1. Midwifery Council of New Zealand Notifications re competence, fitness and conduct HDC Conference 9 March 2015

2. Notifications Notification received The same day …….. Physical and electronic files opened Assessed for seriousness and category If serious, processes for urgent and immediate action put underway HDC notified if health of consumer affected

3. Competence Midwife’s response/clinical notes sought Complaint, response and relevant documents assessed by external s36 competence assessor (new in 2015, previously sorting committee which was a sub-committee of the Council ) Competence assessor’s report discussed by Council and decision made re action

4. Competence Notifications 2004 - 15

5. Addressing competence issues Form of the review is at Council’s discretion Range of processes/actions No further action  reflections & appropriate education already undertaken  midwife demonstrates a change made in practice  midwife ceased practice  Council does not have concerns over competence

6. Competence review tools Special review Competence assessment OSCE assessment Competence review Special Midwifery Standards Review National Midwifery Examination Midwife may be suspended pending review if risk of serious harm identified

7. Competence review tools

8. Competence review - outcomes No further action Competence programme (s38 or s40) Supervision – can include “over the shoulder” Conditions on practising certificate e.g. may only work in certain areas, may not prescribe Suspension during completion of competence programme If there are ongoing issues, has further s43 powers to alter scope of practice or suspend registration

9. Referrals- years in practice

10. Risk Factors? Hard Data Indicators ? Years of Practice5-13 yr cohort Age35-55 yrs Soft Indicators (Circumstance / Storyline) Isolation Relationships with DHB, Partners Handover of care Engagement with Council -Registration; Health

11. Health After notification received, midwife informed of concerns by phone and response sought Medical report sought Considered by health committee. Action may include:  NFA  Monitoring by health committee  Conditions on scope of practice  Suspension

12. Notifications 2004 -15

13. Conduct After notification received, midwife informed of concerns and response sought No action while investigated by HDC Council refers matter to PCC if of sufficient seriousness PCC makes recommendation or determination under s80

14. Conduct processes

15. Council notifications cf to HDC