Cultural Transition to Maternity Services in the UK_ an by malj


									      Facilitating a Cultural Shift with
           Supervision in Action
        Cultural Transition into the Maternity Services in the UK

• Krystyna Grey SOM                 • Ann Kingscott SOM LME SA
• Linda Matthews SOM                • Natasha Carr SOM SL
• Dr. Sarah Church SL
             Project Aims

To develop educational and preceptorship
     programmes to support European
  Midwives transition and integration into
        maternity services in the UK

•   3 routes
•   Automatic recognition
•   Acquired rights
•   Assessment general system for the recognition
    of training programmes
                    The reality …
• Directive from the NMC (2010) has highlighted the need to
  balance the freedom of movement of healthcare professionals
  with the maintenance of patient safety

• NMC not permitted to test competence in English language
  (employers can)

• Many midwives were eligible to practise in the UK

• Finding it hard to secure employment as a midwife
                     The reality …
• Often employed in a supernumerary capacity until employers
  and supervisors considered that the midwife was fit to
  practice clinically

• May have gained employment but then left after a short
  period of time due to difficulties adapting to the NHS and UK
  working practices

• Period of effective registration expired or was about to expire
  as employment could not be gained and practice hours
  maintained as required for by PREP (2011)
            NMC Assurances

• Employers can be assured that such midwives
  have undertaken training at least equivalent
  to that undertaken in the UK

• Under the legislation the NMC is compelled to
  accept midwives with training as low as 1 year
  in length.
Issues to be faced

                 Employed            SOM
 Unable to get   Cultural key   Fit for practise
 employment       practice      Fit for purpose
                   deficits          Safety
     Birmingham City University /
      West Midlands LSA Course
•   To EU midwives from within to the culture and
    organisation of the NHS, and to the provision and
    delivery of midwifery care in the UK
•   To enhance midwives knowledge and skills
    offering opportunity to explore the maternity
    services in the UK
•   To offer proactive supervision of midwifery to
    protect mothers and babies, support and promote
    good midwifery practice
      Delivery of the programme

• 10 university study days at Birmingham City
• Over 20 weeks duration
• Clinical discussion and application
• Supported by local supervisors of midwives
• Visited local units
• No clinical placement / competency assessment
• Formative assessment and certificate of
            Indicative Content
• Midwifery in the UK
• Legal and professional framework for
  healthcare in the UK
• Key skills – writing, numeracy,
  communication, interviews, CVs,
  presentations, personal development
• Evidence Based Practice – partnership
    antenatal, labour, postnatal
            Negotiated Learning
In line the theories of adult learning all aspects of the
programme were negotiable and adaptable to meet the learning
needs of the individual cohort

Requested input about:
1. Medicines management
2. UK legal aspects of midwifery
3. Autonomy of midwifery practice in the UK
4. Hospital visits
Cohort 1 (January 2010)        Cohort 2 ( January 2011)
• Polish (Bank, registration   • Polish x 4 (non working as
  lapsing)                       midwives)
• Italian (working as a        • Bulgarian (not working as
  midwife)                       midwife, registration
• Bulgarian (employed not in     lapsing)
  midwifery, HCA)              • Italian (not working)
                               • Polish x2 (refused NMC
                                 registration, discontinued)
• A portfolio of clinical evidence in line
  with PREP requirements
• Verbal Midwifery Presentation comparing
 a UK and EU midwifery practice
• Numeracy
            Impact on Midwives

• Employment
• Employer satisfaction
• Positive evaluations
• Confidence in writing and speaking English in a
  professional context
• Developed Skills of life long learning
• Development of skills for application and
     Comments from Evaluations
• Why did you join this course?
‘I am trying to find a job as a midwife in the UK
and this course adapt me to the UK midwifery
‘I would like to start work as a midwife in the UK
and the course help me learn differences
between midwife’s work in the UK and Poland’
‘To support my practise. Offered by HOM.’
    Comments from Evaluations
What else did midwives want?
• Practise hours – all
• More clinical scenarios
• Programme Development
  University Northampton Course
                 Midwives employed
• Part-time course
• Delivered over 12 weeks
• Includes 20 days theoretical input alongside clinical
  preceptorship and midwifery supervision provided
  by the employing NHS Trust
• Formal assessment 20 credits at level 5
Portfolio Based Preceptorship

         1. Planned   2. Professional
        Programme         Portfolio

                       4. Positive
         3. Support
Portfolio Based Preceptorship
        Planned Programme

        • Formalised Process
               - co-ordinated by Practice
                 Development Team

        • Induction
                - overview of preceptorship
                - professional portfolio

        • 12 Months Preceptorship Chart:
               - clinical placements
               - preceptorship meetings
• This programme was developed to facilitate the
  cultural transition and integration of EU midwives
  into midwifery practice in the UK by supervisors
  with support from the LSA.

  Role of the Supervisor is: To ensure the workforce
  is appropriately trained, enabled and supported to
  provide evidence based care that is woman and
  family centred.
• Mechanism for referral to supervision by
• Named supervisor for guidance and support
  for EU midwives
• Supervisory lead in preceptorship
• Bank / agency caution
• Role of on call supervisor in supporting bank
Recognition of Professional Qualifications Directive 2005/36/EC.
Available at:
en.pdf Accessed 23/08/10

NMC (2010) Review of Directive 2005/36/EC on recognition of professional qualifications
Available at: http://www.nmc-

NMC (2010)Registration: trained in Europe. Available at: http://www.nmc- Accessed 23/8/10

NMC (2008) Registering as a nurse or midwife in the United Kingdom
For applicants trained within the European Union and European Economic Area. London: NMC

NMC (2011) The Prep handbook. London: NMC.
                 Thank You

•   Any Questions?
•   Contact details

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