Clinical Supervision for midwives in Scotland
The Nursing and Midwifery Council (NMC) and UK Government response to the Morecambe Bay Inquiry has been to separate midwifery supervision from regulation. Regulation of nurses and midwives is a matter which is reserved to the UK Parliament and the Department of Health (DH) in England has taken forward the legislation required to make this change, which came into force on 31 March 2017.
This means that the Local Supervising Authority (LSA, the Health Board in Scotland), alongside the statutory roles and functions associated with its responsibility for governing the standard of midwifery practice on behalf of the NMC are no longer required. Removal of this additional layer of regulation brings midwives in line with other professions and means that governance for the standard of midwifery practice rests exclusively with employers from 1 April 2017.
Transitioning supervision of midwives taskforce
In Scotland, the Chief Nursing Officer (CNO) established a Taskforce made up of a range of stakeholders, including: NHS Boards (an Executive Nurse Director, Director of Finance, Associate Director of HR, Head of Midwifery); LSAs; the Scottish Partnership Forum; the Royal College of Midwives; Scottish Higher Education Institutions; midwives; and public partners. Collaboratively, the Taskforce developed the new employer led model of clinical supervision for midwives in Scotland.
Clinical supervision for midwives – the new approach
Clinical supervision for midwives aims to contribute to improved services, safer care and better outcomes for women and families, by supporting midwives to advocate for women’s needs and to reflect on clinical midwifery practice in line with professional accountability and regulation.
Implementing the new approach
The CNO convened an implementation group in partnership with the Scottish Executive Nurse Directors (SEND) and key stakeholders, to support NHS Boards with the transition to, and implementation of, clinical supervision for midwives. NHS Boards put systems and processes in place from 1 April 2017, in preparation for full implementation of clinical supervision for midwives from 8 January 2018.
Resource for Boards - Information pack
An information pack has been produced in partnership with key stakeholders, which will enable national consistency in approach and aims to support Boards with the implementation of local systems and processes (see downloadable documents opposite for all associated documents).
Ongoing support for Boards - Toolkit
NHS Boards are keen to minimise unwarranted variation in practice across Scotland, so the Implementation Group has produced a toolkit that offers guidance on some of the practicalities of delivering sessions, alongside example national templates and relevant NMC revalidation templates (see downloadable documents opposite for all associated documents).
A national education resource has been developed to prepare clinical supervisors for their role and colleagues from NHS Education for Scotland and the Higher Education Institutions are working with Boards to arrange local delivery of this education. http://www.knowledge.scot.nhs.uk/maternalhealth.aspx
Nursing and Midwifery Revalidation
The Nursing and Midwifery Council (NMC), at its governing council’s meeting on 8 October 2015, made the decision to undertake significant changes to professional regulation for nurses and midwives through the implementation of Revalidation.
Revalidation requires all NMC registrants to demonstrate that they are practising to the Standards of the NMC code, supporting and demonstrating professional values.
All nurses and midwives must meet the requirements for revalidation over the next three years with the first registrants having successfully completed revalidation in April 2016.
Revalidation due dates:
Revalidation requires nurses and midwives to meet a number of elements to ensure that their practice aligns to the revised Code (launched in March 2015):
The elements include completion of the required hours of practice, continuous professional development activity, reflection on practice through the use of feedback, and confirmation from a third party that they have met all of the revalidation requirements. Specifically, nurses and midwives are expected to:
- Undertake a minimum of 450 hours of practice over three years (that equates to approximately 12 weeks for a full-time worker) for each part of the register on which they are enrolled. (a dual-qualified nurse and midwife will need to demonstrate a total of 900 hours);
- Undertake a minimum of 35 hours of Continuous Professional Development (CPD). 20 of the 35 CPD hours should be 'participative' (learning with others);
- Gather five pieces of practice-related feedback (this can be from a variety of different sources including team meetings, feedback from a patient or their family, complaints, compliments);
- Write five reflective accounts, based on the feedback, to demonstrate how this has helped improve practice and fulfil the requirements of the Nursing and Midwifery Council Code, and discuss these with another Nursing and Midwifery Council-registered nurse or midwife;
- Make a health and character declaration (this was a pre-existing requirement for preceptorship);
- Confirm professional indemnity arrangements – a registered nurse or midwife employed by an organisation will most probably already have this in place (this too was an existing requirement that pre-dated the introduction of revalidation); and
- Confirmation from a third party –demonstrating that all of the above requirements have been met; most likely this will be from a line manager at an annual appraisal.
In Scotland, a programme board supported implementation of revalidation; this included a broad range of stakeholders and representatives from NHS and non-NHS organisations, public partnership, professional organisations and the Nursing and Midwifery Council. The programme board also planned for implementation across Scotland and supported the NMC in its commitment to continuously evaluate revalidation.
The Nursing and Midwifery Council has published a range of educational materials and guidance for individual registrants and for employers which can be found on the Nursing and Midwifery Council website and at the NMC revalidation microsite Nursing and Midwifery Council - Revalidation