1Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
ANNUAL REPORTOF THE MIDWIFERY COUNCIL OF NEW ZEALAND
TO THE MINISTER OF HEALTHFOR THE YEAR ENDED 31 MARCH 2015
2 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Detail of painting of Dame Whina Cooper by artist the late Suzy PenningtonDame Whina, awarded the title of Te Whaea o te Motu (Mother of the Nation) by the Maori Women’s Welfare League, holds a special place in New Zealand history as a founder of the League and because of her long life devoted to the service of her people and to the wellbeing of women and children. She particularly stressed the value of primary health and the importance of good midwifery services being available to Maori women and their whanau. The whakatau (Maori proverb) on the painting is the chant “ruia, ruia” from the Muriwhenua iwi of the Far North and symbolises inspiration, challenge and hope. The painting has hung in the Council’s office since its opening in February 2007.
3Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
CONTENTS
03INTrOduCTION
04GOvErNaNCE
10SECrETarIaT
20COmpETENCE, FITNESS TO praCTISE aNd
QualITy
24COmplaINTS aNd dISCIplINE
25appEalS aNd JudICIal rEvIEwS
37CONTaCT dETaIlS
4 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Facts at a glance
• 3100practisingmidwives(3068in2014)
• 134RegisteredNewZealand-educatedmidwives(147in2014)
• Registered38internationallyqualifiedmidwives(42in2014)
• 134midwiferygraduatespassedtheNationalMidwiferyExamination
• 10midwivescompletedaReturntoPracticeprogramme
• Received28notificationsinvolvingmidwives’competenceorconduct
• Conducted7competencereviews
• Required11midwivestoundertakecompetenceprogrammes
• Referred3midwivestoaProfessionalConductCommittee
• Received44notificationsinvolvingmidwives’health
• Contracted6externals36competenceassessors
• Developededucationarounduseofopioidsfollowingchangesinlegislation
• Addedchildbirthemergenciestomaternalandneonatalresuscitationasan
annualrequirementintheRecertificationProgramme
• Published9eMidpoints
• Signed3MOUswithNewZealandCollegeofMidwives
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5Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 3
INTrOduCTION
The Council’s mission:
• ToprotectthehealthandsafetyofwomenandbabiesexperiencingmidwiferycareinNewZealand
• Toestablish,protectandstrengthenaregulatoryframeworkthatembodiesthephilosophyandstandardsofthemidwiferyprofession
• TosetandmaintainhighstandardsofmidwiferypracticeinNewZealand
Council values:
1. Thepartnershipbetweenwomen/wāhineandmidwives/wāhinewhakawhānau
2. PartnershipwithTangataWhenua3. Respectfordiversity4. Integrityandfairness5. Transparent,credibleandaccountable
decisionmaking6. Collegialityandcollaboration7. Reflectionandongoinglearning8. Social,economicandecologicalsustainability
Functions:
ThefunctionsoftheCouncilaredefinedbythe
HealthPractitionersCompetenceAssuranceAct
2003(“theAct”).TheCouncilmust:• DefinetheMidwiferyScope(s)ofPractice
andprescribethequalificationsrequiredofregisteredmidwives
• Accreditandmonitormidwiferyeducationalinstitutionsandprogrammes
• MaintainapublicRegisterofmidwiveswhohavetherequiredqualificationsandarecompetentandfittopractise
• Issuepractisingcertificatestomidwiveswhomaintaintheircompetence
• Establishprogrammestoassessandpromotemidwives’ongoingcompetence
• Dealwithcomplaintsandconcernsaboutmidwives’conduct,competenceandhealth
• Setthemidwiferyprofession’sstandardsforclinicalandculturalcompetenceandethicalconduct
• Promoteeducationandtraininginmidwifery• PromotepublicawarenessoftheCouncil’s
responsibilities
6 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
1 GOvErNaNCE
Chairperson’s Foreword
Tēnā Koutou Katoa. Kia Kotahi Kī. He i oku nei korero anei he whakataukiNo tou rourou, no toku rourou, kia ora te iwi
What you have in your basket and what I have in mine, the combination will enhance all people’s wellbeing
Theyear1April2014to31March2015hasbeenbothabusyandsignificantyearfortheCouncilasithasengagedwithanumberofkeyprojectsandeventsduringthepastyear.
