Future Nurse Future Midwife Midwifery Expert Reference ......supported by a Handbook ......

Future Nurse Future Midwife

Midwifery Expert Reference Group Workshop

27th February 2020

Fern House, Antrim Area Hospital

Agenda 09:00 Registration and Tea/Coffee

09:30 Welcome

Dr. Dale Spence

Department of Health

Caroline Diamond

Northern Health and Social Care Trust

09:35 Future Nurse Future Midwife Project Overview

Frances Cannon

Northern Ireland Practice and Education

Council

10:00 Overview of the Future Midwife Standards

Verena Wallace

Nursing and Midwifery Council

10:20 Standards for Student Supervision and Assessment

Clare Marie Dickson

South Eastern Health and Social Care Trust

11:20 Break

11:35 Midwifery Practice Assessment Document

Clare Hughes

Queen’s University Belfast

Lindsay Gillman

Kingston University London

Judith Sunderland

City, University of London

13:10 Lunch

13:40 Practice Learning Environments/Placements

Dr. Jenny McNeill


Maureen Millar

Western Health and Social Care Trust

Brenda Kelly

Belfast Health and Social Care Trust

15:00 Engagement and Communication

Cathy Hamilton


Judith Tuckey


15:15 Closing Remarks

Dr. Dale Spence


Caroline Diamond


Welcome

Dr. Dale Spence


Caroline Diamond


Midwifery Expert Reference Group

Aim - The overarching aim of the Midwifery Expert

Reference Group is to oversee arrangements to cohesively

embed the outworking’s of the Standards for pre-registration

midwifery programmes and Standards of proficiency for

midwives.

.

Continuity of Carer in Northern Ireland Project (CoCNI)

AIM: To identify current iterations of continuity of care/carer

within the region, to benchmark these against national practices

and provide recommendations for future models of continuity of

carer in Northern Ireland.

Data collection forms from each HSC Trust were

due back 24th February this deadline has been

extended to Tuesday 3rd March at 12MD

Future Nurse Future Midwife Project

Overview

Frances Cannon

Northern Ireland Practice and

Education Council

FNFM Structure (Previous)

Sharon Conlan

SHSCT

Rhonda Brown

BHSCT

Kerrie McLarnon

NHSCT

Carol McGinn

WHSCT

Joanne Fitzsimons

SEHSCT

Bernadette Gribben

NIPEC

Future Nurse Future Midwife Professional Officers

Curriculum Development – Work Stream

Aim: To ensure pre-registration nursing & midwifery 2020/21 curriculum

reflects NI strategic policies and the NI transformation agenda

NI Collaborative Learning

Disability

17th January 2019

Children’s Nursing Network

14th January 2019 Adult Workshop

6th February 2019

Mental Health Review

18th December 2018.

Future Midwife

Curriculum Development

Event

NI Practice Assessment Document

Key messages

• 3 Universities using same NI PAD

• NIPADs adapted for each Field of Practice

supported by a Handbook

• Midwifery to develop own NIPAD

Aim: To Develop a Regional Practice

Assessment Document – NIPAD

Practice Learning Environments – Work Stream

Aim: review the current arrangements for the identification of Practice

Learning Environments with a view to maximising learning opportunities.

Key message:

• changing the narrative from i.e. medical placement or surgical placements- rather

using the placement to achieve a whole range of proficiencies

• maximising learning opportunities in each placement

FNFM Structure (Current)

Sharon Conlan

SHSCT

Rhonda Brown

BHSCT

Kerrie McLarnon

NHSCT

Carol McGinn

WHSCT

Joanne Fitzsimons

SEHSCT

Bernadette Gribben

NIPEC

Future Nurse Future Midwife Professional Officers

Overview of the Future Midwife

Standards

Verena Wallace

Nursing and Midwifery Council

Future midwife: Transforming midwifery care for everyone

FNFM MERG Workshop Verena Wallace MBE Senior Midwifery Adviser (Policy) 27 February 2020

The challenge

What standards of proficiency should we set to make sure newly qualified midwives at the point of registration are:

• Able to meet the needs, views and preferences of women, newborn infants and families

• Safe

• Effective

• Respectful

• Kind and compassionate?

