Current Position Statutory Supervision of Midwives

1. Current Position Statutory Supervision of Midwives NIPEC Workshop Antrim 20 April 2015

2. Supervision of Midwives in NI c1500 midwives

3. Big picture - What’s it all about? Examples: Support Prevent poor practice Reflection Listen to Women Enable choice

4. Right people…

5. Wind of change… Drivers • Francis PSA Professional Standards Authority for Health and Social Care oversees statutory bodies that regulate health professionals in the United Kingdom and social care in England Law Commission It proposes changes to the law that will make the law simpler, more accessible, fairer, modern and more cost-effective. PHSO Parliamentary and Health Service Ombudsman Guernsey – NMC extraordinary review; RCOG report Kings Fund – Midwifery Regulation in the UK Kirkup – The report of the Morecambe Bay Investigation • and also: • The Berwick report • The Cavendish report • The Clwyd Hart report

6. decision: 28 January 2015 Nursing and midwifery regulator calls for supervision to be removed from its legislation • Following an independent review of the regulation of midwives in the UK, the Nursing and Midwifery Council’s (NMC) governing board tday accepted the recommendation that statutory supervision should no longer be part of its legal framework. • The wider role that supervision plays is highly valued by many midwives who will look to sector leaders to take stock of what is good in current practice and options to carry it forward. The NMC is pleased to welcome that the chief nursing officers have agreed to play a leadership role in this transition. • Jackie Smith, NMC Chief Executive and Registrar, said: • “NMC Council is today calling for legislative change to give us direct control of regulatory decisions and allow others to take responsibility for the support and leadership of midwives. • “We will now work with the Department of Health in order to carry that recommendation forward.”

7. http://www.lsamoforumuk.scot.nhs.uk/

8. Further comments… • ‘Our profession needs to begin to explore what lies ahead, what can be done and what is needed to sustain that profession and support the women in our care’ • What happens now has still to be written. If supervision continues in a non-statutory form what would you want to keep. If it doesn’t, what would you want to replace it? • Lewis P, Freemantle D and Ireland J. The loss of midwifery supervision: to mourn or rejoice? The Practising Midwife. Vol18, No 3, March 2015. • As a part of the transition process ahead of any regulatory change, Jackie Smith (NMC Chief Executive) and the four CNOs are holding regular meetings to plan what processes they will put in place to ensure that the supportive elements of statutory supervision (for both midwives and women) are retained and effective. It is this process that the RCM is seeking to influence by our development of options that maintain what was seen by the King’s Fund as effective and important across all four UK countries. https://www.rcm.org.uk/an-update-on-the-supervision-of-midwives

10. How can supervision of midwives help? • Annual review • Remediating practice at a local level • Support and protection for mother and babies • Midwifery leadership • Professional support, information and advice – apply to practice in the best interests of the women • ‘The supervisor of the future needs to have a clear sense of purpose, the diplomatic skills of an advocate and the independence to ensure that a woman’s needs are met in accordance with her informed choices’ • Lewis P et al (2015). The loss of midwifery supervision: to mourn or rejoice? The Practising Midwife. Vol 18, No 3, March.

11. Learning…. • One (NI) approach to: • NI annual review toolkit (acknowledged good practice); record keeping and drug audit part of annual review toolkit • Use of LSAdb to handle the annual ItPs • MHHR (record keeping); safety initiatives (e.g. stickers CTG interpretation, VEs); lessons learned; midwives and medicines interactive work • SoMs influencing and leading

12. What’s next for supervision of midwives? • CNO (NI) commissioned a NIPEC review • Review chaired jointly by HoM/DoN • Report due in June • Workshop today is important and will contribute to the report • Able to influence rest of the UK as report -> 4 CNOs

13. The Code 2015 The Code will be central to revalidation, which is a series of three-yearly checks that the NMC is introducing at the end of 2015. “Public expectations of care have changed radically since the Code was last reviewed in 2008. It is essential that the Code reflects patients’ needs, modern healthcare practice, and the recommendations of reviews such as the Francis Inquiry.” Jackie Smith Chief Executive and Registrar NMC • Prioritise people, • Practise effectively, • Preserve safety, and • Promote professionalism and trust.

14. Supervision of Midwives • Take good points from Kings Fund and others • It is still in statute so continues ‘as is’ or ‘business as usual’ until legislative change • There's willingness and support in NI for midwifery supervision • Consider link to revalidation and clinical governance? • Ensure the safety and wellbeing of mothers and babies

15. Share good practice eg Proficiencies around: • Accountability • Communication • Medicines Management • Professional Practice - monitoring maternal & fetal wellbeing • Record Keeping http://www.lsamoforumuk.scot.nhs.uk/policies-guidelines.aspx