Somehighlightsinthepastyearhavebeen:• AreviewofthegovernancemodelofMidwiferyCouncilmovingtoa
morestrategicratherthanoperationalframework.Thepurposeofthereviewistoensurethat:
TheMidwiferyCouncilandsecretariatcontinuetoworkeffectivelyandefficiently;theCouncilismorestrategicallyfocused;thesystemsandprocessesthatsupporttheCouncilarestreamlined;andskillsandknowledgeoptimised.Theresultsofthechangesthathavebeenimplementedtodateareverypleasing.
• Thereviewofthepre-registrationmidwiferystandardsforeducation,includingconsultationwithallstakeholders,tookplaceduringthisyear.Theconsultationandtheworkofthesteeringgroupledtosomechangesinthestandards.However,theCouncilwaspleasedtoseethat,whenbenchmarkedinternationallyandmeasuredforhoursandoutcomes,thepre-registrationstandardsarerobust,leadingtohighqualitygraduates.
• StrengthenedMidwiferyFirstyearofPracticeProgramme.AftertwoyearsofextensivereviewandworkledbyHealthWorkforceNewZealandandtheMinistryofHealthandwhichinvolvedtheCouncil,alongwithNewZealandCollegeofMidwives,thisprogrammewassignedoffbytheMinisterin2014andbeganFebruary2015.Itwaspleasingtoseethatmanyofthethingsalreadyinplacehadservedmothersandbabieswell.Thestrengtheningoftheprogrammeandmakingitcompulsoryaddedfurthersupport.
• ContinuedengagementwiththeotherRegulatoryAuthoritiesonvariousregulatorymatters.Theissueofco-locationandsharedserviceshasbeenfurtheredandtheCouncilhasrelocatedtoLevel9,79BoulcottStreet.Thisispartofastagedplanwhichwillseeafurthermovein2016,whentenregulatoryauthoritieswillsharelocationandservices.TheCouncilseesthisasapositivemovetoensurethatthefunctioningoftheCouncilandthesecretariatisasefficientandcosteffectiveaspossible.
TheprimaryworkoftheCouncilistoprovidemechanismstoensurethatmidwivesarecompetentinthecaretheygivetowomenandtheirbabies.Ournumberonepriorityisthesafetyofmothersandbabies.
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7Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 5
TheCouncilalsocontinuestovalueitsgrowinginternationalrelationshipsand,inparticular,itsrelationshipwiththeNursingandMidwiferyBoardofAustralia,andtheAustralianNursingandMidwiferyAccreditationCouncil.TheopportunitytoattendtheSouthPacificChiefNursingandMidwiferyOfficersAlliance(SPCNMOA)inTongain2014,aswellasothereventsinthePacific,hasestablishedandfurtheredrelationshipsinthePacific.
TheCouncilengageswithanumberofstakeholdersandgroupsthroughouttheyear.OneofthehighlightsofthisengagementistheMidwiferyForum.In2014/2015twoforumswereheldinAucklandandChristchurch.Theseforums,asalways,weregatheringswherethework,concerns,issuesandplansoftheCouncilcanbepresentedtomidwives,womenandstakeholders,androbustdiscussiononthesematterscantakeplace.TheCouncilcontinuestovaluegreatlyitsrelationshipswithallitsstakeholders,andinparticularwiththeNewZealandCollegeofMidwives,theMinistryofHealth,HealthWorkforceNewZealandandtheDHBmidwiferyleaders.Wethankthesegroupsfortheircontinuedsupportandthecollegialandprofessionalmannerinwhichtheyenteredintodiscussionsandprojectswithusthatareattimeschallenging.
