Introducing A-EQUIP: the new model of midwifery supervision

In the first of a series of blogs this week, Professor Jacqueline Dunkley-Bent highlights the background and benefits of the new model of midwifery supervision for all midwives in England.

There is so much going on across the NHS right now and maternity is no exception.

One of the big programmes of work that we have been working on is the development of a new model of clinical supervision for midwives which will be launched on the 1 April 2017.

As many of you may know, professional development and support similar to clinical supervision has been available to midwives since 1902 through statutory supervision. As a result of legislative change prompted by the Kirkup Report, the Nursing and Midwifery Council and the Department of Health (DH), the governing legislation (the Nursing and Midwifery Order 2001) has been subject to a Section 60 order and the function of Local Supervising Authorities (LSA) and statutory supervision of midwifery will be removed on the 31March.

The DH acknowledged that there were a number of non-regulatory elements of statutory supervision that were highly valued by midwives and women and in January 2016, published a set of principles that were to underpin the development of new models of clinical midwifery supervision.

In response to this, a cross-organisational, multi-stakeholder taskforce was established to oversee the development of a new model of midwifery supervision for England.

To develop the new model, we have engaged with more than 2,400 individuals across the health system through surveys, online platforms, attending events and conferences.

More recently, we have been working with a number of pilot sites that have been testing the new model and the programme of education required to deploy the new model. We have learned from the evaluation findings, undertaken by Sheffield University School of Health, the School of Nursing and Midwifery and of course the pilot sites testing our new model and can now introduce to you ‘A-EQUIP’ (an acronym for advocating for education and quality improvement). This is also a good opportunity to introduce the role of the Professional Midwifery Advocate, the midwife responsible for deploying A-EQUIP.

A-EQUIP is a continuous improvement process that aims to build personal and professional resilience, enhance quality of care for women and babies and support preparedness for professional revalidation. This approach to supervision aims to ensure that through staff development, action to improve quality and experience of care becomes an intrinsic part of everyone’s job, every day, in all parts of the system.

A-EQUIP enables the flexibility required for healthcare organisations to implement this model according to their own workforce requirements and deploy the model to other professions. This means that unlike the current statutory model of supervision where every element had to be deployed, the new employer led model means that there is flexibility, depending on each employer and the issues and challenges they face.

Please watch out for our operational guidance that will be published on the 1 April 2017. This document will provide further information about the model and guidance for midwives, leaders, managers, maternity providers, commissioners and Higher Education Institutes. A significant contribution to the document from a user of maternity services describes how A-EQUIP and the PMA role will work for women who use maternity services, including the role of ‘advocacy’.

The ambitions of the NHS England supervision taskforce and the associated work streams was to develop a model of midwifery supervision that harnesses the strengths of the statutory model, avoids the pitfalls of the past and embraces the opportunities of the future; a model that supports and empowers midwives to provide safe, high quality, kind, compassionate, care to women and their families.  I really believe that this ambition has been achieved.

There is a lot going on in the world of maternity at the moment and there is a natural synergy between the A-EQUIP model of supervision for midwives and the ambitions of the Maternity Transformation Programme, Safer Maternity Care: next steps towards the national maternity ambition and Leading Change, Adding Value, which are some of the national programmes aimed at improving the experiences and outcomes of those who use our health services, today.

Recently, Professor Jane Cummings, Chief Nursing Officer for England wrote to all midwives outlining the coming changes to midwifery supervision. To give all midwives the opportunity to learn more about the model ahead of publication over the next few weeks, this week of action is intended to provide key messages and information about A-EQUIP and demonstrate from a range of organisations how the model will help all midwives, whatever their role, wherever they work.

Keep an eye out for further blogs this week and wherever you can, follow @6CsLive and use the hashtag #A-EQUIP to join the conversation and find out how the model is working in practice at the seven pilot sites.

Jacqueline Dunkley-Bent

Professor Jacqueline Dunkley-Bent has vast experience in healthcare provision and is the first Chief Midwifery Officer in England.

She has worked as a midwife and a nurse and held senior positions in clinical practice, education, leadership and management including: Director of Midwifery and Nursing positions for Women’s and Children’s services at Imperial College Healthcare Trust & Guy’s & St Thomas’ NHS Foundation Trust.

Academic roles have included: Senior Lecturer, Curriculum Leader, LME and Professor of Midwifery.

Jacqueline was appointed Chief Midwifery Officer in Spring 2019 at NHS England and NHS Improvement and is National Maternity Safety Champion for the Department of Health. She is also visiting Professor of Midwifery at Kings College London and London South Bank University.

Her experience has seen her leading and influencing national maternity standards and guidance. She also influences healthcare, nationally and internationally through research, education and publications and is frequently invited to speak at national and international conferences. She is a member of the British Journal of Midwifery editorial board and until recently was an active member of the Maternity and Newborn Forum at the Royal Society of Medicine.

She has joined the Tommy’s Charity National Advisory Board as Midwifery advisor, and the Women of the Year management committee. Her voluntary work currently includes Midwifery Advisor for the Wellbeing Foundation Africa and until recently a trustee.

In 2014 she received the HSJ, BME Pioneers award and in 2015 she was selected from over 100 nominations for inclusion on Nursing Times’ Leaders 2015 list that celebrates nurses and midwives who are pioneers, entrepreneurs and inspirational role models in their profession.


  1. Krystyna Grey says:

    I am curious to know if there will be National guidance for the PMA’s curriculum and the bridging training especially distance learning that existing Supervisors can access.

  2. Cathy Molloy says:

    Please can you help:
    Is there a set ratio for PMAs: midwives?

  3. Ella Caine says:

    How will independent midwives access this model, assuming the NMC’s plans to abolish them are u successful?

  4. Maura Deegan says:

    Really looking forward to hearing about the implementation strategies at local level that will enable this model to be successful. Tokenism at local level will not be acceptable, or indeed sufficient enough to meet the proposed benefits to mothers, midwives and managers. So let’s give the model a chance and ‘fight’ for successful modes of implementation that truly represent the literature evidence.

    Following the removal of the statutory aspect of supervision, as a midwifery profession we need a model that sets us apart as a profession and a model that can be evaluated and researched in the years ahead.

    The strong endorsement of the model at National level is refreshing, however I am sceptic at how that will be reflected at local level.