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The future for Midwifery without Statutory Supervision Joy Kirby RM RN BSc PgCert MA LSA Midwifery Officer.

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Presentation on theme: "The future for Midwifery without Statutory Supervision Joy Kirby RM RN BSc PgCert MA LSA Midwifery Officer."— Presentation transcript:

1 The future for Midwifery without Statutory Supervision Joy Kirby RM RN BSc PgCert MA LSA Midwifery Officer

2 Statutory Supervision of Midwives and Midwifery Practice Supervision is currently a statutory responsibility which provides a mechanism for support and guidance to every midwife practising in the United Kingdom. Supervision is currently a statutory responsibility which provides a mechanism for support and guidance to every midwife practising in the United Kingdom. The purpose of supervision of midwives is to protect women and babies by actively promoting a safe standard of midwifery practice. The purpose of supervision of midwives is to protect women and babies by actively promoting a safe standard of midwifery practice.

3 Midwives Act 1902 Created Central Midwives Board (CMB) Created Central Midwives Board (CMB) Supervising & monitoring of practice delegated to Local Supervising Authority(LSA) Supervising & monitoring of practice delegated to Local Supervising Authority(LSA)

4 The Local Supervising Authority The LSA is responsible for the supervision of all midwives within its geographical boundary, including those working in the private sector, agencies, independent practice and prisons and those employed in the NHS The LSA is responsible for the supervision of all midwives within its geographical boundary, including those working in the private sector, agencies, independent practice and prisons and those employed in the NHS

5 Role of LSA Role of LSA Inspection of midwives notifying intention to practice Inspection of midwives notifying intention to practice Investigate malpractice, negligence or misconduct Investigate malpractice, negligence or misconduct Report midwives guilty of above to CMB Report midwives guilty of above to CMB

6 Role of the Local Supervising Authority Midwifery Officer Responsible for the Statutory Supervision of Midwives and Midwifery Practice Responsible for the Statutory Supervision of Midwives and Midwifery Practice Carries no management responsibility to Trusts Carries no management responsibility to Trusts Does not represent the interests of providers or commissioners of maternity services Does not represent the interests of providers or commissioners of maternity services Focus on midwifery practice Focus on midwifery practice Appoints Supervisors of Midwives who remain accountable to the LSA Appoints Supervisors of Midwives who remain accountable to the LSA

7 Health Service Ombudsman's Report 2013 Report into three cases arising from failures in maternity care at Morecambe Bay. Report into three cases arising from failures in maternity care at Morecambe Bay. Midwifery supervision and regulation should be separate Midwifery supervision and regulation should be separate The NMC should be in direct control of regulatory activity The NMC should be in direct control of regulatory activity NMC accepted that: ‘Supervision structurally flawed’ NMC accepted that: ‘Supervision structurally flawed’

8 Kings Fund Review of Statutory Supervision 2014 The NMC as the health care professional regulator should have direct responsibility and accountability solely for the core functions of regulation. The legislation pertaining to the NMC revised to reflect this. This means that the additional layer of regulation currently in place for midwives and the extended role for the NMC over statutory supervision should end. The NMC as the health care professional regulator should have direct responsibility and accountability solely for the core functions of regulation. The legislation pertaining to the NMC revised to reflect this. This means that the additional layer of regulation currently in place for midwives and the extended role for the NMC over statutory supervision should end.

9 Continued…. The LSA structure should be removed from statute as it pertains to the NMC The LSA structure should be removed from statute as it pertains to the NMC The sub-FtP process involving additional investigations and sanctions should be removed from statute The sub-FtP process involving additional investigations and sanctions should be removed from statute

10 What will change ? Midwives Rules and standards Midwives Rules and standards Notification of Intention to Practise Notification of Intention to Practise Suspension from practice Suspension from practice Supervisory Investigations Supervisory Investigations Referrals to the NMC Referrals to the NMC Employers responsibilities in approach to professional regulation Employers responsibilities in approach to professional regulation Women and complex care needs Women and complex care needs

11 Potential Impact Increased risk of “conflict of interest” as midwifery practice investigations are undertaken within Trust Governance frameworks by peers and in the absence of an independent review process. No further analysis of practice themes from supervisory investigations will result in a lack of proactive, preventative measures being implemented to provide assurance of good public protection methods Increased referrals of midwives to FTP department at the NMC

12 Potential Impact Increased appeals following investigations based on perception of process being undertaken despite “structural flaw” being accepted No local provision for the support of ‘Conditions of Practice’ when applied to registrants during the FTP process, especially those who are self- employed leading to loss of midwives from the profession There will be inadequate data protection policies for the retention of midwifery records. Midwifery records holding personal information and data will not be securely and adequately retained

13 Potential Impact Loss of expertise and professional leadership exercised within the LSA Midwifery Officer role Loss of strategic oversight of maternity services and midwifery practice and also innovative means by which to address regional issues. Loss of professional midwifery advice provided regionally / Country wide Loss of organisational information and data held within the LSA including midwifery workforce data / Maternal Deaths / themes arising from practice investigations / Suspensions of services etc

14 Potential Impact Loss of ITP submissions will result in loss of data regarding current numbers of practicing midwives in the UK on an annual basis. There will be an inability to assure the public that each practicing midwife has verified their PREP and is fit to practice on an annual basis. There will no longer be a process in place to ascertain where midwives with highlighted development needs are practicing which could increase risk to the public this is particularly relevant to agency midwives and self-employed midwives

15 Future Professional Implications Future Professional Implications Professional Midwifery leadership Professional Midwifery leadership Advocacy for women Advocacy for women Support for midwives – Support for midwives – –outside of NHS –where practice puts women at risk Independent view of services Independent view of services

16 Conclusion The dismantling of Statutory Supervision will leave a void that will impact on midwives, women and maternity services. The dismantling of Statutory Supervision will leave a void that will impact on midwives, women and maternity services. The NMC have a ‘moral obligation’ to ensure that the supporting elements of supervision are carried forward - will require innovative thinking The NMC have a ‘moral obligation’ to ensure that the supporting elements of supervision are carried forward - will require innovative thinking The LSAMO’s will work with the SOMs and other stakeholders to try to minimise the inherent risks to mothers and babies during the transition period The LSAMO’s will work with the SOMs and other stakeholders to try to minimise the inherent risks to mothers and babies during the transition period


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