TheprimaryworkoftheCouncilistoprovidemechanismstoensurethatmidwivesarecompetentinthecaretheygivetowomenandtheirbabies.Ournumberonepriorityisthesafetyofmothersandbabies.TheCouncilistheauthorityonmidwiferyregulation,pre-registrationeducationandthestandardstowhichmidwivesarerequiredtopractise.TheCouncilcollectsandanalysesdataaboutallthenotificationsitreceivesaboutmidwives.Itlooksfortrendsandareasofrisks,continuallyevaluatingandactingonanyareasofconcern.Asanyreputableorganisationdoes,itusesthehierarchyofevidenceinassessingwhatisthe“bestevidence”tosupportbestpracticeandpolicy.Thismeansittakesatop-downapproach,rankingtheevidenceontherigouroftheresearchmethodology.TheCouncilisalwaysopentoworkingwithandlisteningtootherinterestedpartiesinmattersrelatedtomidwiferypracticebutitexpectstheyapplythesamerigourtotheirassessment.IntheCouncil’sview,touseanythinglessthan“bestevidence”isnotacceptable.
The Council and the Secretariat
IwouldliketoexpressmysincerethankstoSharronColeasCEOforhercontinuedcommitmenttoensuringCounciloperatesinthemosteffective,efficientandinformedwaypossible.IwouldalsoliketothankSusanCalvertinherroleasMidwiferyAdvisorandtheinvaluablewayshecontinuestosupporttheCouncilinitswork.Inaddition,mythanksgotoNickBennie,MarilynPierson,AndyCrosbie,JudithNormanandChristineWhaanga.TogetherthisteamrunsaveryeffectiveandefficientsecretariatwhichgivesgreatservicetoCouncil,thepublic,andmidwivesofNewZealand.
Iextendmysincerethankstoallthecompetenceassessors,thereviewers,thesupervisors,andthemidwivesandlaypeoplewhomakeuptheProfessionalConductCommittee,aswellasthosemanymidwiveswhoprovidesupportandadvicetotheCouncil.Yourexpertiseandprofessionalismismuchappreciated.
Finally,IoffermyheartfeltthankstotheCouncilmembersfortheirengagementwiththechangingprocessesofCouncil,especiallyduringthisyear,andtheircontinuedcommitmenttoensuringthattheprocessesofCouncilservethepublicofNewZealandwithintegrity,competence,andefficiency.
Noreirateneitemihikiakoutoukatoa.Kiakahakiamaiakiamanawanui.
NaJudithJudithMcAra-CouperChairperson
8 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
members of the midwifery Council at 31 march 2015
Chairperson: Dr Judith McAra CouperPhD,BA,RM,RGONJudithMcAraCouperhasworkedasamidwifebothinNewZealandandoverseas.JudithisanAssociateProfessorandHeadofMidwiferyatAucklandUniversityofTechnology.Sheteachesinthemidwiferyprogrammeanduntilrecently,heldajointappointmentatCountiesManukauasaclinicalmidwiferyeducatorinthebirthingunit.In2009,Judithwasawardedapostdoctoralscholarshipwhichshetookupin2010,focusingonmidwiferyandwomen’shealthresearch.Judithhasalsobeeninvolvedsince2009withtheWorldHealthOrganisationinBangladesh.SheisapastchairpersonoftheAucklandregionoftheNewZealandCollegeofMidwives.JudithlivesinAucklandwithherpartnerandtwocats.JudithwasappointedinFebruary2010andwasreappointedinAugust2015.
Deputy Chairperson: Andrea Vincent RGON,RMAndreahasworkedasamidwifeinavarietyofsettingsinNewZealandandoverseas.Shehasworkedasaself-employedcase-loadingmidwifeinNelsonsince1993,coveringruralandurbanareas,homeandhospitalbirths.SheisapastchairpersonoftheNelson-MarlboroughregionoftheNewZealandCollegeofMidwives.Andrealivesinsemi-ruralNelson,withherhusbandandtwoteenagechildren.ShewasappointedinFebruary2010andwasreappointedforasecondtermwhichwillendinFebruary2016.
