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Midwife supervisors will have to retrain as 'advocates' under national plans

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Supervisors of midwives will need to take part in a “bridging” programme to continue their practice under plans for a new model of supervision in England, which will also see them known as professional midwife advocates in the future.

The change follows a government decision in 2015 to remove statutory supervision for midwives, after a series of high profile reports identified problems with the model.

In a letter sent to all midwives and trust directors of midwifery and nursing last week, the chief nursing officer for England said the new model was still being tested but would be published in full on 1 April.

CNO Professor Jane Cummings said the new A-EQUIP approach – which stands for advocating for education and quality improvement – was a “continuous improvement process that helps to build personal and professional resilience”.

It also “enhances quality of care for women and babies and supports preparedness for appraisal and professional revalidation,” said the letter from the CNO.

“The approach aims to ensure that action to improve quality of care becomes an intrinsic part of everyone’s job”

CNO’s letter to midwives

“The A-EQUIP approach aims to ensure that through staff development, action to improve quality of care becomes an intrinsic part of everyone’s job, every day, in all parts of the system,” it added.

As part of the piloting of the model at 10 maternity providers, so far 41 supervisors of midwives have been trained to become professional midwife advocates (PMAs).

In the future, it is expected that all supervisors will have to complete this four-day bridging programme, which is supported by e-learning, to continue practising.

However, the CNO’s letter acknowledged that transitioning from a statuary model of supervision to one that was being led by employers would be an “iterative approach because of the preparation required to undertake the role”.

Jane Cummings

Jane Cummings

Jane Cummings

Until PMAs were prepared, employers should support supervisors of midwives to continue with the non-statutory elements of their role, it said.

A total of 20 universities have expressed an interest in providing programmes for both existing supervisors and midwives wanting to become PMAs in the future.

NHS England is due to publish guidance before 28 March, and employer contracts in 2017-18 will refer to use of the guidance.

“I’d like to end by asking you to familiarise yourself with the new model as much as you can,” said Professor Cummings in the letter.

“I know and understand the challenges we are facing, and I hope we can align our efforts to ensure that our midwives and the people they care for all benefit from the new model,” she said.

The Royal College of Midwives welcomed the new model and said it was a “significant development” for midwives.

“Since the announcement to remove supervision, the RCM has worked collaboratively to ensure that across the UK any new model retains those elements considered important to retain outside a statutory and regulatory framework,” said RCM chief executive Cathy Warwick.

Cathy Warwick

Cathy Warwick

Cathy Warwick

“We welcome the introduction of the A-EQUIP model of non-statutory supervision in England. It will ensure that the supportive and developmental aspects of supervision which are so critical to the safe, high quality care of women remain in place,” she said.

She noted there were concerns that, without the legal requirement and while the NHS was under financial pressure, supervision would be provided in an “ad-hoc” way.

“It is, therefore, particularly positive to see that commissioning guidance will require NHS maternity services to have the A-EQUIP model in place,” she added.

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