The Report of the

Morecambe Bay

Investigation

Midwifery: the changing context in the UK…

… and internationally

Evidence, key lessons and policy

• Existing and new and emerging evidence

• Changing demographics and population health

• Lessons from key reports and surveys

• National policy in the four countries

Evidence from The Lancet Series on Midwifery

The Thought Leadership Group

• Experts and representatives from across a broad range of backgrounds, including:

• Midwives, student midwives, advocates, managers, policymakers, educators and other health and care professionals

• 10 meetings over more than two years

External engagement (1)


• 600+ people in all four UK countries involved in pre-consultation engagement activities

• 3,000+ people engaged at events or online in consultation opportunities

• 1,600 responses to our consultation survey

• More than 1,000 responses from the public

NMC governance and review The structure that facilitated the future midwife project

• Regulatory review

• Legal review

• Thought Leadership Group

• Education Standards Reference Group

• Consultation Assimilation Teams

• Midwifery Panel

• Council

New standards for the future midwife

• Enabling educators and midwives of the future to provide innovative education and the best and safest care for women and newborn infants

Key themes in the standards (1)

• Enabling and advocating for human rights of women and newborn infants

• Developing, finding, critiquing, using best evidence

• Taking personal responsibility for ongoing learning and development

• Enabling and advocating for needs, views, preferences, decisions


• Understanding local context, connecting with local communities

• Working across the whole continuum of care

• Providing continuity of care and carer

• Coordinating care - interdisciplinary and multiagency


• Optimising normal processes

• Anticipating, preventing, responding to complications

• Working to mitigate health and social inequalities

• Physical, psychological, social, cultural, spiritual factors

• Public health, health promotion and protection

Transformative change (1)

Focussed on the needs, views, preferences and decisions

of women and the needs of newborn infants


Supporting physical, psychological, social, cultural,

and spiritual safety


Understanding the impact of pregnancy, labour and birth,

postpartum, infant feeding and the early weeks of life on

longer term health and wellbeing

Standards of proficiency for midwives Six inter-related domains

1: Being an accountable, autonomous professional midwife – examples

• Understand and act to promote and enable the human rights of women and newborn infants at all times, including women’s sexual and reproductive rights

• Demonstrate the knowledge, skills, and ability to identify, critically analyse, and interpret research evidence and local, national, and international data and reports

2: Safe and effective midwifery care: promoting and providing continuity of care and carer – examples • Demonstrate the ability to provide continuity of midwifery carer across

the whole continuum of care and in diverse settings for women and newborn infants with and without complications and additional care needs

• Demonstrate and apply knowledge and understanding of the social context in which women and their families live to inform, support, and assist in meeting their needs and preferences

• Demonstrate knowledge and understanding of ways of identifying and reaching out to women who may find it difficult to access services, and of adapting care provision to meet their needs

3: Universal care for all women and newborn infants – examples A: the midwife’s role in public health, and health promotion and protection

• Demonstrate the ability to share information on public health, health promotion and protection with women, enabling them to make evidence-informed decisions, and providing support for access to resources and services

• Promote and support parent and newborn mental health and well-being, positive attachment and the transition to parenthood

3: Universal care for all women and newborn infants - examples B: the midwife’s role in assessment, screening and care planning

• Demonstrate knowledge and understanding that women’s circumstances vary widely, and the importance of supporting, promoting and protecting any individual needs and preferences they themselves identify

3: Universal care for all women and newborn infants - examples C: the midwife’s role in optimising normal physiological processes and working to promote positive outcomes and prevent complications

• Use evidence-based, best practice approaches and work in partnership with the woman to provide care for the woman and the newborn infant across the continuum that optimises normal processes, manages common symptoms and problems, and anticipates and prevents complications, drawing on the findings of assessment, screening, and care planning

4: Additional care for women and newborn infants with complications – examples

A: the midwife’s role in first line assessment and management of complications and additional care needs

• Use evidence-based, best practice approaches for the first-line management of complications and additional care needs of the woman, fetus, and/or newborn infant; including support, referral, interdisciplinary and multiagency team working, escalation and follow up, as needed