Annette BlackONMZ,MA,DidEdStud,DipTchg,MBAAnnettewasappointedasalaymemberforathreeyearterminAugust2009andthenreappointedforasecondterm,expiringSeptember2015.ShebeganhercareerasasecondaryschoolhistoryteacherthenjoinedtheNewZealandLawSocietyasitsDirectorofEducationin1983.In1987shewasappointedDeputyExecutiveDirectorandheldbothpositionsconcurrentlyuntilherretirementin2005.SincethenshehascontinuedtoworkwiththeLawSocietyasaconsultant.SheassistedwiththeimplementationoftheLawyersandConveyancersActwhichcameintoforceon1August2008andandplayedamajorroleindesigninganddevelopingtheLawSociety’sfirstcontinuingprofessionaldevelopmentruleswhichcameintoforcein2013.SheisalsoaDirectorofNZLSCLELtd.AnnettelivesinWellingtonandismarriedwithtwoadultchildrenandfourgrandchildren.
Debbie FisherPGDipHealthCare,RM,BN,RCNDebbieFisherwasappointedtotheMidwiferyCouncilinSeptember2011.HercurrenttermexpiresinSeptember2015.SheistheAssociateDirectorofMidwifery-OperationsManagerattheNelsonMarlboroughDistrictHealthBoardwhereherroleisanintegralpartofmaternityservicesacrosstheregion.Shealsoworksclinicallyonacasualbasis.DebbieisamemberoftheNationalDHBMidwiferyLeadersGroupandNZCOM.SheisalsoaLactationConsultantandamemberofNZLactationConsultantsAssociation.DebbiehaslivedinNewZealand,AustraliaandtheUnitedKingdomandworkedinalltypesofmaternitycaresettings,workedonavarietyofmaternityprojectsandhaspresentedatnationalandinternationalmidwiferyconferences.ShehasbeenaNZCOMregionalchairpersoninthepast.DebbiehasaPGDiplomainHealthCareandiscurrentlyapostgraduatestudentatVictoriaUniversity.ShehasalsocompletedaTeReolevelonecertificationandpostgraduatestudyinadultteachingandlearningandclinicalmidwiferypractice.Debbie,herhusbandandherbabydaughtercurrentlyliveinNelson.
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9Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 7
Bronwen Golder BA,MA(withdistinction)BronwenwasappointedasalaymemberforathreeyearterminAugust2011,subsequentlybeingappointedforafurtherthreeyearsinMay2015.Earlyinhercareer,BronwenworkedasapoliticalriskanalystinNewYork.UponreturningtoNewZealand,BronwenjoinedtheDepartmentofLabourfromwhereshewassecondedtotheBeehiveasadvisortotheMinisterofEmployment.Since1993,BronwenhasworkedinGeneva,Brussels,WellingtonandChile-leadingconservationprogrammesfortwoofthelargestenvironmentalNGOsintheworld.BronwencurrentlyleadsaNewZealandconservationinitiativeprovidingstrategicadviceandsupporttoprojectsinAustralia,theSouthPacific,SoutheastAsiaandChile.Bronwenbringstoextensiveexperienceinpublicprivatesectorpartnerships,riskanalysis,strategicandprojectplanningandfacilitation,communications,andmonitoringandevaluation.BronwenlivesinWellingtonwithherhusbandandhighschool-agedson.
Korina VaughnRN,RMNgatiHako,NgatiMaruKorinaVaughnismarriedwith4childrenwhoareofSamoanandMaoridescent.KorinaandherfamilyliveinHuntlyandherchildrenattendalocaltotalimmersionKuraKaupapa.KorinacompletedherRegisteredComprehensiveNursetrainingin1992.ShethenworkedasaPracticeNurseatWaahiMaraeinHuntlyfortwoyears.In1994shebeganhermidwiferytrainingandin1995registeredasaMidwife.Korinahasworkedinavarietyofclinicalmidwiferysettingsbutpredominantlyasaself-employedmidwifeinHuntlyandthesurroundingdistricts.KorinaiscurrentlyemployedastheClinicalManagerofBirthcareHuntlyandshecontinuestocarryasmallcaseloadtomaintainmidwiferycompetencies.HertermbeganendinSeptember2009andshehasbeenreappointedforasecondtermwhichendsinSeptember2015.KorinahasbeenonleavefromtheCouncilsinceMay2013
Joyce Croft, RM,RN Ngapuhi/NgatihineJoycewasborn,raisedandworkedmostlyinTeTaitokerau/Northland.SheismarriedwithtwochildrenandlivesinWhangarei.CurrentlysheworksatNorthlandDHBasamidwifeinvariousroles.Previouslysheworkedasacaseloadingmidwifecaringforwomenfrombothurbanandruralcommunitieshavinghospitalandhomebirths.JoyceisanactivememberoflocalgroupssuchasTeKahuWahine(MaoriMidwives),NZCollegeofMidwives,MERAS,MaternityClinicalGovernance,MaoriWomensWelfareLeague,TeRengaParaoaandManaiaPHOClinicalAdvisoryCommittee.Herotherinterestsandactivitiesincludewhanau,holidays,breastfeeding,Maorihistoryandlanguage.JoycewasappointedtotheCouncilinJune2014.
