Supervision, Support and Safety: NMC Quality Assurance of the Local Supervising Authorities (LSAs)
In compliance with Rule 16 of the Midwives Rules and Standards, the Nursing and Midwifery Council (NMC) has published its report on the main findings of annual reports received from Local Supervising Authorities (LSAs) for last year.
Whilst the annual reports submitted by the LSAs shows progress and innovation in some areas there are still some worrying and consistent trends.
UNISON remains concerns about the following areas listed below, which were highlighted in the NMC’s report:
· Midwife to Birth Ratios
The NMC’s report highlights that the majority of LSAs reported a decrease in the midwife to birth ratio. Whilst it is the duty of trusts and boards to ensure the health and wellbeing of mothers UNISON is concerned that robust systems are put in place to ensure that proper workforce planning is achieved. This should allow trusts and boards to be able deliver a safe service and to work within the birth ratio standards set by the royal colleges.
· Recruitment of Supervisor of Midwives (SoMs)
The NMC reported that the majority of LSAs across the UK continue to face challenges in recruiting new SoMs to meet the recommended SoMs to midwife ratio. This potentially have major implications for trusts and boards particularly when you take into account the future reduction of the workforce within the next 4 to 10 years which will likely be due to retirements, resignations etc. UNISON believes trusts and boards should be looking at new strategies and incentives to encourage midwives in taking up this role. We are interested in hearing your views in avoiding such a crisis.
Another issue of concern is:
· Reconfiguration of Maternity Services
The NMC has also reported that some trusts and boards are reconfiguring care service delivery by transferring some aspects of maternity services to gynaecology wards. UNISON has growing concerns about this particularly as it might impact on quality and care. One of the most important elements in any reconfiguration is to ensure the health and wellbeing of mother and baby. The best way of achieving this is by midwifery services and investing in increasing ratio to mothers to enable mothers to be cared and have a choice. Is the maternity service in your trust being reconfigured? What impact is this having on the service? Please let us have your views.
There is also evidence of some trusts and/or boards altering skill mix and trying to save money by using Band 5 nurses or maternity support workers instead of using midwives. The care of mothers must always lie in the hands of midwives and whilst others help, in certain situations, in that care, the ultimate responsibility lies with the midwife.
The annual reports have also revealed that as well as there being an increase in the birth rate that there also continues to be an increase in the complexity of births. It is clear from this, that specialist midwifery must be maintained, and therefore skills should not be watered down for reasons such as austerity. The NMC recommends that LSAs must engage and work collaboratively with them to monitor and assure the safety and wellbeing of women using maternity services through the quarterly monitoring framework and the LSA annual report.
Moreover, Employers have a responsibility and duty to ensure that care is delivered by appropriate professionals.