The NHS Ombudsman has proposed a radical shake-up of midwifery supervision after the deaths of a mother and 3 babies in Furness General Hospital. The Ombudsman’s report argues that the dual supervisory and regulatory function performed by supervisors of midwives leads to a potential conflict of interest. The report suggests that the two functions should be split and the NMC directly responsible for regulation.
The Ombudsman, Dame Julie Mellor, explained:
‘We questioned why the supervision and regulatory arrangements were not the same for midwives as they are for the main medical professions, hence our recommendation that the roles of supervision and professional regulation are separated to avoid the potential for a conflict of interest. In all three of our cases, the local regulatory midwifery supervision and investigations at local level failed to identify poor midwifery practice. Our report highlighted that the confidential nature of supervision can prevent information about poor care from being escalated effectively into hospital clinical governance or the regulatory system.’
The practical effect of the proposals on the current system are not spelt out, but it seems that the role of the Local Supervisory Authority would be radically diminished or abolished. Supervisors of midwives might continue to have a ‘leadership’ role, supporting midwives in practice, but they would have no role in investigating incidents or complaints. As the report notes, employed midwives are already subject to risk management procedures and supervisory investigations can complicate those procedures.
The report notes that there are some benefits to the current system, including the 24 hour support that supervisors provide to midwives. The report does not mention the important role of supervisors for women using maternity services, who frequently turn to them for advice and support when they have a problem with their named midwife or experience difficulties accessing services. It is critical that this function is retained in any new system.