Marion Hunter MA(Hons1stClass),BA,ADN,RM,RGONMarionwasappointedtotheMidwiferyCouncilinAugust2010forathreeyeartermandthenreappointedin2013forasecondtermwhichwillexpireinAugust2016.SheisaSeniorMidwiferyLecturerattheSchoolofMidwifery,AUTUniversity.Marion’sexperienceincludesLMCmidwiferyinaruralareaandemployedpositionsinbothtertiaryandruralhospitals.SheiscurrentlyaDirectorofthePHARMACSeminarSeries,MemberoftheNZFormularyAdvisoryBoardandhasservedonaMinistryofHealthcommitteeassessingnewprescribergroupsinNewZealand.MarionwasapprovedbyNZCOMasanexpertadvisorandhasundertakenvariousreviewsinrelationtoserviceandmidwiferypractice.Shehasco-authoredtwochaptersintheAustralasianmidwiferytextbookandpublishedelsewhereinrelationtobirthplace.
10 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Strategic Goals
Registration
Midwiveswhomeetthestatutoryrequirementsareregisteredthroughefficient,transparentandconsistentprocesses
EducationandlearningPre-registrationmidwiferyeducationstandardscontributetocompetent,confidentregistrantsandpostregistrationprogrammesassistmidwivestomaintainandenhancemidwiferyknowledgeandskills
FitnesstopractisePractisingmidwivesdemonstratetheircompetenceandfitnesstopractiseandwhenconcernsarise,theCouncil’sassessmentandsupportprocessesareequitable,clearandproportionate
ProfessionalstandardsClinical,culturalandethicalstandardsarevalidandcurrentintheNewZealandpracticecontextandpromotepublictrustandconfidenceintheprofession
GovernanceandOperationsGovernanceandorganisationalprocessesareefficientandeffective,ensuringthatstatutoryresponsibilitiesarefulfilledinameasurableandtransparentmanner
CommunicationandexternalrelationsThereiswidespreadengagementwithstakeholdersandthepublicsothattheCouncil’spoliciesandprocessesarewellinformedandtransparentandthepublichasaclearunderstandingoftheCouncil’sauthorityandresponsibilities
Fees for Council members and appointees
ThefeespaidtoCouncilmembershaveremainedunchangedsincetheyweresetin2004.Currentfeesare:• Agreedspecifictasksandteleconference
meetings$80perhour• Meetings-Chair$650perday• Meetings-Members$450perday• Meetingpreparationtime–4hoursat$50
perhour
Remuneration* received by each member for attendance at Council meetings and Annual Fora
*Grossincome–includesresidentwithholdingtax**AppointedJune2014***OnleavesinceMay2013
JMcAra-Couper(Chairperson)
ABlack
DFisher
BGolder
MHunter
JCroft**
KVaughn***
AVincent
<$4000 $10,001to$18,000
$4,001to$10,000
x
x
x
x
x
x
x
8
11Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 9
Council meetings
During2014,theCouncilcontinueditspatternadoptedthepreviousyearofholdingalternatetwodaymeetingsinWellingtonandhalfdayaudioconferencesbySkype.TheCouncilhadsixtwodaymeetingsandoneonedaymeetinginWellington,andfourhalfdaySkypemeetings.FollowingthegovernancereviewinOctober2014however,itresolvedtomovetosixweeklyonedaymeetingsinWellington
Committee structure
At31March2015,theCommitteesandtheirmembersare:
Education and Audit CommitteeAnnetteBlack,DebbieFisherandJudithMcAra-Couper.
