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Photography by Yasmin Carter

Former Consultant Midwife Faye Macrory MBE is a pioneer in midwifery care, who has been prepared to challenge and change attitudes to ensure a better deal for women who suffer with substance misuse. She was the first consultant midwife in the region to specialise in treating mothers with drug problems and helped lead a scheme to test pregnant women for HIV. Early detection can prevent the baby from contracting the disease.

Her work has helped turn around the way these women are treated across the maternity hospitals in Manchester. Faye became a substance misuse liaison midwife in 1995. She was responsible for managing and strategically developing the service for substance dependent women the city of Manchester. This model of care is now standard practice in many maternity services throughout the UK.

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Faye outside the Zion Community Resource Centre in Hulme the base for the city's Specialist Midwifery Services between 1992 - 2015

When I meet vulnerable women down on the beat, they now say to me, 'when we go into the hospital, they don’t treat us like shit anymore'... that’s a good outcome!

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Faye and her specialist midwifery team were based at the Zion Community Resource Centre in Hulme from 1992 – 2015. She is also directly responsible for developing other services for pregnant women including perinatal mental health; domestic abuse/violence; sex workers; sexual abuse/exploitation and latterly FGM.

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Faye received an Outstanding Achiever Award at a health awards ceremony in 2004 for her work with pregnant drug addicts. In1997, she received an MBE from the Queen for her services to Healthcare.

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Faye receiving her MBE from the Queen in 1997

THE SHOOT: The Zion Community Resource Centre, Hulme

The former base of Manchester's Specialist Midwifery Service

Q & A with Faye Macrory

Q: Where and when were you born?

A: I was born in Bangor Co. Down in N. Ireland in June 1955. I have an older sister Gee who lives nearby in Manchester and a younger brother Charlie who lives in Bangor with his family.  I’m also still in touch with many of my childhood pals and visit as often I can.

Q: When did you leave Northern Ireland to start your career in nursing?

A: In 1976 I decided to pursue a career in Nursing and applied to Sheffield School of Nursing for the 3 year course. Sheffield was also near to my sister who was at University in Manchester. After qualifying in 1979 I took a nursing post with Chester City Hospital until 1981 when I moved to Manchester to study midwifery at St. Mary’s Hospital (SMH). The current 12 month post nursing registration course was being increased the following year to match the 18 month study period to qualify as a Psychiatric Nurse - which was my preferred choice. Although my student midwifery placement as a student nurse wasn’t particularly inspiring I thought it sensible to have some midwifery experience should I need it in the future. I soon realised that the learning begins after qualifying and despite my initial reservations I quickly became passionate about my new role. In February 1984 a friend persuaded me to go with her to an event at a Manchester Hotel where a UK company were recruiting midwives to go to work in Saudi Arabia. We thought it would be a great opportunity and adventure (the salary was also very attractive) so we signed on the dotted line and things moved very quickly. I arrived in Jeddah on April 17thand my pal followed in May. The experience both personally, professionally and salary wise was well worth making the decision to go there.

Q: Now that you were back in Manchester what was your career ambition?

A: I finally came home to the UK in July 1987. I’d already secured both a midwifery post at Withington Hospital and a mortgage on a house for my planned return. I hadn’t any other immediate career ambitions as such. But knew I wouldn’t be working indefinitely in the Middle East. I started my midwifery post in September 1987 and by 1989 I’d made the decision to study for a full-time Degree in Psychology at the University of Manchester. When I trained as a nurse and then a midwife it was not at degree level and I did feel that I was stepping into the unknown. It turned out to be a great decision and a wonderful learning experience that I hadn’t been exposed to before. So I was open to exploring many new opportunities.

Q: At what point did you start to consider the needs of complex women?

A: On graduating in 1992 I returned to SMH to work full-time while thinking about what my future options might be. My degree dissertation focused on the psychology of childbirth and motherhood and the research I did gave me plenty of food for thought.  Even as a student nurse and midwife I was always aware of the inequality that many women needing healthcare faced. On my return to SMH I was working on the delivery unit. I soon noted the often judgemental and dismissive comments from all grades of staff when women with complex lifestyles presented for hospital care. This included those with drug/alcohol problems, in abusive relationships and having themselves been taken into care when they were children. Many women had their own children taken into care and staff seemed at a loss as how to best respond to those most vulnerable in a respectable and empathetic manner.

Q: How did your association with the Zion Community Resource Centre come about?

