OF THE MIDWIFERY COUNCIL OF NEW ZEALAND · OF THE MIDWIFERY COUNCIL OF NEW ZEALAND TO THE MINISTER...

1Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015

ANNUAL REPORTOF THE MIDWIFERY COUNCIL OF NEW ZEALAND

TO THE MINISTER OF HEALTHFOR THE YEAR ENDED 31 MARCH 2015

2 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015

Detail of painting of Dame Whina Cooper by artist the late Suzy PenningtonDame Whina, awarded the title of Te Whaea o te Motu (Mother of the Nation) by the Maori Women’s Welfare League, holds a special place in New Zealand history as a founder of the League and because of her long life devoted to the service of her people and to the wellbeing of women and children. She particularly stressed the value of primary health and the importance of good midwifery services being available to Maori women and their whanau. The whakatau (Maori proverb) on the painting is the chant “ruia, ruia” from the Muriwhenua iwi of the Far North and symbolises inspiration, challenge and hope. The painting has hung in the Council’s office since its opening in February 2007.


CONTENTS

03INTrOduCTION

04GOvErNaNCE

10SECrETarIaT

20COmpETENCE, FITNESS TO praCTISE aNd

QualITy

24COmplaINTS aNd dISCIplINE

25appEalS aNd JudICIal rEvIEwS

37CONTaCT dETaIlS


Facts at a glance

• 3100practisingmidwives(3068in2014)

• 134RegisteredNewZealand-educatedmidwives(147in2014)

• Registered38internationallyqualifiedmidwives(42in2014)

• 134midwiferygraduatespassedtheNationalMidwiferyExamination

• 10midwivescompletedaReturntoPracticeprogramme

• Received28notificationsinvolvingmidwives’competenceorconduct

• Conducted7competencereviews

• Required11midwivestoundertakecompetenceprogrammes

• Referred3midwivestoaProfessionalConductCommittee

• Received44notificationsinvolvingmidwives’health

• Contracted6externals36competenceassessors

• Developededucationarounduseofopioidsfollowingchangesinlegislation

• Addedchildbirthemergenciestomaternalandneonatalresuscitationasan

annualrequirementintheRecertificationProgramme

• Published9eMidpoints

• Signed3MOUswithNewZealandCollegeofMidwives

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5Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 3

INTrOduCTION

The Council’s mission:

• ToprotectthehealthandsafetyofwomenandbabiesexperiencingmidwiferycareinNewZealand

• Toestablish,protectandstrengthenaregulatoryframeworkthatembodiesthephilosophyandstandardsofthemidwiferyprofession

• TosetandmaintainhighstandardsofmidwiferypracticeinNewZealand

Council values:

1. Thepartnershipbetweenwomen/wāhineandmidwives/wāhinewhakawhānau

2. PartnershipwithTangataWhenua3. Respectfordiversity4. Integrityandfairness5. Transparent,credibleandaccountable

decisionmaking6. Collegialityandcollaboration7. Reflectionandongoinglearning8. Social,economicandecologicalsustainability

Functions:

ThefunctionsoftheCouncilaredefinedbythe

HealthPractitionersCompetenceAssuranceAct

2003(“theAct”).TheCouncilmust:• DefinetheMidwiferyScope(s)ofPractice

andprescribethequalificationsrequiredofregisteredmidwives

• Accreditandmonitormidwiferyeducationalinstitutionsandprogrammes

• MaintainapublicRegisterofmidwiveswhohavetherequiredqualificationsandarecompetentandfittopractise

• Issuepractisingcertificatestomidwiveswhomaintaintheircompetence

• Establishprogrammestoassessandpromotemidwives’ongoingcompetence

• Dealwithcomplaintsandconcernsaboutmidwives’conduct,competenceandhealth

• Setthemidwiferyprofession’sstandardsforclinicalandculturalcompetenceandethicalconduct

• Promoteeducationandtraininginmidwifery• PromotepublicawarenessoftheCouncil’s

responsibilities


1 GOvErNaNCE

Chairperson’s Foreword

Tēnā Koutou Katoa. Kia Kotahi Kī. He i oku nei korero anei he whakataukiNo tou rourou, no toku rourou, kia ora te iwi

What you have in your basket and what I have in mine, the combination will enhance all people’s wellbeing

Theyear1April2014to31March2015hasbeenbothabusyandsignificantyearfortheCouncilasithasengagedwithanumberofkeyprojectsandeventsduringthepastyear.

Somehighlightsinthepastyearhavebeen:• AreviewofthegovernancemodelofMidwiferyCouncilmovingtoa

morestrategicratherthanoperationalframework.Thepurposeofthereviewistoensurethat:

TheMidwiferyCouncilandsecretariatcontinuetoworkeffectivelyandefficiently;theCouncilismorestrategicallyfocused;thesystemsandprocessesthatsupporttheCouncilarestreamlined;andskillsandknowledgeoptimised.Theresultsofthechangesthathavebeenimplementedtodateareverypleasing.

• Thereviewofthepre-registrationmidwiferystandardsforeducation,includingconsultationwithallstakeholders,tookplaceduringthisyear.Theconsultationandtheworkofthesteeringgroupledtosomechangesinthestandards.However,theCouncilwaspleasedtoseethat,whenbenchmarkedinternationallyandmeasuredforhoursandoutcomes,thepre-registrationstandardsarerobust,leadingtohighqualitygraduates.

• StrengthenedMidwiferyFirstyearofPracticeProgramme.AftertwoyearsofextensivereviewandworkledbyHealthWorkforceNewZealandandtheMinistryofHealthandwhichinvolvedtheCouncil,alongwithNewZealandCollegeofMidwives,thisprogrammewassignedoffbytheMinisterin2014andbeganFebruary2015.Itwaspleasingtoseethatmanyofthethingsalreadyinplacehadservedmothersandbabieswell.Thestrengtheningoftheprogrammeandmakingitcompulsoryaddedfurthersupport.

• ContinuedengagementwiththeotherRegulatoryAuthoritiesonvariousregulatorymatters.Theissueofco-locationandsharedserviceshasbeenfurtheredandtheCouncilhasrelocatedtoLevel9,79BoulcottStreet.Thisispartofastagedplanwhichwillseeafurthermovein2016,whentenregulatoryauthoritieswillsharelocationandservices.TheCouncilseesthisasapositivemovetoensurethatthefunctioningoftheCouncilandthesecretariatisasefficientandcosteffectiveaspossible.

TheprimaryworkoftheCouncilistoprovidemechanismstoensurethatmidwivesarecompetentinthecaretheygivetowomenandtheirbabies.Ournumberonepriorityisthesafetyofmothersandbabies.

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TheCouncilalsocontinuestovalueitsgrowinginternationalrelationshipsand,inparticular,itsrelationshipwiththeNursingandMidwiferyBoardofAustralia,andtheAustralianNursingandMidwiferyAccreditationCouncil.TheopportunitytoattendtheSouthPacificChiefNursingandMidwiferyOfficersAlliance(SPCNMOA)inTongain2014,aswellasothereventsinthePacific,hasestablishedandfurtheredrelationshipsinthePacific.

TheCouncilengageswithanumberofstakeholdersandgroupsthroughouttheyear.OneofthehighlightsofthisengagementistheMidwiferyForum.In2014/2015twoforumswereheldinAucklandandChristchurch.Theseforums,asalways,weregatheringswherethework,concerns,issuesandplansoftheCouncilcanbepresentedtomidwives,womenandstakeholders,androbustdiscussiononthesematterscantakeplace.TheCouncilcontinuestovaluegreatlyitsrelationshipswithallitsstakeholders,andinparticularwiththeNewZealandCollegeofMidwives,theMinistryofHealth,HealthWorkforceNewZealandandtheDHBmidwiferyleaders.Wethankthesegroupsfortheircontinuedsupportandthecollegialandprofessionalmannerinwhichtheyenteredintodiscussionsandprojectswithusthatareattimeschallenging.