4: Additional care for women and newborn infants with complications – examples

B: the midwife’s role in caring for and supporting women and newborn infants requiring medical, obstetric, neonatal, mental health, social care and other services

• Demonstrate the ability to work in collaboration with the interdisciplinary and multiagency teams while continuing to provide the midwifery care needed by women and newborn infants

• Use evidence-based, best practice approaches to keep mothers and newborn infants together whenever possible when providing midwifery care, even when complications and additional care needs occur

5: Promoting excellence: the midwife as colleague, scholar and leader – examples A: working with others: the midwife as colleague

• Recognise risks to public protection and quality of care and know how to escalate concerns in line with local and national escalation guidance and policies

• Demonstrate the ability to act safely in situations where there is an absence of good quality evidence

5: Promoting excellence: the midwife as colleague, scholar and leader – examples B: Developing knowledge, positive role modelling and leadership: the midwife as scholar and leader

• Demonstrate knowledge and understanding of the importance of current and ongoing local, national and international research and scholarship in midwifery and related fields, and how to use this knowledge to keep updated, to inform decision-making, and to develop practice

• Demonstrate knowledge and understanding of the principles and methods of sustainable health care

• Demonstrate the ability and commitment to develop as a midwife, to understand career pathways that may include practice, management, leadership, education, research, and policy, and to recognize the need to take responsibility for engaging in ongoing education and professional development opportunities

6: The midwife as skilled practitioner Integrating knowledge and skills

Standards for pre-registration midwifery programmes

Outcomes focussed and future proofed standards that enable flexibility and pedagogical innovation

Part 1

• Learning culture

• Educational governance and quality

• Student empowerment

• Educators and assessors

• Curricula and assessment

Part 2

• Effective practice learning

• Supervision of students

• Assessment of students and confirmation of proficiency

Part 3

• LME role

• Selection, admission and progression

• Curriculum

• Practice learning

• Supervision and assessment

• Qualification and award

• Lead Midwife for Education (LME) role

• Whole continuum of care for all women and infants

• Midwifery led services and needs of diverse populations

• Continuity of midwifery carer

• Caring for women and newborn infants when complications and additional care needs arise

• Interdisciplinary and multiagency working

Key features of the new programme standards (1)

Specific proficiencies


Learning culture

• Education and training valued in all learning environments

• Promotion of mental and physical health and well being

• Effective use of management information

• Requirement to support opportunities for research collaboration and evidence-based improvement in education and service provision


Governance and quality

• Partnership approach with shared responsibility for theory and practice

• Overall accountability lies with approved education institution

• Student recruitment to address under-representation

• Commitment to continuous improvement


Student empowerment

• Opportunities for interdisciplinary and multiagency learning and teaching

• Supervision tailored to individual needs – level of supervision can decrease as students’ level of proficiency and confidence increases

• Provision of learning and pastoral support

• Opportunities for students to learn from other students

• Need for the student voice to be heard


Curricula and assessment

• Co-production of curricula

• Integration of theory and practice

• Use of self reflections in assessment process

• Service users contributing to assessment

• No compensation between theory and practice

[email protected]

Thank you

Standards for

Student Supervision and Assessment

Clare Marie Dickson

South Eastern Health and Social Care Trust

Karen McCutcheon


Name of member Representing / Organisation

Frances Cannon (Project Manager) NIPEC

Joanne Fitzsimons (Professional Officer) SEHSCT

Clare Hughes Midwifery / QUB

Dorothy Patterson Midwifery / QUB

Donna Gallagher Open University

Carol Chambers BHSCT

Sally Martin WHSCT

Gail Doak SHSCT

Tracie Fleming NHSCT

Sonya McVeigh SEHSCT

Evelyn Whittaker Independent Sector / NI Hospice

Eileen Dunlop Independent Sector / Four Seasons

Bernadette Gribben Independent Sector /NIPEC

Seana Duggan Ulster University

Maggie Bennet QUB

Rosario Baxter NMP / Ulster University

Aim:

To ensure regional implementation of the Standards for Student Supervision & Assessment across all NMC approved programmes

Story so far…

• The Northern Ireland Model

• SSSA Guide for those responsible for student Supervision & Assessment in Practice

• Transitioning Arrangements

• FAQ’s

• Close links with other subgroups

Midwifery representation at all levels - Programme Board, Working Group, sub-group work streams and attendance at workshops.