A: Soon after returning to work I joined Manchester Action on Street Health (MASH) as a volunteer. However in that role I could only offer generic advice and encourage the uptake of mainstream health/maternity services for women working on the streets as sex workers.  A multi-agency steering group was created in June 1993 and hosted by Fay Selvan at the Zion Community Health Resource Centre. I already knew Fay from working with MASH. The dilemma lay in how to best to provide an appropriate and appropriate maternity service to women that would not stigmatize  but would offer specialist care and support in a sensitive and non-judgmental way.   HIV had also come into the discussion and we predicted this would be soon of concern in delivering maternity care. In the following five months I completed an HIV Counselling Course. I then gained valuable experience by working as a volunteer HIV counsellor in the pre-and post-testing clinic at Manchester Royal Infirmary (1993-99). Several years of campaigning for change with colleagues and services across the city led to my appointment as Drug Liaison Midwife post (DLM) in August 1995. It was the first jointly funded post between drug and maternity services in the UK. Based in Manchester Drug Service and with a city-wide responsibility was a big challenge but a wonderful opportunity to try to make a change in addressing the care for those most vulnerable.   My previous volunteer role with MASH was now included in my job description as was my HIV Counselling role.  The multi-agency approach and the sharing of information led to many referrals and included women who sought me out as a trusted health professional. The role also included staff training, safeguarding issues and regular meetings with all the involved families and agencies across the city. As my role became established it was obvious that the volume of work was becoming impossible to manage without additional support... and before I forget to mention it I gave birth to my baby boy in October 1997. An experienced SMH midwife (thank you Renata) took over my role while I was on maternity leave.

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So moving forward...

In 2000 a Consultant Midwife (CM) role was proposed by Manchester, Salford and Trafford Health Action Zone    (MST HAZ) in response to the success of the Drug Liaison Midwife post (1995-2001).  The overwhelming volume of work and the unmet needs identified in the DLM role was evidence that many changes needed to be made in maternity and neonatal care. Fay Selvan (Zion CC) and Edna Robinson (Director HAZ) took the lead in developing the business case. The Chief Executive (CMFT) then supported the proposal. The first year for the post to be was funded by the HAZ and would then continue to be funded by CMFT. The required MSc. for the role was also financed. I was appointed in April 2001 as Consultant Midwife and based in the newly built and fabulous Zion Community Centre. It was decided to name the new project as Manchester Specialist Midwifery Service (MSMS).  In September 2001 Sharon Wilson was appointed as the Lead for HIV/Sexual Health in developing the care for women identified through the forthcoming Antenatal HIV Testing Programme. Our goal was to provide a service to women and their families where drug/alcohol use, domestic violence/abuse and mental health was problematic. Service provision was firmly rooted in the sphere of public health and embraced all aspects of a vulnerable and socially excluded life-style. The previous city-wide remit and broad ranging responsibilities included providing input to three maternity hospitals, four drug service bases, the sexual health project for sex workers (MASH), the regional in-patient detoxification unit and HMP Styal. A wide range of training was provided both to the NHS and to all other agencies involved with the families we shared.

MSMS team developed over the years with the HIV Lead Midwife, 4 Specialist Midwives and a personal secretary. For a brief period we also had funding for a Health Visitor post which unfortunately wasn’t sustainable in the long term.  The sharing of information was absolutely the key to multi-agency collaboration as the majority of women coming through our service were well known to many other agencies.  Why wouldn’t we share crucial information particularly when there were Safeguarding issues?

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Q: Can you describe the chain of events which led to you leaving the NHS? 

A: I was diagnosed with cancer in November 2012 after a routine mammogram.  I then returned full-time to work in April 2014 after chemo and surgery. Some months later I was informed that following an options appraisal and service reconfiguration the MSMS team would be relocated to be based in SMH and I would no longer manage the team. Bit of a shock... To cut a long story short - funding was withdrawn for MSMS by Manchester City Council (MCC) in March 2015 and only the women attending St. Mary’s would now be part of midwifery care from the team of Specialist Midwives with previously city-wide responsibilities.  Having to move from the Zion Centre to SMH after 15 years was difficult and stressful. My role as Consultant Midwife was then up for review.  A consultation started in early 2015 and it was made clear that offering redundancy was not being included in the discussion. The ‘alternative suitable offer of employment’ was neither suitable nor acceptable. The RCM (Royal College of Midwives)Regional  Representative was an excellent and eloquent defender on my behalf. (I salute you Lesley Wood). By October the RCM had taken legal advice and we were considering the best way forward.  There was then another meeting convened with the new HR Senior Manager present. Following further discussion at the meeting we were informed the Trust had now decided that all our objections to the change in my job description were now accepted. My post would now be made redundant. We were completely stunned as this option had never been on the table.

 

Q: Did you consider consultancy work then?