TheprimaryworkoftheCouncilistoprovidemechanismstoensurethatmidwivesarecompetentinthecaretheygivetowomenandtheirbabies.Ournumberonepriorityisthesafetyofmothersandbabies.TheCouncilistheauthorityonmidwiferyregulation,pre-registrationeducationandthestandardstowhichmidwivesarerequiredtopractise.TheCouncilcollectsandanalysesdataaboutallthenotificationsitreceivesaboutmidwives.Itlooksfortrendsandareasofrisks,continuallyevaluatingandactingonanyareasofconcern.Asanyreputableorganisationdoes,itusesthehierarchyofevidenceinassessingwhatisthe“bestevidence”tosupportbestpracticeandpolicy.Thismeansittakesatop-downapproach,rankingtheevidenceontherigouroftheresearchmethodology.TheCouncilisalwaysopentoworkingwithandlisteningtootherinterestedpartiesinmattersrelatedtomidwiferypracticebutitexpectstheyapplythesamerigourtotheirassessment.IntheCouncil’sview,touseanythinglessthan“bestevidence”isnotacceptable.

The Council and the Secretariat

IwouldliketoexpressmysincerethankstoSharronColeasCEOforhercontinuedcommitmenttoensuringCounciloperatesinthemosteffective,efficientandinformedwaypossible.IwouldalsoliketothankSusanCalvertinherroleasMidwiferyAdvisorandtheinvaluablewayshecontinuestosupporttheCouncilinitswork.Inaddition,mythanksgotoNickBennie,MarilynPierson,AndyCrosbie,JudithNormanandChristineWhaanga.TogetherthisteamrunsaveryeffectiveandefficientsecretariatwhichgivesgreatservicetoCouncil,thepublic,andmidwivesofNewZealand.

Iextendmysincerethankstoallthecompetenceassessors,thereviewers,thesupervisors,andthemidwivesandlaypeoplewhomakeuptheProfessionalConductCommittee,aswellasthosemanymidwiveswhoprovidesupportandadvicetotheCouncil.Yourexpertiseandprofessionalismismuchappreciated.

Finally,IoffermyheartfeltthankstotheCouncilmembersfortheirengagementwiththechangingprocessesofCouncil,especiallyduringthisyear,andtheircontinuedcommitmenttoensuringthattheprocessesofCouncilservethepublicofNewZealandwithintegrity,competence,andefficiency.

Noreirateneitemihikiakoutoukatoa.Kiakahakiamaiakiamanawanui.

NaJudithJudithMcAra-CouperChairperson


members of the midwifery Council at 31 march 2015

Chairperson: Dr Judith McAra CouperPhD,BA,RM,RGONJudithMcAraCouperhasworkedasamidwifebothinNewZealandandoverseas.JudithisanAssociateProfessorandHeadofMidwiferyatAucklandUniversityofTechnology.Sheteachesinthemidwiferyprogrammeanduntilrecently,heldajointappointmentatCountiesManukauasaclinicalmidwiferyeducatorinthebirthingunit.In2009,Judithwasawardedapostdoctoralscholarshipwhichshetookupin2010,focusingonmidwiferyandwomen’shealthresearch.Judithhasalsobeeninvolvedsince2009withtheWorldHealthOrganisationinBangladesh.SheisapastchairpersonoftheAucklandregionoftheNewZealandCollegeofMidwives.JudithlivesinAucklandwithherpartnerandtwocats.JudithwasappointedinFebruary2010andwasreappointedinAugust2015.

Deputy Chairperson: Andrea Vincent RGON,RMAndreahasworkedasamidwifeinavarietyofsettingsinNewZealandandoverseas.Shehasworkedasaself-employedcase-loadingmidwifeinNelsonsince1993,coveringruralandurbanareas,homeandhospitalbirths.SheisapastchairpersonoftheNelson-MarlboroughregionoftheNewZealandCollegeofMidwives.Andrealivesinsemi-ruralNelson,withherhusbandandtwoteenagechildren.ShewasappointedinFebruary2010andwasreappointedforasecondtermwhichwillendinFebruary2016.

Annette BlackONMZ,MA,DidEdStud,DipTchg,MBAAnnettewasappointedasalaymemberforathreeyearterminAugust2009andthenreappointedforasecondterm,expiringSeptember2015.ShebeganhercareerasasecondaryschoolhistoryteacherthenjoinedtheNewZealandLawSocietyasitsDirectorofEducationin1983.In1987shewasappointedDeputyExecutiveDirectorandheldbothpositionsconcurrentlyuntilherretirementin2005.SincethenshehascontinuedtoworkwiththeLawSocietyasaconsultant.SheassistedwiththeimplementationoftheLawyersandConveyancersActwhichcameintoforceon1August2008andandplayedamajorroleindesigninganddevelopingtheLawSociety’sfirstcontinuingprofessionaldevelopmentruleswhichcameintoforcein2013.SheisalsoaDirectorofNZLSCLELtd.AnnettelivesinWellingtonandismarriedwithtwoadultchildrenandfourgrandchildren.

Debbie FisherPGDipHealthCare,RM,BN,RCNDebbieFisherwasappointedtotheMidwiferyCouncilinSeptember2011.HercurrenttermexpiresinSeptember2015.SheistheAssociateDirectorofMidwifery-OperationsManagerattheNelsonMarlboroughDistrictHealthBoardwhereherroleisanintegralpartofmaternityservicesacrosstheregion.Shealsoworksclinicallyonacasualbasis.DebbieisamemberoftheNationalDHBMidwiferyLeadersGroupandNZCOM.SheisalsoaLactationConsultantandamemberofNZLactationConsultantsAssociation.DebbiehaslivedinNewZealand,AustraliaandtheUnitedKingdomandworkedinalltypesofmaternitycaresettings,workedonavarietyofmaternityprojectsandhaspresentedatnationalandinternationalmidwiferyconferences.ShehasbeenaNZCOMregionalchairpersoninthepast.DebbiehasaPGDiplomainHealthCareandiscurrentlyapostgraduatestudentatVictoriaUniversity.ShehasalsocompletedaTeReolevelonecertificationandpostgraduatestudyinadultteachingandlearningandclinicalmidwiferypractice.Debbie,herhusbandandherbabydaughtercurrentlyliveinNelson.

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Bronwen Golder BA,MA(withdistinction)BronwenwasappointedasalaymemberforathreeyearterminAugust2011,subsequentlybeingappointedforafurtherthreeyearsinMay2015.Earlyinhercareer,BronwenworkedasapoliticalriskanalystinNewYork.UponreturningtoNewZealand,BronwenjoinedtheDepartmentofLabourfromwhereshewassecondedtotheBeehiveasadvisortotheMinisterofEmployment.Since1993,BronwenhasworkedinGeneva,Brussels,WellingtonandChile-leadingconservationprogrammesfortwoofthelargestenvironmentalNGOsintheworld.BronwencurrentlyleadsaNewZealandconservationinitiativeprovidingstrategicadviceandsupporttoprojectsinAustralia,theSouthPacific,SoutheastAsiaandChile.Bronwenbringstoextensiveexperienceinpublicprivatesectorpartnerships,riskanalysis,strategicandprojectplanningandfacilitation,communications,andmonitoringandevaluation.BronwenlivesinWellingtonwithherhusbandandhighschool-agedson.

