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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?