The new model of midwifery supervision, Advocating for Education and QUality ImProvement (A-EQUIP), ‘aims to build personal and professional resilience of midwives, enhance quality of care for women and babies and support preparedness for appraisal and professional revalidation’ (NHS England 2017: 3). Two midwifery leaders, Jane Herve (JH), Director of Midwifery at Oxford University Hospitals NHS Foundation Trust, and Carmel McCalmont (CM), Director of Midwifery and Associate Director of Nursing at University Hospitals Coventry and Warwickshire, shared their vision for implementation.
A-EQUIP in Oxford
How do you plan to roll out A-EQUIP?
JH: Following discussion about the needs of maternity services in Oxford, I developed a business case for the implementation of A-EQUIP and the PMA [professional midwifery advocate] role. This showed a different approach to implementation and was recently approved by the Trust board.
What are the key elements of your business plan?
JH: PMAs will deploy A-EQUIP, offer professional advice and be involved in service developments.
They will be part of a Professional Advisory Council (PAC), managed by the Head of Midwifery, and comprising eight midwives who will apply for these roles.
PMAs will receive £1000 per annum, as well as their substantive positions. Time to complete the role is likely to be 8 hours per month, and while ‘on calls’ are not a requirement, we will introduce this to support midwifery managers. The PAC will be reviewed after a 12-month period and necessary changes made.
Investigating incidents is not a function of the A-EQUIP model. Does this sit comfortably with you?
JH: Absolutely. We have a well established governance structure to support the incidence process. The PMAs in Oxford will, however, support individuals involved in investigations and will offer professional advice. They will also support those who require additional help and training.
What other plans do you have for PMAs in Oxford?
JH: Future opportunities include involvement in the Birth Afterthoughts service, and developing a process to feed back lessons from complaints to all staff. The PAC will enable the development of midwifery leaders and succession planning into senior management and leadership roles.
A-EQUIP in Coventry and Warwickhire
In collaboration with Coventry University, Carmel McCalmont states that their approach will support midwives and keep women and families at the centre of care.
How will your approach support midwives working as PMAs?
CM: As a pilot site for the preparation of A-EQUIP, we now have ten PMAs across the Trusts. An away day with PMAs and supervisors was a resounding success, resulting in supervisors (non-statutory) volunteering to undertake the PMA bridging programme with Coventry University, which will provide us with approximately 20 PMAs.
The A-EQUIP national guidance (NHS England, 2017), states that the employer should choose the whether PMAs are employed full time or on a sessional basis. We chose the sessional approach.
What plans do you have for the future?
CM: The PMA group is considering a lead PMA role to support the team and we are excited about our app, which will enhance the way midwives and PMAs experience A-EQUIP. The app is in the final stages of development and we are quietly confident that it will be successful.
Leaders and followers
These plans show how A-EQUIP and the PMA role are being implemented by those translating national guidance into practice to showcase their vision, creativity and courage.
Many other leaders and managers will have developed plans for A-EQUIP, which will be welcomed by midwives, women and families. For those undecided about A-EQUIP, remember:
‘The secret of change is to focus all of your energy not on fighting the old, but on building the new’ (Socrates).