're free, I'd love to catch up with you for actual coffee.

 Sarah-Jane Pedler  42:31
Fabulous. I'd love that. Yeah. So much bringing us together.

 Gaynor Armstrong  42:36
Absolutely. Absolutely. Thank you as always, Gill. It's just so great, like you said, just to be able to have this opportunity. And hopefully, it will help reignite the passion in the midwives and remember why they do what they do as well, which for me is so important right now.

 Gill Phillips  42:54
I'm sure it will. I don't think I could have spoken to two better advocates for that. So thank you both so much.

 Gaynor Armstrong  43:00
Oh, thank you. Thank you both of you. Take care now. See you. 

 Gill Phillips  43:04
Bye, Gaynor!

 Sarah-Jane Pedler  43:07
Oh, she's fabulous!! :) 

Gill Phillips  43:08
 Yeah! 

Sarah-Jane Pedler  43:09
Oh, I could have just talked to her all day - or listened to her all day. I had to keep remembering to say something and not just listen! :) 

Gill Phillips  43:17
I hope you have enjoyed this episode. If so, please subscribe now to hear more of these fascinating conversations on your favourite podcast platform. And please leave a review. I tweet as @WhoseShoes. Thank you for being on this journey with me. And let's hope that together we can make a difference.