Our midwifery legislation is changing: A-EQUIP, a Nursing and Midwifery Council perspective

Ahead of the launch of A-EQUIP, England’s new model of midwifery supervision, Jackie Smith Chief Executive and Registrar of the Nursing and Midwifery Council (NMC) highlights the importance of the model and how it will support midwives in England.

Our midwifery legislation is finally changing. This is a welcome change and something we have asked for after a number of critical incidents and independent reports confirmed that current arrangements are not appropriate to protect the public.  The biggest change will be the removal of supervision from our regulatory legislation.
These adjustments will allow the NMC for the first time, to be solely responsible for all aspects of midwifery regulation and I am happy that this overdue change is finally coming to pass. As is the case for other health care professionals, all midwifery referrals will be made directly to the NMC by employers, colleagues and the public.
Last year the Department of Health launched a consultation on the proposed changes to our legislation and in January 2017 the Government published its response to this consultation. While the Government acknowledged the concerns raised by midwives in relation to these changes, it also set out clearly why it believed these changes were necessary.

There have been some concerns about these changes within the midwifery community, but it’s very important to understand that these changes do not alter the status of midwifery as a distinct profession; midwifery will still continue to have its own standards of proficiency and be on a separate part of the register. There will be no change to the protected title of midwife, and delivering a baby remains a protected function for a midwife or a medical practitioner.

Although these changes mean that supervision will no longer be linked to regulation, this does not mean it will not exist at all. Each of the four countries of the UK is taking forward their own plans for new models of supervision that focus on the professional and developmental aspects of supervision.

I’m delighted to see that plans for a new model of supervision, developed by the National Local Supervising Authority taskforce in England are well advanced.  The new model, A-EQUIP (advocating for education and quality improvement), will provide a new framework of clinical supervision, no longer linked to regulation. This new model of supervision is designed to be a continuous improvement process, aiming to build personal and professional resilience, enhance quality of care for women and babies and support readiness for revalidation. I am hopeful that this new model will be embraced by midwives and employers alike and ensure that the parts of supervision most valued by midwives are retained going forward.

As part of these important changes to our legislation, the requirement for the NMC to have a statutory Midwifery Committee is also being removed. But this does not mean that midwives will no longer have a voice at the NMC, far from it. We are committed to ensuring that midwives retain a strong voice within the NMC.

We have already established the Midwifery Panel, which provides high-level advice on key midwifery issues including these important changes to our legislation.  The panel also provides a crucial forum for the group to develop strategic thinking on the NMC’s future approach to midwifery regulation.

Members of the midwifery panel include representatives from the RCM, past members of the NMC’s Midwifery Committee, Chief Nursing Officers from the four countries of the UK, and other leading midwifery figures. We also intend to strengthen the membership of this group over coming weeks and months. The panel currently meets on a quarterly basis and discussions are reported to the NMC’s Council as part of its regular update on midwifery matters. It’s a group that has vast experience and knowledge and it is determined to ensure positive outcomes for midwives in the NMC.

So change is coming to midwifery and I believe that this is something to be embraced by midwives and employers alike. I want to reassure midwives that the NMC is committed to maintaining a strong midwifery voice and supporting changes that will benefit midwives and above all, improve public protection.

Jackie Smith

Jackie Smith was appointed the NMC’s Chief Executive and Registrar in October 2012, having been appointed as acting Chief Executive and Registrar in December 2011.
Jackie joined the NMC as the director of Fitness to Practise (FtP) in August 2010, driving forward improvements to meet the NMC’s goal of safeguarding the health and wellbeing of the public.
Jackie’s background is in law and she spent many years working for the Crown Prosecution Service at the Old Bailey and in the Director of Public Prosecutions Office. Jackie has a Law degree from Wolverhampton University, a qualification in Six Sigma and a diploma in Psychotherapy and Hypnotherapy.
Jackie has extensive experience in healthcare regulation, working for the General Medical Council (GMC) for over 10 years as an assistant director and heading up their investigation unit for six years.
Jackie sat on the West Midlands Pathfinder Steering Group, and was a member of Revalidation Project Group for the London SHA.