Examination CommitteeMarionHunter,JudithMcAra-Couper,AndreaVincent,AnnetteBlack(JudithMcAra-CouperandMarionHunterarepost-examinationonly).
Health CommitteeJoyceCroft,BronwenGolder,MarionHunterandAndreaVincent.Thiscommitteehasfullydelegateddecisionmakingpower.
Finance CommitteeAnnetteBlack,BronwenGolder,DebbieFisher,JudithMcAra-Couper(withtheChiefExecutive)
Sorting CommitteeThe“SortingCommittee”wasestablishedtobettermanagetheworkloadofaddressingmattersrelatingtomidwives’competenceandconduct.ThisCommitteeanalysesallnewcases,includingtheinitialresponsefromthemidwife,thentablesthematterbeforeafullCouncilmeeting.Membersat31March2014wereDebbieFisher,MarionHunter,JudithMcAra-CouperandAndreaVincent.However,asaresultofthegovernancereview,theCouncilinlate2014disestablishedtheSortingCommittee,itsworknowbeingundertakenbynewlyappointeds36CompetenceAssessors.
Council EducationInMayandJune2014,anumberofCouncilmembersattendedtheinauguralHRANZRegulationConferenceandtheannualPerinatalandMaternityMortalityReviewCommitteeworkshop.
Photo: Milldove Birth and Newborn Photography www.birthandnewborn.co.nz
12 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
2 SECrETarIaT
Chief Executive’s review 14/15
Registration and midwifery education
Goal:Midwiveswhomeetthestatutoryrequirementsareregisteredthroughefficient,transparentandconsistentprocesses
Goal:Pre-registrationmidwiferyeducationstandardscontributetocompetent,confidentregistrants
Asallapplicationsforregistrationaremadeon-line,theCouncilhascontinuedtorefinetheITsystemtoensureitis“userfriendly”andaccurate.Towardstheendof2014/15,itbeganaprojecttodigitiseallregistrationrecordsheldbytheCouncilandaimstohavethiscompletedbythetimeitco-locateswiththeNursingCouncilandeightotherRegulatoryAuthoritiesinearly2016.
TheVulnerableChildren’sActhasledtheCounciltoreviewitsprocesseswithrespecttotheverificationofidentityandthefitnessforregistrationofapplicantsforEntrytotheRegisterofMidwives.Despitethemovetomorestringentlyscreenthefitnessofpersonswhoworkwithchildren,theNewZealandPoliceadvisedthatasmidwiferycareisnotpredominantlyinvolvedintheplanning,managementanddeliveryofservicestochildren,theCriminalRecords(CleanSlate)Act2004applies,withtheexceptionof“specifiedoffences”asdefinedinSchedule2oftheVulnerableChildren’sAct2014.
Thecurrentpre-registrationmidwiferyeducationstandardswhichcameintoeffectatthebeginningof2009,withreviewsofthefourschoolsofmidwiferytakingplaceover2012/13.AreviewofthestandardsbeganinNovember2013andwasnearingcompletionattheendofthe2014/15practisingyear.Therevisedstandardshaveincorporatedfeedbackfortheneedtostrengthentheprogrammeinresponsetothechangingmaternityandsocialenvironment
Duringtheyear,changeswerealsomadetotheInternationallyQualifiedMidwivespolicyinordertogiveaddedreassurancearoundtheirreadinessandabilitytopractisewithintheNewZealandmaternitymodelofcare.
Education and Learning and Firness to practise
Goal: Postregistrationprogrammesassistmidwivestomaintainandenhancemidwiferyknowledgeandskills
MythankstoallCouncilandstaffmemberswhoaremindfulofandcommittedtoprotectingthehealthandsafetyoftheNewZealandpublicbyhavinginplacesprocessestoensurethatmidwivesarecompetenttopractisetheirprofession.
