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National Survey of Supervisors of Midwives - JMD Events

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					The Cost of Remuneration
for Supervision –
     Can it be Sustained?

                       January 2012
Aim and Objectives
Aim:
 To review current structure and remuneration for supervision


Objectives:
 Establish the amount and type of remuneration given to SOM’s
 To identify if recruitment of SOM’s was a problem for local
  teams
 Explore factors perceived to affect recruitment of supervisors
 Explore the COST of statutory supervision
Context - Concern Raised by NMC
2007, 2008, 2011      Variations between trusts in the
                                          ratios SoM ratios and
 Part of National Survey of              remuneration offered
  Supervision
    Concern raised by NMC 2007,
                                         Continued difficulty in recruiting
     2008, 2011
                                          the necessary number of SoMs

      Questionnaire
                                         The reluctance of some
                                          healthcare organisations to
      Distributed to contact SOM’s       recognise the value of statutory
       through LSMA                       supervision for midwives

      3 follow ups                      Need to embed Supervision this
                                          within the governance structure
                                          (NMC Supervision, support and safety Analysis of the 2009-2010 LSA annual reports
                                          to the NMC)
Results
Overall Response Rate

 72% (115/159 SOM teams)

Key Facts

 95% of SOMs supervisory duties linked to employer

 47% of teams met required ratio of 1-15

 Significant variations within LSAs and between LSAs in
  relation to ratio of SOMs to midwives.
Profile of Substantive Teams
Remuneration Type
   Individual LSA
Nationwide Remuneration Amounts
       Financial Remuneration Amount
                      Average Remuneration Amounts




The nationwide average for remuneration of SOMs is £750 per annum.
                Protected Time Amount
                      Individual LSA Mode Average




Average protected time amount nationwide is 1 day per month.
               SoM Resource Support
                               Nationwide/Overall

               Resource                Percentage of trusts receiving
                                                resource
Trust Mobile                                        35%

Pager/Bleep                                         10%

Dedicated supervisory office                        32%

Payments made for telephone calls                   8%

Dedicated administrative support                    25%

Other                                               10%

Other                                               2%
    SoM Recruitment and Retention
Is recruitment and retention of supervisors problematic in your trust? (31% yes)




   Of our selected group, no SOMs from the North East, South East Coast and Yorkshire & The Humber
   LSA’s stated they had any problems with the recruitment and retention of SOMs.
First Cause of Recruitment and Retention Problems
Second Cause of Recruitment and Retention Problems
Third Cause of Recruitment and Retention Problems
Key Findings
 Approximately half of LSAs across England have required SOM to midwife ratio highest
    ratios
                    London
                    East of England
                    South Central
                    Southeast Coast


 More than 95% of midwives are supervised by SOM’s employed by their employer

 93% of SOM’s receive remuneration for the role

 Significant variation in remuneration between LSA’s and within LSA’s

   33% of responders' had difficulty with recruitment

 Remuneration not significantly linked to units or LSA’s experiencing difficulty with
    recruitment

 Average cost of SOM nationally based on 2000 SOM’s , average protected time received
    and payment is ? Estimated at band 7 midpoint)

 Main factors affecting recruitment were competing demands with substantive post, on-calls,
    as well as competing demands with personnel live
Protecting the Public …..- How is this best
achieved? structure?
 Review current
      The current structure results in a conflict of interest

 Profile of SOM’s in relation to leadership function


 Key focus on how “protecting the public can be achieved appears to be
  premised on increasing ratio of SOM’s to practicing midwives- No
  evidence base for recommended ratio’s

 Fundamental restructuring of how Supervision operates and what is
  required to enable SOM’s to best promote safety within maternity

 Take stock of what is demanded of SoM’s and what is required for
  SoM’s to meet these demands (protected time)
Themes from Comments
Pressured
     Supposed to get protected time but rarely get it
     Area so busy, don't get time to do anything
     Time pressure to fulfil our SOM role is a problem for all of the SOMs in regard to
      support for midwives, clinical governance / risk investigation and review
     Difficult to make time to fulfil supervisory role around usual job responsibilities


Inadequacy /frustration
     “Demands or role increasing”
     “I am finding it very difficult to reach my expectations as a new supervisor within
      the confines of this trust.”
     With the present climate of high capacity and reduced experience midwives, there
      is a high level of pressure in practice. This has an impact on increasing
      investigations and a sometimes punitive interpretation of statutory supervision of
      midwives
     Better if SoMs not linked to trust employed. Give role more clout to take
      standards forward
Discord
     Also due to the level of investigation expected by the trust into issues midwives
      are feeling that supervision is becoming punitive and not supportive
     Supervisors are becoming more involved in risk management
     There are some negative attitudes towards the role of the SoM as a 'policing' role.
      Making sure that proactive, supportive supervision outweighs this negative aspect
      can be difficult with time restraints and workloads

Lack of recognition and value
    The lack of understanding from Trust at board level in the true value of midwifery
      supervision still continues to be truly acknowledged. The role is expected to be
      performed within existing contracted hours, which is proving difficult for many
      supervisors
More SoM Comments Captured…

                                        “Supervisior is very productive and
                                           well received in this trust and is
“We are happy with the pay and             also well supported by the trust as
  conditions of our supervisory role,      in financial remuneration“
  we are currently waiting for a 4th
  SOM to be designated.”
Thank you

				
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