1. Supervision of Midwives Fit for the Future
Sue Jose
LSA Midwifery Officer
Healthcare Inspectorate Wales
20th April 2015

2. Drivers for Change
Robust, integrated governance can be held up to scrutiny.
Arms length investigation and review by individuals who are independent, have the right authority and clinical expertise;
All qualities expected of the SoM
PHSO, Francis, Kirkup

3. The solution Multi agency steering group convened June 2013 devised;
An assurance framework including 9 KPIs
A detailed fully costed workforce plan based on BR+
Aim - supervision has clear standards and processes to protect the public by proactively supporting midwives

4. Future Proofing Model Dedicated SoM team – a rotational role Benefits:
Greater focus on proactive SoM activity
Timely intervention/completion of inv. & reports and restoration of midwives practice
Proactive leadership/change management
No competing demands clinical duties/SoM role

5. Future Proofing Model No conflict of interest substantive / SoM role
Greater impartiality and transparency
Improved communication –managers / LSA / SoMs
Consistency in application of SoM standards
Effective performance management and development of SoMs by the LSA

6. Future Proofing Model Benefits:
Ability to meet statutory responsibilities for LSA and LHB – support internal governance arrangements
Proactive rather than reactive supporting midwives and women in a timely manner
Enhanced reputation – a sustainable provision

7. Key Performance Indicators
KPI 1 The LSA review/update, workforce planning forecasts
KPI 2 The LSA database used to monitor SoMs completion of relevant CPD.
KPI 3 100% of SoMs have an ASR & IPR
KPI 4 100% of midwives are compliant with the ASR process – LSA random audits of quality

8. Key Performance Indicators
KPI 5 100% of st.m/w meet a SoM x2 / year
Key % of newly qu. m/w meet a SoM x2 in 6/12, x3 by 12/12 to agree/monitor preceptorship programme
KPI 7 SoM record keeping & storage
KPI 8 Random audits of SoM on call response times – t&t collated/used

9. Key Performance Indicators
KPI 9 Monitor timeliness/quality of inv. process - 30/7 to draft report, 45/7 to complete - sign off of objectives - in No. of report iterations - +ive midwife/SoM feedback - in same midwives needing support for same shortcomings - Nos. of midwives subject to LSAPP referred to NMC Vs those who go on to succeed

10. Local & Corporate Visibility
All SoMs wear HIW colours
Increases visibility & corporate image
Cohesive team
Consistent standards and messages
LSA Uniform

11. Achievements so far
All Wales approach to group supervision for ASR process
Taxi rank for equity of opportunity to undertake SoM investigations
SoM attendance at governance meetings
Sharing lessons learnt and good practice across Wales

12. Access to On Call SoM 24 hour all Wales number
16 SoMs have 2-3 on calls per month, 4 weekends a year
Monthly audits monitor number and types on calls
Themes from calls received from midwives and users inform service development

13. Highlights from SoMs
Action learning with midwives to discuss lessons learnt from incidents
Sharing ideas and innovations
Offering regular contact and support to newly qualified midwives
Midwives recognise who the SoMs are
Enjoy working as an all Wales SoM team
Peer support and networking with small SoM team

14. Highlights from Midwives group supervision
“first experience of group supervision was excellent”
“I prefer group supervision compared to individual interviews, the session enables group discussion and a learning environment”
“Group supervision is an excellent way of discussing your issues openly and sharing experiences”
“In the past it was a paper exercise, now I feel I benefitted from the additional support my supervisor offered”
“found the group supervision session for my annual review very valuable”

15. NMC Quality Assurance (triennial review)
Dec 2014, 5mths into project, 6 wks notice!
Wide stakeholder representation day 1
3 day process, 3 HB visits and 1 HEI
All standards met, no areas for development, very complimentary re new model, level of collaboration and change management.

16. Welsh Perspective
CNO in Wales believes the current model of supervision provides a high standard of support and development and is interested in its links with revalidation for all registrants

17. Formal evaluation
Swansea University have been commissioned to produce a report
“A critical review of group supervision (Action learning) in the Future-Proofing model of Midwifery Supervision in Wales”
(Due August 2015)

18. Supervision in Wales – a pathfinder Any questions?