Korina VaughnRN,RMNgatiHako,NgatiMaruKorinaVaughnismarriedwith4childrenwhoareofSamoanandMaoridescent.KorinaandherfamilyliveinHuntlyandherchildrenattendalocaltotalimmersionKuraKaupapa.KorinacompletedherRegisteredComprehensiveNursetrainingin1992.ShethenworkedasaPracticeNurseatWaahiMaraeinHuntlyfortwoyears.In1994shebeganhermidwiferytrainingandin1995registeredasaMidwife.Korinahasworkedinavarietyofclinicalmidwiferysettingsbutpredominantlyasaself-employedmidwifeinHuntlyandthesurroundingdistricts.KorinaiscurrentlyemployedastheClinicalManagerofBirthcareHuntlyandshecontinuestocarryasmallcaseloadtomaintainmidwiferycompetencies.HertermbeganendinSeptember2009andshehasbeenreappointedforasecondtermwhichendsinSeptember2015.KorinahasbeenonleavefromtheCouncilsinceMay2013

Joyce Croft, RM,RN Ngapuhi/NgatihineJoycewasborn,raisedandworkedmostlyinTeTaitokerau/Northland.SheismarriedwithtwochildrenandlivesinWhangarei.CurrentlysheworksatNorthlandDHBasamidwifeinvariousroles.Previouslysheworkedasacaseloadingmidwifecaringforwomenfrombothurbanandruralcommunitieshavinghospitalandhomebirths.JoyceisanactivememberoflocalgroupssuchasTeKahuWahine(MaoriMidwives),NZCollegeofMidwives,MERAS,MaternityClinicalGovernance,MaoriWomensWelfareLeague,TeRengaParaoaandManaiaPHOClinicalAdvisoryCommittee.Herotherinterestsandactivitiesincludewhanau,holidays,breastfeeding,Maorihistoryandlanguage.JoycewasappointedtotheCouncilinJune2014.

Marion Hunter MA(Hons1stClass),BA,ADN,RM,RGONMarionwasappointedtotheMidwiferyCouncilinAugust2010forathreeyeartermandthenreappointedin2013forasecondtermwhichwillexpireinAugust2016.SheisaSeniorMidwiferyLecturerattheSchoolofMidwifery,AUTUniversity.Marion’sexperienceincludesLMCmidwiferyinaruralareaandemployedpositionsinbothtertiaryandruralhospitals.SheiscurrentlyaDirectorofthePHARMACSeminarSeries,MemberoftheNZFormularyAdvisoryBoardandhasservedonaMinistryofHealthcommitteeassessingnewprescribergroupsinNewZealand.MarionwasapprovedbyNZCOMasanexpertadvisorandhasundertakenvariousreviewsinrelationtoserviceandmidwiferypractice.Shehasco-authoredtwochaptersintheAustralasianmidwiferytextbookandpublishedelsewhereinrelationtobirthplace.


Strategic Goals

Registration

Midwiveswhomeetthestatutoryrequirementsareregisteredthroughefficient,transparentandconsistentprocesses

EducationandlearningPre-registrationmidwiferyeducationstandardscontributetocompetent,confidentregistrantsandpostregistrationprogrammesassistmidwivestomaintainandenhancemidwiferyknowledgeandskills

FitnesstopractisePractisingmidwivesdemonstratetheircompetenceandfitnesstopractiseandwhenconcernsarise,theCouncil’sassessmentandsupportprocessesareequitable,clearandproportionate

ProfessionalstandardsClinical,culturalandethicalstandardsarevalidandcurrentintheNewZealandpracticecontextandpromotepublictrustandconfidenceintheprofession

GovernanceandOperationsGovernanceandorganisationalprocessesareefficientandeffective,ensuringthatstatutoryresponsibilitiesarefulfilledinameasurableandtransparentmanner

CommunicationandexternalrelationsThereiswidespreadengagementwithstakeholdersandthepublicsothattheCouncil’spoliciesandprocessesarewellinformedandtransparentandthepublichasaclearunderstandingoftheCouncil’sauthorityandresponsibilities

Fees for Council members and appointees

ThefeespaidtoCouncilmembershaveremainedunchangedsincetheyweresetin2004.Currentfeesare:• Agreedspecifictasksandteleconference

meetings$80perhour• Meetings-Chair$650perday• Meetings-Members$450perday• Meetingpreparationtime–4hoursat$50

perhour

Remuneration* received by each member for attendance at Council meetings and Annual Fora

*Grossincome–includesresidentwithholdingtax**AppointedJune2014***OnleavesinceMay2013

JMcAra-Couper(Chairperson)

ABlack

DFisher

BGolder

MHunter

JCroft**

KVaughn***

AVincent

<$4000 $10,001to$18,000

$4,001to$10,000

x

x

x

x

x

x

x

8


Council meetings

During2014,theCouncilcontinueditspatternadoptedthepreviousyearofholdingalternatetwodaymeetingsinWellingtonandhalfdayaudioconferencesbySkype.TheCouncilhadsixtwodaymeetingsandoneonedaymeetinginWellington,andfourhalfdaySkypemeetings.FollowingthegovernancereviewinOctober2014however,itresolvedtomovetosixweeklyonedaymeetingsinWellington

Committee structure

At31March2015,theCommitteesandtheirmembersare:

Education and Audit CommitteeAnnetteBlack,DebbieFisherandJudithMcAra-Couper.

Examination CommitteeMarionHunter,JudithMcAra-Couper,AndreaVincent,AnnetteBlack(JudithMcAra-CouperandMarionHunterarepost-examinationonly).

Health CommitteeJoyceCroft,BronwenGolder,MarionHunterandAndreaVincent.Thiscommitteehasfullydelegateddecisionmakingpower.

Finance CommitteeAnnetteBlack,BronwenGolder,DebbieFisher,JudithMcAra-Couper(withtheChiefExecutive)

Sorting CommitteeThe“SortingCommittee”wasestablishedtobettermanagetheworkloadofaddressingmattersrelatingtomidwives’competenceandconduct.ThisCommitteeanalysesallnewcases,includingtheinitialresponsefromthemidwife,thentablesthematterbeforeafullCouncilmeeting.Membersat31March2014wereDebbieFisher,MarionHunter,JudithMcAra-CouperandAndreaVincent.However,asaresultofthegovernancereview,theCouncilinlate2014disestablishedtheSortingCommittee,itsworknowbeingundertakenbynewlyappointeds36CompetenceAssessors.

Council EducationInMayandJune2014,anumberofCouncilmembersattendedtheinauguralHRANZRegulationConferenceandtheannualPerinatalandMaternityMortalityReviewCommitteeworkshop.

Photo: Milldove Birth and Newborn Photography www.birthandnewborn.co.nz


2 SECrETarIaT

Chief Executive’s review 14/15

Registration and midwifery education

Goal:Midwiveswhomeetthestatutoryrequirementsareregisteredthroughefficient,transparentandconsistentprocesses

Goal:Pre-registrationmidwiferyeducationstandardscontributetocompetent,confidentregistrants

Asallapplicationsforregistrationaremadeon-line,theCouncilhascontinuedtorefinetheITsystemtoensureitis“userfriendly”andaccurate.Towardstheendof2014/15,itbeganaprojecttodigitiseallregistrationrecordsheldbytheCouncilandaimstohavethiscompletedbythetimeitco-locateswiththeNursingCouncilandeightotherRegulatoryAuthoritiesinearly2016.