A: I looked forward to that as an option when I would eventually make the choice to retire. I loved teaching, presenting, lecturing and training with many multi-agency and diverse audiences. It was all part of my role and I also worked freelance in my own time. Having had the opportunity to do both nationally and internationally was such a privilege and a wonderful experience. After my redundancy was finally agreed in October 2015 I had many offers for external work opportunities but the stress of going through the 8 month consultation period had taken its toll. I was exhausted, quite unwell and also awaiting 2 major reconstructive surgeries. It had felt such an undermining and disrespectful experience and I had lost all confidence in myself. I felt I had lost much more than just my job.  My contract ended in January 2016.

Q: When you look back on your career in the Health Service what is your greatest achievement?

A: That’s a difficult question – maybe others could answer better..?

Reflecting on my career here are just some of my thoughts and the many opportunities that I was privileged to have had:

  • Not being afraid to challenge poor practice and judgemental attitudes - throughout my whole career

  • Developing the MSMS Team

  • Establishing ante-natal HIV Screening Programme 1999/2001

  • Inter-agency sharing of information (previously kept confidential) with other agencies

  • Raising awareness for NHS Staff to identify victims of Domestic Abuse and Violence

  • IDVA (Independence Violence Advisor) now based in SMH Antenatal Clinic (PathWay Project 2010)

     CMFT Trust Lead for Domestic Violence/Abuse I attended weekly at MARAC (Multi-Agency Risk Assessment         Conference) and a member on the Domestic Homicide Review Panel

  • Antenatal Perinatal Mental Health Clinic/Dr. Angelika Wieck, Consultant Psychiatrist

  • Sharing our model of practice locally, nationally and internationally.

  • Invited to share our model of care with many others nationally and internationally

     Plenty more to share if anyone is interested! Contact me at fayemacrory@gmail.com

     And to all below in no particular order - a very special thank you:

  • Fay  Selvan (Zion), Edna Robinson (HAZ) Debbie Garrod (NHS)

  • Bridget Hughes (Sexual Health/)HIV)

  • Tim Dindger  (Sexual Health/)HIV)

  • Mike Narayn Singh (MDS)

  • David Regan (MCC}

  • Sarah Crosby (MASH)

  • Evelyn Asante-Mensah and Priscilla Nkwenti (Black Health Agency)

  • Sharon Wilson HIV Lead/MSMS and Specialist Midwives Team

  • George House Trust (HIV Charity)

  • Mark Holland  (Consultant Nurse: Mental Health/Dual Diagnosis MHHT)

  • Sue Chesters (MDS) and all my MDS friends and colleagues

  • Ian Jefferies (DAST) & MCC colleagues

  • Children’s/Social Services

  • Dr. Doug G. Sims & Dr. Anthony Emmerson, Consultant Paediatricians Dr. Michael Maresh: Consultant Obstetrician SMH

  • Contribution to Eradication of FGM (2014-15) Sandra Cahill and Peggy Mulongo (NESTAC)

And to so many more who made it work for many years – while I may have missed your name you’re not forgotten.  It was so huge and wonderful to have so many colleagues and buddies fighting for the same cause. Sharing information between all the agencies opened the door to joined-up care and working together.

*And thank you so much to Emma Taylor for putting me forward to be part of this fantastic exhibition*

Just to sign off - I had a message out of the blue at the end of November from L, a woman I’d supported and who was involved in the video when I received a prestigious award - Outstanding Achiever Award in 2003. She is now in employment and very happy. No problems with drug misuse anymore. Her now adult children are thriving and she is soon getting married. She had been looking for me online and just wanted to say thank you for everything I did for her. It wasn’t so much maybe but somehow it helped. It was very emotional after 20 years to get her message. It’s certainly somewhere in the greatest achievements list methinks. Let’s all remember the little things we say or do can make a big difference so never, ever give up.

 

Bye for now X 

Related links:

Student reflection: Yasmin Carter

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Over the last few years, I have done a number of shoots for Greater Mancunians and each one is unique. Photographing Faye was an absolute privilege and incredible fun. She turned up in a leather jacket, sunglasses, red lipstick and boots which just seems to reflect her outgoing personality.

We did all of the photography in and around the Zion Centre and it was a bright day so the light was ideal. Faye was open to suggestions for locations and poses. Faye gave us a a tour of the building where she bumped into old friends and work colleagues who greeted her such love and affection. We move from inside of the building to the centre’s beautifully kept and peaceful garden where the light was amazing. The colour and greenery made a fantastic backdrop for portraiture helping to emphasise Faye’s dress and her facial features.

During the shoot I took the opportunity to chat to Faye about her work and I can honestly say that she is one of the most inspirational women I have ever met. It is easy to see how she has inspired so many others. I am incredibly pleased with my final images, they really do capture Faye’s effervescent personality.

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Yasmin & Faye

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