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Changes to midwifery regulation

Read about the changes

An update on midwifery regulation

In January 2015 NMC Council took a decision to ask for a change in its legislation in order to remove the additional tier of regulation applying to midwives. Our legislation currently includes supervision as a statutory function with a regulatory role.

The background to that decision may be found in the resources cited below.

The Secretary of State for Health announced on 16 July 2015 that the government will change the legislation governing our regulation of midwives. The main effect of the changes will be to take supervision out of our regulatory legislation.

This is a change that we requested following a number of critical incidents and independent reports confirming that the current arrangements are not appropriate for public protection. The changes will make sure that, as the regulator, we are responsible for all regulatory decisions regarding midwives.

Supervision has developed over time beyond the "regulatory" component of the role – investigating allegations concerning midwives' practice. Midwives tell us they are less concerned with changes to the investigation of allegations and most keen to know about the future of the supportive, developmental and leadership roles of supervision. The NMC has been clear that while these are not regulatory matters, there is nothing in our legislative change to prevent supervision continuing outside regulatory legislation. The Department of Health in England has now published a paper on the future of supervision (22 January 2016). It has been prepared with the involvement of the four UK chief nursing officers, the RCM and the LSAMO Forum and can be found here:

Changes to midwifery supervision in the UK - Department of Health

Since the Secretary of State for Health's announcement we have been working closely with the Department for Health (DH) on the likely scope of the change, which was shared with the NMC Midwifery Committee before the summer. The proposals will need to secure ministerial approval and clear various government processes before the parliamentary process begins.

DH has reviewed its provisional timetable for the Section 60 Order. The timeline now suggests that the work will be complete in early 2017, although that may still be subject to change. On a positive note, this gives the sector longer to agree and implement plans for a new model of non-statutory supervision, 'decoupled' from regulatory legislation. However, we recognise that it presents challenges for all of us in maintaining the current arrangements until the legislative change is complete, and we will need to work together to address these challenges and minimise the impact on women and babies, and the midwives who work with them.

In April 2016 the Department of Health launched a consultation on proposed changes to NMC legislation including midwifery supervision.

Following discussion with the Royal College of Midwives we have also been looking in detail at some of the most significant parts of the framework: protected title, protected function and scope of practice. We have taken legal advice on these matters and shared this with the RCM, and we have prepared the attached briefing note which is designed to assure midwives that nothing in the proposed changes will alter or erode the distinctive identity of midwifery in our regulation. Please do bring this note to the attention of others who may find it useful.

Modernising midwifery regulation: Protected title, function and midwifery scope of practice

Finally, we have been hearing from midwives about the role that Midwives Rules and Standards play in their professional lives, as an authoritative, midwifery-specific single point of reference on regulation. As a consequence we are happy to commit to producing a new source document for midwifery regulation when the legislative changes take effect so that midwives can continue to be clear about their framework.

In the meantime the current Midwives Rules and Standards remain in force. It is very important that we, along with employers of midwives and the midwifery community, continue to uphold them in the interest of women and babies.

2016 is going to be all about working together to ensure a smooth and safe transition. This means that everyone who will be involved in overseeing standards of midwifery following legislative change is fully informed, and prepared for the role they will play. We will be working with the boards that have been set up in each of the four countries of the UK to contribute to their planning for transition. We are already working with LSAMOs on a proportionate model of LSA oversight for the last year of LSA operations, and preparing for the safe transfer of appropriate information relating to fitness to practise.

Employer awareness and preparedness will be key. If you are an employed midwife you can play your part by asking how your employer is preparing for the change ahead.

We will continue to provide updates on our website and other channels as we understand the importance of good communication during this period of change.

Council paper and review of midwifery regulation (January 2015) 
King's Fund review
PHSO report
Kirkup report
Our statement on 16 July 2015