Standards for Student Supervision & Assessment (SSSA)

s

• Effective practice learning

• Supervision of students

• Assessment of students and confirmation of proficiency

New Roles

• Nominated Person

• Practice Supervisor

• Practice Assessor

• Academic Assessor

Nominated Person Who – Ward Sister/Charge Nurse, Nurse Manager/Team Leader Identified on the Practice Learning Environment Education Audit (PLEEA)

• Responsible for: • identifying the nominated practice assessor • identifying the practice supervisor/s • ensuring that both the practice supervisors and nominated practice

assessors receive on-going training and support to fulfil their roles. • overseeing & ensuring continuity for the student and actively support

learning

Practice Supervisor Who - All NMC Registered Nurses and Midwives and other registered health and social care professionals • At least one practice supervisor for each practice learning experience however there

may be multiple practice supervisors -Team approach • The same person cannot fulfil the role of the practice supervisor and practice assessor

for the same student (exceptional circumstances – do not apply to Midwifery) • Organise and co-ordinate Midwifery student learning activities in practice, ensuring

quality, safe and effective learning experiences that uphold public protection and the safety of people and record proficiencies achieved in Northern Ireland Practice Assessment Document (NIPAD)

• Midwifery students will also work with and learn from a range of people who may not be registered healthcare professionals - the supervisory role that non-registered professionals play will be dependent on their skill, knowledge and experience

NMC Guidance - Supporting information regarding practice learning

environments (non-registered professionals)

• Students can still avail of learning / enrichment opportunities in areas where there are no ‘professional’ registrants as long as their nominated practice assessor, supervisor(s) or any other suitable person has oversight of the learning within that placement

• The person or people who are coordinating the students learning may wish to draw up a plan for these placements, and coordinate with the student and those within the environment before, during and after the placement to discuss the learning outcomes that may be learnt and how they can be achieved

• The university (QUB) with its practice learning partners, must ensure that all such placements have proper oversight and governance through audits, visits etc

Who – Registered Nurse / Midwife (Appropriate equivalent experience eg SCPHN, SPQ, NMP) To assess a midwifery student you must be a registered midwife • The student will have a nominated practice assessor, identified by the nominated person, for

each practice placement or series of practice placements • The same person cannot fulfil the role of the practice supervisor and practice assessor for the

same student (exceptional circumstances – NMP, Specialist Practice & SCPHN ONLY) • Practice Assessor will undertake Initial, Mid and Final review for pre-reg students in each

placement AND Formative (with link lecturer / practice tutor) / Summative Assessment (academic assessor)

• Periodically observe student across environments (7.6) • Co-ordinate feedback from practice supervisor/s and practice assessors to evaluate and

recommend the student for progression to the next part of the programme (7.7)

Practice Assessor

Academic Assessor Who - Registered Nurse / Midwife with appropriate equivalent experience for the students field of practice. The academic assessor will be an affiliated member of staff from the student’s university (QUB) and hold relevant qualifications • The student will have a nominated academic assessor for each part of the

programme. Students will not be assigned to the same academic assessor in concurrent parts of the programme.

• The academic assessor will not simultaneously be the practice supervisor and practice assessor for the same student

• Collate and confirm student achievement of proficiencies and programme outcomes in the academic environment for each part of the programme

• Work in partnership with the practice assessor to evaluate and recommend the student for progression for each part of the programme

Separating out the supervision and assessment roles ensures greater consistency and more objectivity in the assessment process. The nominated academic assessor works in partnership with the nominated practice assessor to evaluate and recommend the student for progression for each part of the programme, informed by feedback sought and received from practice supervisor/s and

practice assessors

Preparation Programmes

Transitioning

Transitioning of students on Midwifery programmes to be confirmed by MERG

• All registrants will become practice supervisors from 2020 and all mentors, sign off mentors and practice teachers will transition to practice assessor

• SLAiP will remain in place until the last student has graduated from the current programme

• HSC Trusts will maintain their own practice assessor database • Universities will maintain a practice assessor database for the

Independent Sector. • A practice assessor database will record the following details: Name,

NMC PIN, Part of NMC Register, Field of Practice and date of Preparation for Role.