TheVulnerableChildren’sActhasledtheCounciltoreviewitsprocesseswithrespecttotheverificationofidentityandthefitnessforregistrationofapplicantsforEntrytotheRegisterofMidwives.Despitethemovetomorestringentlyscreenthefitnessofpersonswhoworkwithchildren,theNewZealandPoliceadvisedthatasmidwiferycareisnotpredominantlyinvolvedintheplanning,managementanddeliveryofservicestochildren,theCriminalRecords(CleanSlate)Act2004applies,withtheexceptionof“specifiedoffences”asdefinedinSchedule2oftheVulnerableChildren’sAct2014.

Thecurrentpre-registrationmidwiferyeducationstandardswhichcameintoeffectatthebeginningof2009,withreviewsofthefourschoolsofmidwiferytakingplaceover2012/13.AreviewofthestandardsbeganinNovember2013andwasnearingcompletionattheendofthe2014/15practisingyear.Therevisedstandardshaveincorporatedfeedbackfortheneedtostrengthentheprogrammeinresponsetothechangingmaternityandsocialenvironment

Duringtheyear,changeswerealsomadetotheInternationallyQualifiedMidwivespolicyinordertogiveaddedreassurancearoundtheirreadinessandabilitytopractisewithintheNewZealandmaternitymodelofcare.

Education and Learning and Firness to practise

Goal: Postregistrationprogrammesassistmidwivestomaintainandenhancemidwiferyknowledgeandskills

MythankstoallCouncilandstaffmemberswhoaremindfulofandcommittedtoprotectingthehealthandsafetyoftheNewZealandpublicbyhavinginplacesprocessestoensurethatmidwivesarecompetenttopractisetheirprofession.

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Goal:Practisingmidwivesdemonstratetheircompetenceandfitnesstopractiseandwhenconcernsarise,theCouncil’sassessmentandsupportprocessesareequitable,clearandproportionate

Goal:Clinical,culturalandethicalstandardsarevalidandcurrentintheNewZealandpracticecontextandpromotepublictrustandconfidenceintheprofession

WhenmidwivesareenteredontotheRegisterofMidwives,theyhavebeendeemed,byvariousobjectivemeasures,ascompetentandfittopractise.Thereareseveralcharacteristicswhichdefinecompetenceincludingprofessionalnetworkingandengagement,andsatisfactionwithcareerchoiceandwithpersonallives.‘Competencydrift’hasbeenidentifiedasculminatingincomplaintsandconcernsaboutahealthprofessionalpractice.Itoccurswheretherearepoorsupervisorystructures,lackofpeersupport,professionalisolationanddisengagementfrompractice.

ThechallengefortheCouncilisgettingthebalancerightbetweenqualitycontrolandqualityimprovement,bothofwhichfallwithinitsjurisdictionunderitsempoweringAct.Qualitycontrolisaboutidentifyingthosemidwiveswhoarepractisingbelowtherequiredstandardandputinplacethenecessaryrestrictionsorremedialactions.Qualityimprovementisaboutpromotingandsupportingmaintenanceofcompetenceinallpractitioners.

TheCouncil’smainqualityimprovementorcontinuingcompetencemodelistheRecertificationProgrammewhichwasrevisedfrom1April2014toincludechildbirthemergenceswithmaternalandneonatalresuscitationasannualupdate.TheMidwiferyPracticeDaywhereissuesandtrendsinmidwiferypracticeareaddressedwasalsorevisedtobecomeamoreactivelearningday.FeedbackfrommidwivesindicatesthatthechangestotheRecertificationProgrammehavebeenpositive.

TheCouncilhasagreedtoparticipateintheUKProfessionalStandardsAuthority-ledcomparativereviewofthehandlingofnotifications,includingthemonitoringoftheprioritylevelgiventoeachno-tification.Intheinterim,theCouncilhasmovedtomodifythewayinwhichitassessesandprioritisescompetencenotificationsbycontractingexternalassessorstoundertakethisprocess,allowingforin-creasedobjectivityandexpertise.

Stakeholder engagement

Goal: ThereiswidespreadengagementwithstakeholdersandthepublicsothattheCouncil’spoliciesandprocessesarewellinformedandtransparentandthepublichasaclearunderstandingoftheCouncil’sauthorityandresponsibilities

AtitsstrategicplanningandgovernancereviewworkshopinOctober2014,theCouncilrecognisedtheneedtobemoreeffectiveincommunicatingwithitskeystakeholderssothattheCouncil’sstatutoryroleinprotectingthesafetyofmothersandbabiesthroughitsregulationofmidwivesisbetterunderstood.Inearly2015,itapprovedacomprehensivecommunicationsstrategy“ChangingPerceptions”tobeimplementedinthe2015/16year.

TheCouncilcontinueditsactiveinvolvementinHealthRegulatoryAuthoritiesNewZealand(HRANZ)atbothoperationalandgovernancelevel.IthasalsocontinuedtoexpanditscollegialworkingrelationshipwithitsAustraliancounterparts,havingMemorandaofUnderstandingwiththeNursingandMidwiferyBoardofAustraliaandtheAustralianNursingandMidwiferyAccreditationCouncil.During2014,theCouncilhasbecomemorefocusedonthePacificregion,joiningtheSouthPacificChiefNursingandMidwiferyOfficersAllianceandattendingthebiennialSouthPacificNursingandMidwiferyForuminTonga.


ThemonthlyelectronicnewslettereMidpointissenttoallmidwiveswithapractisingcertificateandmanyotherstakeholders.

Governance and Operations

Goal:Governanceandorganisationalprocessesareefficientandeffective,ensuringthatstatutoryresponsibilitiesarefulfilledinameasurableandtransparentmanner

TheCouncilheldstrategicplanningandgovernancereviewworkshopsinOctoberandNovember2014.Itsubsequentlyadoptedathreeyearstrategicplantobecomemorestrategic,withaccurateinformationandanalysisallowingittoevaluateriskandtoalignitsregulatoryprocesseswithwhattheUKProfessionalStandardsAuthoritydefinesas“righttouchregulation”.

InNovember2014,theCouncilco-locatedwithfourotherRegulatoryAuthoritiesinordertoachieveoperationalefficiencies.Italsoremainedpartoftheongoingdiscussionwithnineotherauthoritiesoverco-locationandsharedadministrativeservicestoachievegreatercostssavings.InFebruary,theCouncilsignedaMemorandumofUnderstandingwiththeNursingCouncilonsharedservicesandinMarch,signedabaselevelServiceLevelAgreement.Worktowardssharedserviceswillprogressoverthe2015-16year,withtheaimoffullimplementationoftheSLAbeforeMarch2016.Sharedserviceswillmeananorganisationalreviewbutinthemeantime,thesmall6.5FTEstaffremainsunchanged.

MythankstoallCouncilandstaffmemberswhoaremindfulofandcommittedtotheprimarypurposeofourempoweringactwhichistoprotectthehealthandsafetyoftheNewZealandwomenandbabiesbyhavinginplacesprocessestoensurethatmidwivesarecompetenttopractisemidwifery.

SharronColeChiefExecutiveandRegistrar

Table 1 Summary of expenditure – 2014 to 2015

9%

24%

25%

5%

3%

9%

8%

9%

8%

Communica1on with Stakeholders

Prac1sing Cer1ficates and Recer1fica1on

Competence

Examina1ons

Health

HPDT

PCC

Registra1on

Educa1on and Audit

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Registration of, and Practising Certificates for, Midwives

a. Scopes of practiceThe Council has the responsibility to:• specifythemidwiferyscopeofpractice

Ankylogossia and frenotomy

TheCouncilconvenedamultidisciplinaryworkingpartyin2013toconsidertheissueoffrenotomywithinthemidwiferyscopeofpracticeandthemidwife’sroleintheassessment,diagnosisandtreatmentofankyloglossia(tonguetie).Adraftstatementwassentforconsultationin2014.WorkcontinuesonthisprojectbuttheCouncil’spositionhasnotchangedfrom2005whenitstatedthattheskilloffrenotomystaywithinthescopeofpracticeofsomemidwiveswhohadreceiveadditionaleducation.

