A-EQUIP: the benefits to midwives, a higher education perspective

Senior Lecturer and Lead Midwife for Education at the University of Hull explains the importance of A-EQUIP, the new model of midwifery supervision and highlights the benefits from an education perspective.

I was overjoyed when I was asked to become a member of the national Local Supervising Authority (LSA) taskforce for England to support with scoping, developing and rolling out a new model of midwifery supervision for all midwives in England.

Being a member of the taskforce has certainly been interesting and extremely rewarding. As co-chair of the education work stream with my colleague Toni Martin, Lead Midwife for Education at the University of Worcester, we were tasked with developing an education programme to prepare the new Professional Midwifery Advocates (PMAs) for their role.

As a group of educationalists, LSA and consultant midwives and Heads of Midwifery, our planning commenced.  After much discussion, enriched by the experience and expertise in the group, the programme started to take shape.

The competencies of the new PMA were formed and built around the CQC’s five key lines of enquiry: safety, effective, caring, responsive and well-led. This aligns with A-EQUIP which has quality improvement, advocacy and leadership at its core with the new vision and direction of the regulation of health and social care services.

The competencies of the Preparation of Supervisors of Midwives programme (PoSoM) were then mapped against those developed from the A-EQUIP model. This exercise immediately identified that there were elements from the PoSoM programme that were also part of the new model. This was significant as it was at this point we realised a short bridging programme was therefore needed to prepare existing SoMs to be PMAs. It was this shortened bridging programme that has subsequently been piloted across the six A-EQUIP sites.

The pilot of the programme has been successfully evaluated by Sheffield University and the operational guidance providing further information about both the shortened (bridging) and full PMA programmes will be published in the very near future. As a result of this publication, the programmes can be developed by HEI’s using the guidance, the published standards and the UK wide principles, so keep a look out for local providers near you.

The A-EQUIP model will raise the concept of advocacy, within the maternity services, something which all midwives and users helped build the new model said was important. Together with the restorative element, midwives will feel empowered to be advocates for the women they care for.

The PMA is a midwife for midwives.  The development of the new standards for pre-registration midwifery provides a golden opportunity for the PMA to be part of the student midwife journey, and will embed the concept firmly at the root. Currently student midwives are assigned to a SoM and this strand of support will end on 1 April. To facilitate the PMA process at the start of their Midwifery career embraces the A-EQUIP philosophy of a continuous improvement process that aims to build personal and professional resilience and enhance quality of care. I strongly believe that to truly embed the PMA process, its inclusion in the new standards for pre-registration midwifery education will be pivotal.

So from an education and development perspective, A-EQUIP provides all midwives in England with a model of supervision that both supports midwives and student midwives which enables them to flourish and develop.

The shortened PMA programme for existing SOMs has been determined following evaluations gleaned from the pilot. This work based learning can include online, e-learning, and face-to-face sessions. The structure of the shortened A-EQUIP programme may be arranged in a block or separate days dependent upon the development by the education provider.

The PMA programme for midwives wishing to become a PMA is still under development and is envisaged to be a credited module at level seven. The rationale for this being that it is not cost effective to be individual days, nor to be at level six; level seven attracts higher education funding and has the value added benefit of contributing to a masters degree. It also provides the assurances of adherence to the Qualifications Higher Education Framework (QAA 2008) alongside the quality assurance processes of the institution.

Both programmes will be preceded by a free e-learning module developed by HEE as a requirement.

As a lead midwife for education at the University of Hull, it is my responsibility to ensure that all midwifery programmes are current and standards are followed to ensure consistency and quality of the provision. There is a lead midwives for education (LME) strategic reference group, where all lead midwives for education in every university that provides midwifery education are members. We meet four times a year, and two of these are with the NMC. We liaise regularly via the LME network to support and address issues affecting our midwifery provision.

I would like to be bold and suggest that there is scope within this network for shared responsibility with the A-EQUIP programme to provide assurance to midwives of consistency and quality with this development moving forward. Longevity of this is critical to its success, and we all have a role to play.

Nicky Clark

Nicky is a Senior Lecturer, Lead Midwife for Education and the Head of department for Midwifery and Child Health at the University of Hull. Nicky provides professional advice at strategic and operational levels and takes full responsibility for the impact of midwifery practice, midwifery research and midwifery education within the Faculty.

Nicky has significant experience in Higher education, having worked in HE since 1990. Nicky is a member of the NHS England’s taskforce for developing a New Model of Supervision and is co-chair of the education workstream. Nicky chairs the LME strategic reference group; is a member of the NMC Education stakeholder forum to provide input and have oversight of the NMC’s education framework and is a member of the CoDH Midwifery advisory group working on the vision for the future midwife.

Nicky qualified as a registered general nurse in 1982 and her first midwife teacher post was in 1990. Nicky has undertaken many national and international external collaborations, working in the UK and across Europe and Asia providing expert advice on programme approvals in midwifery, and also undertaking institutional quality assurance reviews across the UK and Croatia.


  1. Wendy Blackwood says:

    “Both programmes will be preceded by a free e-learning module developed by HEE as a requirement.”

    Hi Nicky

    Any e-learning that is connected to an NHS England or equivalent organisations does not allow or enable non-nhs midwives due to not having a NHS email.

    I wonder if you can clarify that midwives working outside of the NHS will be able to access this free learning module for PMA?

    Also will non-NHS midwives, whether a SOM or not, be able to apply for a PMA course?

    Thanks a lot

    • NHS England says:

      Hi Wendy,

      Thanks for your question.

      If you have previously been a SoM and completed the preparation of supervisors of midwives course or equivalent, then you are only required to complete the shortened PMA preparation programme. If you have never been a SoM then you are required to complete the PMA long programme.

      Please access the operational guidance that will explain more.

      Kind Regards
      NHS England