Supervision of Midwives Fit for the Future

Sue JoseLSA Midwifery Officer

Healthcare Inspectorate Wales

20th April 2015

Drivers for Change

• Robust, integrated governance can be held

up to scrutiny.

• Arms length investigation and review by

individuals who are independent, have the

right authority and clinical expertise;

• All qualities expected of the SoM

The solution

• Multi agency steering group convened

June 2013 devised;

• An assurance framework including 9 KPIs

• A detailed fully costed workforce plan based on BR+

• Aim - supervision has clear standards and processes to protect the public by proactively supporting midwives

Future Proofing Model

• Dedicated SoM team – a rotational role

Benefits:

• Greater focus on proactive SoM activity

• Timely intervention/completion of inv. & reports and restoration of midwives practice

• Proactive leadership/change management

• No competing demands clinical duties/SoM role

Future Proofing Model

• No conflict of interest substantive / SoM role

• Greater impartiality and transparency

• Improved communication –managers / LSA /

SoMs

• Consistency in application of SoM standards

• Effective performance management and

development of SoMs by the LSA

Future Proofing Model Benefits:

• Ability to meet statutory responsibilities for

LSA and LHB – support internal governance

arrangements

• Proactive rather than reactive supporting

midwives and women in a timely manner

• Enhanced reputation – a sustainable

provision

Key Performance Indicators

• KPI 1 The LSA review/update, workforce

planning forecasts

• KPI 2 The LSA database used to monitor

SoMs completion of relevant CPD.

• KPI 3 100% of SoMs have an ASR & IPR

• KPI 4 100% of midwives are compliant with

the ASR process – LSA random audits of

quality

Key Performance Indicators

• KPI 5 100% of st.m/w meet a SoM x2 / year

• Key 6 - 100% of newly qu. m/w meet a SoM

x2 in 6/12, x3 by 12/12 to agree/monitor

preceptorship programme

• KPI 7 SoM record keeping & storage

• KPI 8 Random audits of SoM on call

response times – t&t collated/used

Key Performance Indicators

• KPI 9 Monitor timeliness/quality of inv.

process - 30/7 to draft report, 45/7 to

complete - sign off of objectives - in No. of

report iterations - +ive midwife/SoM

feedback - in same midwives needing

support for same shortcomings - Nos. of

midwives subject to LSAPP referred to NMC

Vs those who go on to succeed

Local & Corporate Visibility

LSA Uniform • All SoMs wear HIW colours

• Increases visibility & corporate image

• Cohesive team

• Consistent standards and messages

Achievements so far

• All Wales approach to group supervision

for ASR process

• Taxi rank for equity of opportunity to

undertake SoM investigations

• SoM attendance at governance meetings

• Sharing lessons learnt and good practice

across Wales

Access to On Call SoM

• 24 hour all Wales number

• 16 SoMs have 2-3 on calls per month, 4

weekends a year

• Monthly audits monitor number and types

on calls

• Themes from calls received from midwives

and users inform service development

Offering regular contact and

support to newly qualified

midwives

Enjoy working as an all Wales

SoM team

Peer support and

networking with

small SoM team

Sharing ideas

and innovations

Midwives recognise who the SoMs are

Highlights from SoMs

Action learning with midwives to discuss lessons learnt from

incidents

“first experience of group supervision was excellent”

“Group supervision is an excellent way of discussing your issues openly and

sharing experiences”

“In the past it was

a paper exercise, now I feel I

benefitted from the additional

support my supervisor offered”

“I prefer group supervision

compared to individual

interviews, the session

enables group discussion

and a learning

environment”

“found the group

supervision session for my annual review very valuable”

Highlights from Midwives group supervision

NMC Quality Assurance (triennial review)

• Dec 2014, 5mths into project, 6 wks notice!

• Wide stakeholder representation day 1

• 3 day process, 3 HB visits and 1 HEI

• All standards met, no areas for development,

very complimentary re new model, level of

collaboration and change management.

Welsh Perspective

• CNO in Wales believes the current model of

supervision provides a high standard of

support and development and is interested

in its links with revalidation for all registrants

Formal evaluation

• Swansea University have been commissioned to produce a report

“A critical review of group supervision (Action learning) in the Future-Proofing

model of Midwifery Supervision in Wales”

(Due August 2015)

Supervision in Wales – a pathfinder

Any questions?