Misuse of Drugs Act and Regulations

Since2012,theCouncilhasworkedwiththeMinistryofHealthandtheCollegeofMidwivesaroundanamendmenttotheMisuseofDrugsActandRegulationsthatallowsmidwivestoprescribecontrolleddrugsinadditiontopethidine.TheAmendmenttotheActandregulationscameintoeffecton1July2014andtheCouncilpublishedastatementontheMidwife’sscopeofpracticeatthattime.ScheduleCintheregulationsliststheadditionalcontrolleddrugsthatmidwivescanprescribeandtheCouncil’sstatementdescribestheindicationsforprescribing.Aneducationprogrammewasdevelopedandimplementedthatallmidwives,includingthoseregisteringfromoverseas,mustcomplete.

b. Accreditation

The Council has the responsibility to:• accreditandmonitortheinstitutionsoffering

thepre-registrationMidwiferyprogramme• setstandardsfortheMidwiferypre-

registrationprogramme

Pre-registration education TheBachelorofMidwiferyprogrammesare

deliveredatfourschoolsofmidwifery-AucklandUniversityofTechnology(AUT),WaikatoInstituteofTechnology(WINTEC),ChristchurchPolytechnicInstituteofTechnology(CPIT)andOtagoPolytechnic.Theschoolsdeliverthefouryear(480credit)programmeoverthreeextendedacademicyearsinordertomaximiseopportunitiesformidwiferypracticeexperiencesandconsolidation.

InNovember2013,theCouncilinvitedrepresentationontheworkingpartytoreviewthe2007Standardsforapprovalofpre-registrationmidwiferyeducationprogrammesandaccreditationoftertiaryeducationorganisations.Itsentoutthedraftrevisedstandardsforconsultationduring2014andwillpublishtherevisedstandardsin2015.

Monitoring of Schools of Midwifery

TheCouncilreviewedtheapprovedprogrammesofeducationinthetwoyearsafterthefirstgraduatesfromthecoursesagainstthe2007standardswereenteredontotheRegisterofMidwives.

ThereviewgavetheCouncilreassurancethatstudentsfromtheseprogrammesaremeetingtherequirementsforEntrytotheRegisterofMidwives.Further,therewaswidespreadfeedbackthattheprogrammesofeducationwhichhavebeendesignedtoensurethatthegraduatesareconfidentandcompetenttopractisemidwiferyintheNewZealandmaternityenvironmentarefulfillingthatexpectation.

Italsoconfirmedpreviousanecdotalreportingthatthereis:

• Increasedproficiencywithpracticalskills• Earlierintegrationoftheoryandpractice• Increasedconfidenceinfinalyearstudents• Perceptionofearlier‘readiness’forpractice

National Midwifery Examination

ApassintheNationalMidwiferyExaminationisoneoftherequirementsforEntrytotheRegisterofMidwives.InMarch2014,all44candidatesattainedapass;inJuly2014,all3candidatesattainedapassandinDecember2014,89studentssattheexamand87attainedapass.Thesuccessratesforeachschoolofmidwiferyfor2014areshowninTable2.


Table 2National Midwifery Examination passes 2014

HPCAA Number Outcomes Section Registered Registered Not with registered conditions

Total 15 185 134 38 13*

Reasons for non-registration*

Qualificationsdidnotmeetrequiredstandard 15b 3 - - 3

Didnotmeetthecompetenciesforpractice 15c 3 - - 3

CommunicationincludingEnglishlanguagerequirements 16a,b - - -

Convictionbyanycourtfor3monthsorlonger 16c - - -

Mentalorphysicalcondition 16d - - -

ProfessionaldisciplinaryprocedureinNZoroverseas 16e,f,g - - -

Other–dangertohealthandsafety 16h - - -

School Numbers Numbers % passed sitting passed

AUT 42 42 100

WINTEC 30 28 93

CPIT 19 19 100

Otago 45 45 100

c. Registration

The Council has the responsibility to:

• setstandardsofcompetencerequiredforentrytotheRegisterofMidwives

• assessapplicationsandauthoriseregistration• setandmonitorindividualcompetence

programmesfornewlyregisteredinternationallyqualifiedmidwives

Midwivesapplytoregisterandmakepaymentonline.Allapplicationsareassessedtoensurethatapplicantssatisfytherequirementsforregistrationassetoutins16oftheHealthPractitionersCompetenceAssuranceAct2003.

Table 3Applications for registration decided in the 2014 – 2015 year

*In7cases,theapplicanteitherwithdrewordidnotcompletetheapplication.

*In7cases,theapplicanteitherwithdrewordidnotcompletetheapplication.

14


Type/Year 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15

NewZealandgraduates 109 107 126 129 149 133 147 134

AustralianTTMRA* 17 11 13 7 12 8 13 15

Internationallyqualified 71 60 63 37 46 26 29 23

Total 197 178 202 173 207 167 189 172

Table 4Number of Midwives registered between 1 April 2014 and 31 March 2015 with comparisons with previous years

*TransTasmanMutualRecognitionAct1997

Table 5Percentage of registrations between 1 April 2014 and 31 March 2015 with comparisons with previous years: New Zealand graduates compared to all internationally qualified midwives

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 NZ Graduates 55.3% 60.1% 62.4% 74.6% 72.0% 79.6% 77.8% 77.9%

Overseas 44.7% 39.9% 37.6% 25.4% 28.0% 20.4% 22.2% 22.1%


Midwifery First Year of Practice Programme

TheMidwiferyFirstyearofPracticeprogramme(MFYP),fundedbyHealthWorkforceNewZealandandprovidedbytheNewZealandCollegeofMidwives,wasimplementedin2007andasfrom1February2015,theCouncilhasmadeitmandatoryforallnewgraduatestoenrolinandsuccessfullycompletetheprogramme.

TheCouncilismindfulofitsroletoprotectthesafetyofthepublicbyensuringmidwivesarecompetenttopractiseandthatthepublicmusthaveconfidencethatthepracticeofnewgraduatesdoesnotputthematgreaterrisk.Itsanalysisofthecomplaintsithasreceivedaboutthepracticeofnewgraduatemidwivesshowstherehavebeen10between2004and31March2015.Ofthese,5havebeenfoundtohavecompetenceissues.Duringthistime,1351newgraduateshavebeenenteredontotheRegisterofMidwives.

TheCouncilwelcomedtheFebruary2015changeswhichwillfurtherenhancethesupportandguidancetonewgraduatemidwivesInadditiontomakingtheprogrammecompulsory,itnow:• Providesamechanismforimproved

regulatoryoversightbytheMidwiferyCouncilthroughestablishmentofreportinglinesbytheprovideroftheprogrammetotheCouncil

• Hasincreasedfundingtoenableclinicalattendancebyanexperiencedmidwifetosupportthenewgraduateinclinicalpracticewhenrequired

Theresearchproject“SteppingforwardintolifeasamidwifeinNewZealand/Aotearoa”concludedinearly2015,withareportbeingpresentedtotheCouncilandotherstakeholders.TheresearchwasananalysisoftheMidwiferyFirstYearofPracticecohorts2007-2010andwasundertakentoascertainiftheprogrammesupportedretentionofnewgraduatemidwives.