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13Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 11
Goal:Practisingmidwivesdemonstratetheircompetenceandfitnesstopractiseandwhenconcernsarise,theCouncil’sassessmentandsupportprocessesareequitable,clearandproportionate
Goal:Clinical,culturalandethicalstandardsarevalidandcurrentintheNewZealandpracticecontextandpromotepublictrustandconfidenceintheprofession
WhenmidwivesareenteredontotheRegisterofMidwives,theyhavebeendeemed,byvariousobjectivemeasures,ascompetentandfittopractise.Thereareseveralcharacteristicswhichdefinecompetenceincludingprofessionalnetworkingandengagement,andsatisfactionwithcareerchoiceandwithpersonallives.‘Competencydrift’hasbeenidentifiedasculminatingincomplaintsandconcernsaboutahealthprofessionalpractice.Itoccurswheretherearepoorsupervisorystructures,lackofpeersupport,professionalisolationanddisengagementfrompractice.
ThechallengefortheCouncilisgettingthebalancerightbetweenqualitycontrolandqualityimprovement,bothofwhichfallwithinitsjurisdictionunderitsempoweringAct.Qualitycontrolisaboutidentifyingthosemidwiveswhoarepractisingbelowtherequiredstandardandputinplacethenecessaryrestrictionsorremedialactions.Qualityimprovementisaboutpromotingandsupportingmaintenanceofcompetenceinallpractitioners.
TheCouncil’smainqualityimprovementorcontinuingcompetencemodelistheRecertificationProgrammewhichwasrevisedfrom1April2014toincludechildbirthemergenceswithmaternalandneonatalresuscitationasannualupdate.TheMidwiferyPracticeDaywhereissuesandtrendsinmidwiferypracticeareaddressedwasalsorevisedtobecomeamoreactivelearningday.FeedbackfrommidwivesindicatesthatthechangestotheRecertificationProgrammehavebeenpositive.
TheCouncilhasagreedtoparticipateintheUKProfessionalStandardsAuthority-ledcomparativereviewofthehandlingofnotifications,includingthemonitoringoftheprioritylevelgiventoeachno-tification.Intheinterim,theCouncilhasmovedtomodifythewayinwhichitassessesandprioritisescompetencenotificationsbycontractingexternalassessorstoundertakethisprocess,allowingforin-creasedobjectivityandexpertise.
Stakeholder engagement
Goal: ThereiswidespreadengagementwithstakeholdersandthepublicsothattheCouncil’spoliciesandprocessesarewellinformedandtransparentandthepublichasaclearunderstandingoftheCouncil’sauthorityandresponsibilities
AtitsstrategicplanningandgovernancereviewworkshopinOctober2014,theCouncilrecognisedtheneedtobemoreeffectiveincommunicatingwithitskeystakeholderssothattheCouncil’sstatutoryroleinprotectingthesafetyofmothersandbabiesthroughitsregulationofmidwivesisbetterunderstood.Inearly2015,itapprovedacomprehensivecommunicationsstrategy“ChangingPerceptions”tobeimplementedinthe2015/16year.
TheCouncilcontinueditsactiveinvolvementinHealthRegulatoryAuthoritiesNewZealand(HRANZ)atbothoperationalandgovernancelevel.IthasalsocontinuedtoexpanditscollegialworkingrelationshipwithitsAustraliancounterparts,havingMemorandaofUnderstandingwiththeNursingandMidwiferyBoardofAustraliaandtheAustralianNursingandMidwiferyAccreditationCouncil.During2014,theCouncilhasbecomemorefocusedonthePacificregion,joiningtheSouthPacificChiefNursingandMidwiferyOfficersAllianceandattendingthebiennialSouthPacificNursingandMidwiferyForuminTonga.
14 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
ThemonthlyelectronicnewslettereMidpointissenttoallmidwiveswithapractisingcertificateandmanyotherstakeholders.
Governance and Operations
Goal:Governanceandorganisationalprocessesareefficientandeffective,ensuringthatstatutoryresponsibilitiesarefulfilledinameasurableandtransparentmanner
TheCouncilheldstrategicplanningandgovernancereviewworkshopsinOctoberandNovember2014.Itsubsequentlyadoptedathreeyearstrategicplantobecomemorestrategic,withaccurateinformationandanalysisallowingittoevaluateriskandtoalignitsregulatoryprocesseswithwhattheUKProfessionalStandardsAuthoritydefinesas“righttouchregulation”.