• All existing mentors, sign off mentors and practice teachers will automatically transition onto a practice assessor database following suitable preparation.

• The current mentor register will also be maintained until all students are transitioned onto the NMC Education Standards (2018) programme/s.

• Universities will maintain an academic assessor database.

Assessor Databases

Practice Education Teams Practice Education Teams will provide professional support, advice and guidance to the nominated person, practice supervisors, practice assessors, and in partnership with universities support students to ensure that the NMC Education Standards (2018) are met, which include Standards for Student Supervision & Assessment. • Work in partnership with others to contribute to systems that monitor the effectiveness

of learning and education activities within all NMC Approved programmes • Collate and maintain the practice assessor database and facilitate a process to share

required information with universities, within GDPR regulations • Ensure quality practice learning experiences through the completion and

monitoring/updating of the Educational Audit • Monitor the quality of the learning environment in collaboration with universities (QUB

for Midwifery) and student evaluations.

Escalating Concerns/Issues

Support Systems for Practice Supervisors and

Assessors

Separate supervision & assessment roles to: • Increase consistency in assessment judgements & avoid ‘Failing to fail’ situations • Joint assessment - Practice Assessor and Academic Assessor • Team approach to student supervision • Supporting students becomes every NMC registrant’s responsibility (it’s in the

Code) • Opens up placements in Independent Sector • More flexibility - 40%, 1 hour Protected Time, Triennial Review, Mandatory Annual

Update, Due Regard, specific number of students to remain ‘live’ – all removed • Reduced time for preparation programme • No portfolio of evidence required • Improve inter-professional working & learning

“A practice supervisor or a practice/academic assessor becomes a

permanent source of inspiration and admiration in a student’s life…...make it count!”

Any questions?

Thank you for your time!

Midwifery Practice Assessment

Document

Clare Hughes


Lindsay Gillman

Kingston University London

Judith Sunderland

City, University of London

MERG Practice Assessment Document Work Stream

Aim - To integrate a Midwifery Practice Assessment Document into the

Northern Ireland midwifery pre-registration curriculum.

Objectives

• To ensure that the PAD fully integrates with the new midwifery curriculum

• To review and decision-make following stakeholder engagement with

regard to grading or non-grading in practice.

• To develop a strategy for educating practice supervisors, practice

assessors and academic assessors in relation to the new PAD.

MERG Practice Assessment Document Work Stream

Objectives Phase 1:

• Engage in the final development phase of the PAD and feedback to

stakeholders to ensure Northern Ireland representation is provided.

Objectives Phase 2:

• Ensure that the PAD Framework aligns to both the NMC standards of

proficiency and the newly developed midwifery curriculum.

• Develop materials to support students, practice supervisors, practice

assessors and academic assessors in the use of the PAD.

• Make recommendations in respect of the proposed way forward - in

relation to electronic solution - for consideration to the FNFM Working

Group and Programme Board.

• Ensure that GDPR/DPA requirements are met

Table Mat Exercise 1

Do you think we should continue to grade

students in practice, or should we move to a

pass/fail [achieved/not achieved] approach?

[please include the rationale for your thoughts]


The new Mora Assessment Document suggests two

formative reviews and one final summative review

each year by a practice assessor.

Do you feel this is the right balance – or is one

formative review and a summative review

sufficient?


Systematic newborn examination is now highlighted as a proficiency

for a newly qualified midwife. Different Universities are recommending

different numbers to reflect competency ranging from 20-40 [NMC

have not stipulated a number].

How many do you think we should ask our students to

complete to demonstrate competency?

{Please take into consideration student numbers 90 per annum}


The NMC Proficiencies reflect the expectation of

students providing continuity of care[r] to women.