Theanalysisshowedatthetimeofdatacollection,94.1%ofparticipantsremainedinthemidwiferyworkforce.Therewasanalmostevensplitbetweenhospitalandcommunity-basedmidwiferypractice,theimportanceofnewgraduatesbeingabletoworkintheenvironmentthattheychosebeing

demonstrated.Practisingmidwivesprovidedclinicalsupporttonewgraduates,withbothclinicalandpracticereviewintheformofmentoring.Mostparticipantsadvisedthattheywereabletoattendtheelectiveeducationoftheirchoice.

OveralltheMFYPprogrammewasidentifiedasbeingflexibleandindividualisedandcontributedtotheretentionofgraduatemidwives.Internationalpublicationshavearisenfromthiswork.

Competence Programmes for internationally qualified midwives

AllinternationallyqualifiedmidwivesarerequiredtoundertakethiscompetenceprogrammewhichaddressesaspectsofmidwiferypracticewhichareuniquetoNewZealand.Theprogrammecomprisesthefollowingcomponents:• NZMidwiferyandMaternitySystems• PharmacologyandPrescribing• AssessmentoftheNewborn(theoryand

practice)• TreatyofWaitangi• CulturalCompetence

InAugust2014,theCouncilmadethefollowingchangestoitsInternationallyQualifiedMidwives(IQMs)RegistrationPolicyinordertoenhanceassurancearoundthecompetenceofIQMstopractisewithintheNewZealandmaternityenvironment:

1.Thatmidwivesseekingregistrationmustprovideevidenceoftwoyears’postregistrationmidwiferypractice,withintheimmediate5yearsprecedingapplication.Thismustincludepracticeacrossthescope.TheCouncilwillnolongerregisterInterna-tionallyQualifiedNewGraduatemidwives.ThisdoesnotapplytomidwivesregisteredundertheTransTasmanMutualRecognitionAgreement

2.Thatatthetimeofapplicationfortheirfirstprac-tisingcertificate,IQMsmustprovidetheirplantocompletetheOverseasCompetenceProgrammeatthetime.ThismustincludeevidenceofeithercompletionoforenrolmentintheNewZealandmaternityandmidwiferysystemsmodule

3.Thatthecondition“MaynotworkaloneasaLeadMaternityCarer”bechangedto“MustworkasanemployedmidwifeorasaLeadMaternityCarerinanestablishedgrouppractice*”.Atthetime

16


Table 6: Applications for an annual practising certificate 2014/15

Reasons for non-issue of Practising Certificate

Total*

FailedtocomplywithaconditionNotcompletedrequiredcompetenceprogrammesatisfactorily**

Failedtodemonstraterequiredstandardofcompetence

Recencyofpractice

Notlawfullypractisingwithin3years***

Mentalorphysicalcondition

Falseormisleadingapplication

HPCAA Section

27(1)b

27(1)a

27(1)c

27(1)d

27(1)f

27(1)e

27(3)

Number Outcomes

APC no conditions

3077

-

-4

3

4

-

-

-

-

-

-

-

APC with conditions

88

-

-

-

-

-

-

-

Interim

476

-

-

-

-

-

-

-

No APC**

-

4

-

3

4

-

-

*Somemidwivesheldmorethanonepractisingcertificateduringtheperiod-oneormoreinterimpractisingcertificatesweregranted.3,571practisingcertificateswereissuedto3,129individualmidwivesduringtheperiod.**Inadditiontothereasonsabove,nineapplicationswerewithdrawnbytheapplicantandonewasdeclinedduetonon-paymentofthefee.

ofapplicationfortheirfirstpractisingcertificate,IQMsmustprovideevidenceofemploymentor,ifintendingtoworkasanLMC,ofdetailsofhowtheywillpractisewithinanestablishedgrouppractice.AllIQMmustalsoatthistimeinformtheCouncilofthenameofanominatedmen-tor.Areportwillbesoughtfromthementorattheendofeachyear,givingfeedbackontheIQM’sintegrationintotheNZmaternitysystem.*Establishedgrouppracticemeansformalprofes-sionalpracticearrangementswithstructuredbackupandregularpracticemeetings.NomidwivesinthepracticemaybeunderCouncilprocesses

4.ThattheassessmentofEnglishlanguageproficiencynowincludesOET,withapassmarkofeitherAorBineachsection.ApassineitherIELTSorOETmaybeachievedoveranumberofsittingsnotmorethan12monthsapart

d. Practising certificates


• issue annual practising certificates to those midwives who it is satisfied are competent to practise midwifery

Thenumberofmidwivesleavingtheworkforceintheyearending31March2015remainedstaticataround5%.Asthenumberofbirthshascontinuedtodecline,togetherwithanincreasednumberofnewgraduatemidwivesenteringtheworkforce,therearesufficientmidwivestoprovidecaretowomenandtheirfamilies.However,theCouncilrecognisestherecontinuestobemisdistributionissueswithsomeregionsstillfindingitdifficulttorecruitandretainmidwives.

3571 21

-

-


Fees

TheCouncilhasmaintainedthefeeforanannualpractisingcertificateat$350,plusa$50disciplinarylevy.

Return to Practice Programme


• set and monitor individual competence programmes for midwives returning to midwifery after three years or more

MidwiveswhoseektoreturntoworkasamidwifeafteranabsenceofmorethanthreeyearsmustdemonstratetheircompetencetopractisebycompletingaformalReturntoPracticeProgrammeagreedwiththeCouncil.

ThecurrentReturntoPracticeprogrammerequirementsforallmidwiveswhohavetakenabreakofmorethanthreeyearsareavailableontheCouncilwebsitewww.midwiferycouncil.health.nz/return-to-practice-programmes/

Table 7: Comparative figures of midwives holding a practising certificate at the end of the year and at the beginning of the following year

UPDATE

2,200

2,300

2,400

2,500

2,600

2,700

2,800

2,900

3,000

3,100

3,200

2007 2008 2009 2010 2011 2012 2013 2014 2015 End of March 2,779 2,796 2,823 2,903 2,980 3,044 3,072 3,068 3,100

End of April 2,500 2,507 2,626 2,725 2,779 2,879 2,890 2,919 2,947

17


Table 8: Number of formal Return to Practice programmes finished each year between 2005/2006 and 2014/2015

UPDATE0

5

10

15

20

25

30

35

2005/2006 2006/2007 2007/2008 2008/2009 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014 2014/2015 Completed 5 8 6 11 31 13 21 4 10 11

Did not complete 0 2 4 4 4 3 4 3 3 3



Competence reviews

Therewere7formalcompetencereviewsundertakenbytheCouncilin2014/15ThereviewtoolscommonlyincludeObjectiveStructuredClinicalAssessments(OSCAs)inwhichthecomponentsofclinicalcompetencesuchashistorytaking,physicalexamination,procedures,documentation,communication,multidisciplinaryworkingattitude,referencetostandards,referralguidelinesandprofessionalbehaviouraretestedagainstevidence-basedstandardsforpractice.

TheCouncilappointsreviewerswhoarerepresentativeofthepracticecontextofthemidwifeundertakingthecompetencereview.TheCouncilhasapoolofexperiencedmidwivesnominatedbytheprofessionfromwhichtodrawforcompetencereviewpanelsortoconductcasereviews.

Membersofcompetencereview/casereviewpanelsduringthe2014-2015yearwere:

SusanCrabtreeRobynCroninBerylDaviesElizabethNash

3 COmpETENCE, FITNESS TO praCTISE aNd QualITy aSSuraNCE


• providemechanismsforimprovingthecompetenceofmidwivesandforprotectingthepublicfromhealthpractitionerswhopractisebelowtherequiredstandardofcompetenceorwhoareunabletoperformtherequiredfunctions

a. Performance

TheCouncilencouragesthemidwiferyprofessiontoengageinaprocessofself-reflectionandprofessionaldevelopmentwhichwillimprovestandardsofmidwiferycareandcontributetoqualityimprovementinthemidwiferyworkforce.Thelevelofpublictrustandconfidenceisincreasedwhenthemidwiferyworkforcedemonstratescompetence,conscientiousnessandengagementintheprofession.

