by Cathy Ashwin, Tania McIntosh
‘Has supervision had its day?’ This was the title for a lively debate held recently during the Royal College of Midwives’ (RCM) Legal Birth Conference.
The conference was held at the Royal College of Obstetricians and Gynaecologists in London on 3rd July 2014 in association with Bond Solon. As in previous years, the agenda comprised of excellent presentations provoking good discussion throughout the day, which culminated in the debate.
Supervision has been an accepted part of midwifery since regulations came into force and has until recently rarely been questioned; the debate opened the opportunity for this issue to be brought under scrutiny.
In today’s economic climate, one has to consider the ‘value for money’ which includes the supervisor of midwives (SOM). Some would argue that supervision is a luxury and that it is not essential in ensuring midwives are well supported in practice.
However, considering the rising birth rate and the number of midwives leaving the profession due to retirement at this time, then the need for support through supervision has never been greater.
The RCM agrees insomuch as supervision is part of clinical governance, protecting women and their families within a regulatory framework through safe practice (Bird 2014). However, supervision should not be confused with the Nursing and Midwifery Council (NMC) regulations which govern the registration of midwives.
This distinction was highlighted by the Parliamentary and Health Services Ombudsman’s report (PHSO 2013) while undertaking investigations into a number of serious incidents that occurred within a NHS Trust.
It was also noted that the role and remit of supervision is not consistent and may vary between maternity units across the UK.
The origins of supervision
The first Midwives Act, covering England and Wales, was passed in 1902 (Great Britain. Local Government Board 1903).
The governing body it created, the Central Midwives Board (CMB), had wide-ranging powers to regulate midwifery training and practice, as well as organising the submission of all midwives to regular statutory supervision.
Untrained midwives continued to practice under the terms of the Act which meant that the CMB felt it needed the midwives rules (CMB 1903) to describe and govern midwifery, and supervisors to police their work.
In this way, it was hoped, care would be of a standard level, which would impact positively on infant and maternal health.”
MIDIRS Midwifery Digest
Keep up-to-date with 136 pages of academic evidence-based original articles and reprints that discuss topics in detail.
Subscriptions start at an unbeatable £11.50 per quarter for students and £15.75 for professionals.