The organisation

The Northern Care Alliance NHS Foundation Trust (NCA) is a group of hospitals and community facilities in Greater Manchester with around 22,000 staff.  The NCA delivers healthcare excellence to over one million people across Salford, Oldham, Rochdale and Bury, as well as providing more specialist services to patients from Greater Manchester and beyond.

NCA has three core values: Care, Appreciate, Inspire.  The workforce includes a huge variety of clinical and non-clinical roles across four hospitals, diagnostics and pharmacy services, and corporate functions.

The rationale for action

Employee wellbeing has always been a core concern for NCA.  Recognising that there can be unique wellbeing challenges for female staff, and that this was also being flagged at a National level via the Government Women’s Health Strategy, NCA made a commitment to identifying key women’s health and wellbeing issues in their organisation and developing bespoke responses – via their innovative Well Women Strategy.

NHS employee turnover and retention data at a national level has also been a driver for a specific focus on maternity management. There is a concerning trend across the NHS of nurses leaving the workforce typically within five years of achieving their qualifications, and when they are usually aged in the mid-to-late 20's - the average age for having a first child.  Work strain and work-life conflict are key forces causing staff to leave and these are particularly present during pregnancy and maternity - when combining work with pregnancy and infant care is a huge challenge. This is even more prevalent in healthcare roles which are physically demanding and require shift work.

What we did

NCA is leading the way in relation to women’s health and maternity management in the NHS context.  In 2021 they started work on their innovative Well Women Strategy.  The initial phase focused on women’s reproductive health issues, covering menstruation and menstrual health, endometriosis, fertility issues, pregnancy loss and menopause. The NCA carried out workforce research in collaboration with Manchester Metropolitan University and identified a number of areas for policy and practice development. One notable finding was the importance of recognising the mental health as well as physical impacts of these issues, and ensuring parity in policies, supports and communications.

The second phase is focused on maternity management, where there are two parallel streams of activity.  The organisation is again collaborating with Manchester Metropolitan University in a Management Knowledge Transfer Partnership project which is focused on an innovate maternity coaching management process. This is initially focusing on Nurses and Allied Health Professionals.  On a broader level, the organisation is reviewing the maternity policy and associated documentation. The NCA has identified perinatal mental health as a specific area of focus for the next steps of their Well Women Strategy.  

Innovations to practice

To date, the NCA has:

1. Added a Well Women Strategy page on the intranet, with a range of resources for line managers and colleagues and the development of training sessions for HR, managers and mental health champions

2. Introduced three new policies covering fertility treatment; pregnancy loss; and menstrual health and endometriosis

3. Started work on updating the maternity policy and associated policies to ensure a focus on wellbeing as well as process/legal compliance

4. Started planning maternity management training and coaching for line managers as part of the Knowledge Transfer Partnership project, which explicitly covers complications of maternity journeys including pregnancy loss, birth trauma, neonatal care and perinatal mental illness

5. Gained commitment to a new Well Men Strategy, recognising pathways to parenthood and associated challenges in addition to other men’s health issues

6. Utilised local questions within the NCA Quarterly Pulse Survey to understand how many colleagues are aware of the Well Women Strategy and indirectly promoting the strategy

Impact so far

Feedback from training sessions with different stakeholders and the circulation of case studies suggests that awareness around diverse women’s health issues in the workplace is increasing, and line managers are growing in confidence.

There has been interest in our approach to the Well Women Strategy from other NHS Trusts who want to follow suit, and the Chartered Institute of Development (CIPD) have featured this as a good practice example on their website.