Insettingthecompetencestandardsandestablishingaprocessbywhichtodeterminetheon-goingcompetenceofmidwives,theMidwiferyCouncilrequiresallpractisingmidwivestoparticipateinitsRecertificationProgrammeinordertomeetthecompetencerequirementsnecessaryforapractisingcertificatetobeissued.

Source

HealthPractitioner(UnderRA) HealthandDisabilityCommissioner

Other

Employer

Total

HPCAA Section

34(1)

34(2)

34(3)

Number

10

13

8

-

31

Table 9: Competence referrals *

*Thesecompriseallnotificationsaboutamidwife’spracticereceivedbytheCouncil,withtheexceptionofhealth.Afterreceipt,theyarereferredasrequiredtotheHealthandDisabilityCommissionerunders64oftheHPCAA.TheCouncildecidesifthenotificationinvolvescompetenceorconductandwhatfurtheractionisrequired.

AdriennePridayJaneTownsendStephanieVagueNimishaWaller

20


Notification of risk of harm to public

(Totalnumber)Initialinquiries

Nofurtheraction

Interimsuspension/conditions

Competenceprogramme

Ordersconcerningcompetence

Recertificationprogramme

Unsatisfactoryresultsofcompetenceorrecertificationprogramme

HPCAA Section

43

41

40

39

38

35

Number

NewExisting (at 1 April 2013)

-

-

11

-

11

-

27

NotApplicable NotApplicable

1

-

8

2

2

2

30

Closed

1

-

10

-

5

2

26

Still active

-

-

9

2

8

-

27

Outcomes

Table 10: Outcomes of competence referrals

b. Recertification/continuing competence

Recertification Programme

TheRecertificationProgrammerequiresmidwivestoundertakevariouscoursesandactivitiesoverathreeyearperiodinorderthattheycandemonstratetotheCouncilthattheyarecompetentandsafetopractise.

TheCouncilimplementedchangesintheRecertificationprogrammefrom1April2014.Thesechangeswere:• MidwiferyRefresherDay,formerlythree

yearly,isnowanannualrequirementcalledtheCombinedEmergencySkillsDayandincludesmaternityemergenciesaswellasthematernalandneonatalresuscitationupdates

• anadditionalbreastfeedingactivityeverythreeyears

• 5pointsannuallyineachofelectiveeducationandprofessionalactivities

Recertification audit

TheCouncilmonitorsallpractisingmidwives’engagementinrecertification.ThisismainlycarriedoutelectronicallyalthoughtheCouncilstillauditsportfolioswhenissuesaroundamidwife’scompetenceariseorifamidwifeappearstobeconsistentlynoncompliantwiththeprogramme.Throughitsregistrationdatabase,itlinkstheissuingofannualpractisingcertificatestodemonstratedengagementintheRecertificationProgramme.ThosemidwiveswhowereunabletosatisfytheCouncilofsubstantialengagementarerequiredtoundertakespecificactivitieswithindefinedtimeframes,withanumberbeingissuedwithinterimpractisingcertificatesuntilrequirementsaremet.ItispleasingtonotethatthenumberofIPCsissuedfornon-compliancehascontinuedtofall.

Midwifery Standards Review

TheCouncilhascontractedtheCollegeofMidwivestoconductMidwiferyStandardsReviewsaspartofitsRecertificationProgrammesince2005.Allmidwivesare expected to undertake Midwifery StandardsReview biennially although this timeframe may bevariedtothreeyearlyorshortenedtoafurtherreview


c. Health/fitness to practise


• protect the public by ensuring midwives are fit to practise

being required in six or twelvemonths, dependingontheoutcomesofthereview.Thepurposeofthereview is to assist midwives with their on-goingprofessional development by reflecting on theirpracticewithmidwiferyandconsumerreviewers.

UKresearchcarriedoutbythePickerInstitute*hasshownthatconsumerfeedbackisanimportantpartofthehealthprofessionalcompetenceassessmentprocess.Ithasbeenshownthatconsumerscanusefullycommenton(provideconstructivefeedbackonpracticeareas):

• Interpersonalskills• Communicationinformation• Engagementandenablement• Aspectsoftechnicalcompetence

*Chisholm,A.&Sheldon.H.(2011).Serviceuserfeedback:anevidencereviewandDelphiconsultationandtheirapplicationtocontinuingfitnesstopractise.Oxford,UK.PickerInstituteEurope

Statement on Cultural Competence

TheStatementonCulturalCompetencewhichexplainshowculturallycompetentmidwivesmustdrawonthethreeframeworksofMidwiferyPartnership,CulturalSafetyandTurangaKaupapainbuildingandmaintainingrelationshipswiththeirclients,wasformallyadoptedbytheCouncilin2011.In2012,OtagoPolytechnicmadeavailableaculturalcompetencecourseforinternationallyqualifiedmidwivestoprovidethemwiththeknowledgeandskillsrequiredtoachievetheCompetenciesforEntrytotheRegisterofMidwivesthatrelatetoculturalcompetenceintheNewZealandcontext.CompletionofboththiscourseandaTreatyofWaitangiworkshopiscompulsoryforallinternationallyqualifiedmidwiveswithintwoyearsofcommencingpracticeinNewZealand.

TheCouncilreceived44newnotificationsofconcernaboutamidwife’shealthwhichhadaffectedherpractice.AllmidwiveswerereferredtotheHealthCommitteewhichhasdelegatedauthorityfromtheCounciltomakedecisionsrelatingtomidwives’health.

ElevenmidwivesremainedunderHealthCommitteemonitoringfollowingreferralsinpreviousyears.

Employer

Healthpractitioner

Healthservice

Anyperson

Personinvolvedwitheducation

Medicalofficerofhealth

HPCAA Section

45(3)

45(1)d

45(1)c

45(1)b

45(1)a

Number

NewExisting ( at 1 April 2014)

-

7

-

1

2

1

38

3

2

Closed

--

13

--

1

-

-1

Still active

-

32

-

4

2

2

Source

Table 11: Notifications of inability to perform required functions due to mental or physical (health) condition

22


OutcomesNofurtheraction

Ordermedicalexamination

Interimsuspension*

Total

Conditions

Restrictionsimposed

HPCAA Section

49

48

48

50

Number of practicioners

4

16

1

18

9

12

Table 12: Outcomes of health notifications

d. Quality assurance activities

WhiletheCouncilconductedanumberofqualityassuranceactivitiesduringtheyear,itdidnotmakeanyapplicationsfortheactivitiestobeprotectedunders54oftheHPCAAct.

*6Midwivesremainedunfittopractise



4 COmplaINTS aNd dISCIplINE


• actoninformationreceivedaboutthecompetenceandconductofmidwives• monitormidwiveswhoaresubjecttoconditionsfollowingdisciplinaryaction

a. Complaints

Table 13: Complaints re conduct from various sources and outcomes during 2014 – 2015 year

HealthPractitioner(UnderRA)

HealthandDisabilityCommissioner

Consumers

Courtsnoticeofconviction

Employer

Other

OtherHealthPractitioner

Number

3

-

1

1

-

Outcome

Referred to Professional

Conduct Committee

No further disciplinary

action**

-

-

-

1

-

3

-

Referred to the Health and Disability

Commissioner

--

-

--

NotApplicable

5

--

Source

2

-

-

-

-

b. PCC

TheCouncilhasapoolofexperiencedmidwivesnominatedbytheprofessionfromwhichtodrawasrequiredforProfessionalConductCommittees.Thetwochairsarelaymembersofthecommittee.

