At the end of April, the Department of Health (DH) launched a consultation on proposed changes to the Nursing and Midwifery Council (NMC) legislation regarding midwifery regulation (Proctor, 2016). Proposals include removal of statutory supervision, removal of the statutory Midwifery Committee, and improvements to the NMC's fitness to practise processes.
Statutory supervision has been an aspect of British midwifery for more than a century, and many midwives find it valuable for professional support and development (Roseghini and Olson, 2015; Lavery et al, 2016). The Royal College of Midwives (RCM) has welcomed some of the proposed changes but expressed concern over whether a system of non-statutory supervision is sustainable in the long term. Each UK chief nursing officer has convened a task force to deliver the new system.
The DH has suggested that benefits of removing statutory supervision will include greater clarity about who needs to take action on behalf of service users and midwives when things go wrong, and cost savings ‘arising from the cessation of regulatory activity that does not add to public protection’ (Proctor, 2016: 17).
This point about cost savings may be significant. Following the NMC's decision early in 2015 that supervision should no longer be part of its framework, RCM director for midwifery Louise Silverton (2015: 160) commented in BJM that a new system may lead to inconsistency in the provision of clinical supervision among maternity services across the UK: ‘Well-run services will probably see this clinical supervision for midwives as a vital and central component of good clinical governance arrangements and risk management. But what about the others? Will axing clinical supervision for midwives be seen as a cost-saving measure?’ She added that it is essential for midwives to make the case locally to ensure this does not happen.
The RCM has now expressed concern over the proposal to remove the NMC's Midwifery Committee. Although the DH has stated that this ‘does not prevent the NMC from establishing committees or groups on midwifery’ (Proctor, 2016: 18), the RCM points out that non-statutory groups can be dismantled as quickly and easily as they can be established. RCM chief executive Cathy Warwick said: ‘The statutory Midwifery Committee is currently the only voice of midwifery within a nursing-dominated council. What is worrying is that, without this voice, regulation for midwives will be largely determined by another profession’ (Dabrowski, 2016).
As the present model of supervision is unique to midwifery, there is a sense that many outside the profession do not fully understand its importance and value. It is essential, therefore, that midwives respond to the current consultation, so that the views of the profession are heard before final decisions are made. To add your voice, access the consultation documents at http://tinyurl.com/DHconNMC16.