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Changes to Midwifery Regulation - update

Cathy Warwick, CEO
21 December, 2016

Changes to Midwifery Regulation - update

Having submitted our response to the Department of Health (DH) consultation on the changes to midwifery regulation in June we are still waiting for the government response and are extremely disappointed that it has taken so long to be published. At the time of writing I have been advised by the DH that the Section 60 (S60) Order has been signed off by the Minister. This, together with the consultation response, impact assessment (IA) and equality impact assessment (EqIA), have gone to the next stage of approval through government wide and devolved administrations. The intention is that the response, IA and EqIA will be published at the same time as the Order is laid in parliament. However, it is uncertain when this will happen and therefore, when the subsequent debates will take place before the regulatory changes can be enacted by the proposed date of 31st March 2017.

In the meantime cross-organisational, multi-stakeholder taskforce groups have been established in each of the UK countries, led by the Chief Nursing Officers (CNOs), to examine and embed the principles for midwifery supervision outlined in the DH policy paper, Proposals for changing the system of midwifery supervision in the UK, published in January 2016

All of the taskforce groups are in the process of developing a framework for the delivery of an employer-led model of support for midwives. Key work streams include the development of a model including a description and title for the new role, the education and training required to undertake the role and processes and resources required to embed the new model and role in practice. The four countries are at different stages and will publish their respective framework and model in due course. 

In England information on the supervision taskforce and five work streams formed by NHS England can be found on their website: https://www.england.nhs.uk/ourwork/futurenhs/mat-transformation/midwifery-task-force/.  The new model has been designed in line with the vision set out in Better Births, the report of the National Maternity Review published in February 2016 and aims to respond to the CNO framework for nurses and midwives Leading Change and Adding Value, published in May 2016 https://www.england.nhs.uk/wp-content/uploads/2016/05/nursing-framework.pdf.

The new model has the working title of A-EQUIP (advocating for education and quality improvement). This model is intended to foster a continuous improvement process that: builds personal and professional resilience, enhances the quality of care for women and babies and supports preparedness for appraisal and revalidation. It is currently being piloted in six units in the four regions of England https://www.england.nhs.uk/ourwork/futurenhs/mat-transformation/midwifery-task-force/midwifery-supervision/

The S60 Order also proposes to remove the Midwifery Committee within the NMC from statute. The purpose of the Committee is not to represent midwives but to provide advice to Council on all matters that relate to midwifery, at the Councils request or otherwise. As part of its constitution it is required to have a midwife from each of the four countries of the UK and to have equal lay and midwife membership on the Committee. Selection and appointment is subject to individuals meeting specified criteria and is undertaken by an internal Appointments Board. 
The RCM has been clear from the outset that it does not support the proposal to remove the Committee from statute and the rationale put forward within the DH consultation document for its dissolution is weak.  This is compounded by the lack of progress that has been made by the NMC in developing robust processes for the establishment of a non-statutory forum by which the Council can be advised on midwifery matters going forward. There is still much work to do in this area and we will continue to lobby to delay the removal of the statutory Midwifery Committee until such time as the overarching regulation of the professions is reviewed and a separate Register for midwives is established within the NMC or possibly, another professional regulator.

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