Members of Professional Conduct Committees during the 2014-2015 year were:

SandyGill(Chair)BernardKendall(Chair)KerryAdamsKayFaullsYvonneMorganJennyWoodley

- 2

24


5 appEalS aNd JudICIal rEvIEwS

TherewerenoappealsorjudicialreviewsofdecisionsmadebytheCouncilin2014/15.

25

Notificationofconviction

Concernsaboutstandardsofpractice

Fraudulentclaiming

Conduct

Practisingoutsidescope

Practisingwithoutannualpractisingcertificate

Other

Theft

DHB

Court

OutcomeNumberSourceNature of issue

1

3

1 Stillinprogress

-

-

-

-

-

ChargeslaidatHPDT

NFA

-

-

-

-

-

Court

-

-

-

-

Table 14: Professional Conduct Committee cases

c. Health Practitioners Disciplinary Tribunal

TherewasonehearinginvolvingamidwifebeforetheTribunalduring2014/15.Thechargeofprofessionalmisconductwasproven.

TheTribunal,whenhearingachargeinvolvingamidwife,comprisesachairpersonwhoisalawyer,threemidwivesandalayperson.AllTribunalmembersareappointedbytheMinisterofHealth.

d. Code of Conduct

TheCouncilhasthestatutoryresponsibilitytosetstandardsofethicalconduct.TheCounciladoptedaCodeofConductin2011.ItisintendedtoformallyreviewtheCodein2016-17.

-


6 lINKING wITH STaKEHOldErS


• Communicatewiththemidwiferyprofession• Liaisewithhealthregulatoryauthoritiesand

otherstakeholdersovermattersofmutualinterest

• PromotepublicawarenessoftheCouncil’srole

National forum - TheCouncilholdsannualforatoprovideanopportunityfortheCounciltodiscusspoliciesandprocessesandfortheprofession,stakeholdersandconsumerstogiveinformalfeedbacktoCouncil.Duringtheyear,theforawereheldinAucklandandChristchurch.

eMidpoint - TheCouncilpublisheditselectronicnewslettereMidpointmonthly.Aswellasbeingsentbyemailtoallmidwivesandotherstakeholders,thenewsletterisalsopublishedontheCouncil’swebsite.

New Zealand College of Midwives - TheInternationalConfederationofMidwivesstatestherearethreepillarsnecessarytocreateandmaintainahighqualitymidwiferyworkforce–midwiferyeducationprogrammes,regulatoryframeworksandprofessionalassociation.TheCouncilunderstandsallthreepillarsneedtobestrongandtothisend,maintainsacollegialworkingrelationshipwiththeCollegeofMidwivesastheprofessionalassociation.TheCouncilalsohadformalmeetingswithCollegetodiscussmattersofmutualinterest.TheChiefExecutiveandtheMidwiferyAdvisorattendedtheannualmidwiferyeducators’workshop,hostedbytheCollege.

Ministry of Health - TheCouncilhasmetwiththeMaternityAdvisorsonanumberofoccasionsduringtheyear.

District Health Boards – TheCouncilmaintainsgoodworkingrelationshipswithDHBmidwiferyleaders,women’shealthmanagersandmidwiferyeducators.

Australian Nursing – Nursing and Midwifery Board of Australia –TheCouncilhasaMemorandumofUnderstandingwiththeNMBAtoworkclosely

overpolicyandprofessionalissuesrelatingtotheregulationofmidwives.InAugusts,ithostedadelegationfromNMBAtodiscussissuesandprojectsofmutualinteresttobothcountries.TheChairandRegistrarattendedaNMBABoardmeetinginMelbourneinAugustwhenattendingtheNationalRegulatoryAuthoritiesSchemeConference.

Australian Nursing and Midwifery Accreditation Council - TheCouncilhasaMemorandumofUnderstandingwithANMACtocooperateandliaiseoverTrans-Tasmanmidwiferymattersrelatingtotheeducation,accreditationandassessmentofmidwives.TheCouncilagreedtoparticipateinaprojecttodevelopanAssessmentFrameworkforinternationally-qualifiedmidwives.

International Consultative Committee – TheChiefExecutiveistheCouncilrepresentativeonthisANMACcommitteewhichmeetstwiceyearlyinCanberratoconsiderissuesrelatingtotheassessmentofthequalificationsofinternationalnursingandmidwiferyapplicantstoensurethatpolicies,proceduresandinformationmanagementmeetbestpracticeandthusthehealthandsafetyofthepublicareprotected.

South Pacific Chief Nursing and Midwifery Officers Alliance - TheChiefExecutive participatesinthebimonthlyteleconferencesofSPCNMOAwhichbringtogethernursingandmidwiferyleadersinregulationandeducationtodiscussandplaneffectiveprogrammesforthePacificinregulation,education,legislationandservicedelivery.InNovember,theCEOandChairattendedinTongatheSPCNMOAmeeting,heldinconjunctionwiththeSouthPacificNursesandMidwivesForum.

Health Regulatory Authorities New Zealand Collaborations - HRANZprovidesaforumforallthehealthregulatoryauthoritiestoshareinformationandtoworkonmattersofcommoninterestincarryingoutourrolesundertheAct.TheCouncilhasactivelyparticipatedinHRANZ,bothintheoperationalandstrategicmeetings.SeveralCouncilmembersandstaffattendedtheinauguralHRANZregulatoryconferenceheldinWellingtoninMay.

1. Finance

a. Audited accounts

To be included here

2. Contact details

SECRETARIAT

StaffmembersoftheMidwiferyCouncilat31March2015were:

ChiefExecutiveandRegistrar: SharronColeDeputyRegistrar: NickBennieMidwiferyAdvisor: SusanCalvertAccountsandRegistration: MarilynPiersonProgrammesManager: AndyCrosbyAdministrator:ChristineWhaangaAssistantAdministrator:JudithNorman

Legal AdvisorsMatthewMcClellandHarbourChambersPOBox10-242TheTerraceWellington6143

AndrewS.McIntyre(forPCC)BeachcroftNZPOBox5530Wellington6145

ClaroLawPOBox11-455Wellington6142

AccountantsCroweHorwath(NZ)LtdPOBox11976MannersStWellington6142

BankersWestpacPOBox691Wellington6011

26


8 FINaNCE

28


9 CONTaCT dETaIlS

SECRETARIAT

Staff members of the Midwifery Councilat 31 March 2015 were:Chief Executive and Registrar: Sharron ColeDeputy Registrar: Nick BennieMidwifery Advisor: Susan CalvertAccounts and Registration: Marilyn PiersonProgrammes Manager: Andy CrosbyAdministrator: Christine WhaangaAssistant Administrator: Judith Norman

LEGAL ADVISORS

Matthew McClellandHarbour ChambersPO Box 10-242The TerraceWellington 6143

Andrew S. McIntyre (for PCC)Beachcroft NZPO Box 5530Wellington 6145

All correspondence to the Council should be addressed to:

Midwifery CouncilPO Box 24-448Manners StreetWellington 6142

Email: [email protected]: (04) 499 5040Fax: (04) 499 5045

ACCOUNTANTS

Crowe Horwath (NZ) Ltd (formerly WHK Wellington)PO Box 11 976Manners StWellington 6142

BANKERS

WestpacPO Box 691Wellington 6011

KiwibankWellington

OF THE MIDWIFERY COUNCIL OF NEW ZEALAND · OF THE MIDWIFERY COUNCIL OF NEW ZEALAND TO THE MINISTER...

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