The new PAD enables flexibility in how students gain

experience.

How could we provide this in the practice area?

Practice Learning

Environments/Placements

Dr. Jenny McNeill


Maureen Millar

Western Health and Social Care Trust

Brenda Kelly


MERG Practice Learning Environments Work Stream

Aim - Within the context of the new Standards for Student Supervision and

Assessment, review the current arrangements for the identification of Practice

Learning Environments with a view to maximising learning opportunities.

Objectives

• Explore how current Practice Learning Environments could be enhanced or

extended in the context of the new standards.

• Explore how midwifery students will be supported to experience continuity of care

and carer/fundamentals of care, perinatal, mental health and recognition of the

contribution the future midwife will play in population/public health mitigating

health and social inequalities and inter disciplinary and multi-agency working.

• Explore the current mapping process and how this will need revised in line with

the new standards.

MERG Practice Learning Environments Work Stream

• Explore, identify, develop and make recommendations on how to support and

sustain current and new Practice Learning Environment opportunities across all

years of the programme.

• Agree a set of principles to maximise Practice Learning Environment opportunities

aligned to the new standards.

• Make recommendations to the Working Group (FNFM) on:

– the implementation and sustainability of Practice Placements

– identified barriers and solutions to support implementation and culture change

– the potential for additional placement opportunities ie Mental Health

• Agree a regional approach for the allocation of pre-registration Midwifery students

to practice learning environments.

How do PLEs Support Opportunities to Achieve Proficiencies?

Consider possible solutions/how could opportunities be

created:

Domain 1: Being an accountable, autonomous, professional

midwife

Domain 2: Safe and effective midwifery care: promoting and

providing continuity of care and carer

– Continuity of care/carer


Consider possible solutions/how could opportunities be created:

Domain 3: Universal care for all women and newborn infants

– Examination of the new born

– Public Health

Domain 4: Additional care for women and newborn infants with

complications

– Perinatal mental health

– Critical Care

– Social complexities and inequalities


Consider possible solutions/how could opportunities be created:

Domain 5: Promoting excellence: the midwife as colleague,

scholar and leader

– Leadership

– IQI

– Governance

– Resilience and self-care

Domain 6: The midwife as skilled practitioner


How do you maximise the potential of Practice

Learning Environments currently used for Midwifery?

How do you broaden the opportunities to use

Practice Learning Environments not currently used

for Midwifery?

Engagement and Communication

Judith Tuckey


Cathy Hamilton


Establishment

of Midwifery Expert

Reference Group

FNFM information slides

shown at AEI and CEC

classes

Local contact: • Trust & AEI

• Local FNFM

Implementation

• Mentor Updates

• Meetings

• Supervision

• Audit

NIPEC communiques

NIPEC FNFM

Micro Site

Trust & AEI

intranet

FNFM

Professional

Officers

E&C Membership

Chair : Brendan MC Grath

HSC Trusts, AEI’s, PCC

Independent Sector,

and Students

NIPEC FNFM

Roadshows

541

attendances

• MERG

• Local trust FNFM

Implementation

groups

Dec 19 -

QUB midwifery

curriculum

workshop

Feb 2020 -

QUB Midwifery

NIPAD workshop

To come….Future

Midwife

Information leaflets

To come ….. Future

Midwife webinars

& podcasts

TODAY!

NIPEC

FNFM

regional

midwifery

workshop

To come….SSSA

Preparation

Programmes

Jan - NMC

launch

“Standards

of proficiency

midwives”

How to keep up-to-date?

• NMC website

• NIPEC website

• Trust staffnet

Cascade, feedback &

share

Do you know

your

professional officer?

Who is your PEF?

What now…

Let’s “talk/tweet”

FNFM to midwife

colleagues

Engagement and Communication

What engagement and

communication activity

would you like to see for

Midwifery?

Closing Remarks

Dr. Dale Spence


Caroline Diamond


Future Nurse Future Midwife Midwifery Expert Reference ......supported by a Handbook ......

Documents

Transcript of Future Nurse Future Midwife Midwifery Expert Reference ......supported by a Handbook ......