InNovember2014,theCouncilco-locatedwithfourotherRegulatoryAuthoritiesinordertoachieveoperationalefficiencies.Italsoremainedpartoftheongoingdiscussionwithnineotherauthoritiesoverco-locationandsharedadministrativeservicestoachievegreatercostssavings.InFebruary,theCouncilsignedaMemorandumofUnderstandingwiththeNursingCouncilonsharedservicesandinMarch,signedabaselevelServiceLevelAgreement.Worktowardssharedserviceswillprogressoverthe2015-16year,withtheaimoffullimplementationoftheSLAbeforeMarch2016.Sharedserviceswillmeananorganisationalreviewbutinthemeantime,thesmall6.5FTEstaffremainsunchanged.
MythankstoallCouncilandstaffmemberswhoaremindfulofandcommittedtotheprimarypurposeofourempoweringactwhichistoprotectthehealthandsafetyoftheNewZealandwomenandbabiesbyhavinginplacesprocessestoensurethatmidwivesarecompetenttopractisemidwifery.
SharronColeChiefExecutiveandRegistrar
Table 1 Summary of expenditure – 2014 to 2015
9%
24%
25%
5%
3%
9%
8%
9%
8%
Communica1on with Stakeholders
Prac1sing Cer1ficates and Recer1fica1on
Competence
Examina1ons
Health
HPDT
PCC
Registra1on
Educa1on and Audit
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15Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 13
Registration of, and Practising Certificates for, Midwives
a. Scopes of practiceThe Council has the responsibility to:• specifythemidwiferyscopeofpractice
Ankylogossia and frenotomy
TheCouncilconvenedamultidisciplinaryworkingpartyin2013toconsidertheissueoffrenotomywithinthemidwiferyscopeofpracticeandthemidwife’sroleintheassessment,diagnosisandtreatmentofankyloglossia(tonguetie).Adraftstatementwassentforconsultationin2014.WorkcontinuesonthisprojectbuttheCouncil’spositionhasnotchangedfrom2005whenitstatedthattheskilloffrenotomystaywithinthescopeofpracticeofsomemidwiveswhohadreceiveadditionaleducation.
Misuse of Drugs Act and Regulations
Since2012,theCouncilhasworkedwiththeMinistryofHealthandtheCollegeofMidwivesaroundanamendmenttotheMisuseofDrugsActandRegulationsthatallowsmidwivestoprescribecontrolleddrugsinadditiontopethidine.TheAmendmenttotheActandregulationscameintoeffecton1July2014andtheCouncilpublishedastatementontheMidwife’sscopeofpracticeatthattime.ScheduleCintheregulationsliststheadditionalcontrolleddrugsthatmidwivescanprescribeandtheCouncil’sstatementdescribestheindicationsforprescribing.Aneducationprogrammewasdevelopedandimplementedthatallmidwives,includingthoseregisteringfromoverseas,mustcomplete.
b. Accreditation
The Council has the responsibility to:• accreditandmonitortheinstitutionsoffering
thepre-registrationMidwiferyprogramme• setstandardsfortheMidwiferypre-
registrationprogramme
Pre-registration education TheBachelorofMidwiferyprogrammesare
deliveredatfourschoolsofmidwifery-AucklandUniversityofTechnology(AUT),WaikatoInstituteofTechnology(WINTEC),ChristchurchPolytechnicInstituteofTechnology(CPIT)andOtagoPolytechnic.Theschoolsdeliverthefouryear(480credit)programmeoverthreeextendedacademicyearsinordertomaximiseopportunitiesformidwiferypracticeexperiencesandconsolidation.
InNovember2013,theCouncilinvitedrepresentationontheworkingpartytoreviewthe2007Standardsforapprovalofpre-registrationmidwiferyeducationprogrammesandaccreditationoftertiaryeducationorganisations.Itsentoutthedraftrevisedstandardsforconsultationduring2014andwillpublishtherevisedstandardsin2015.
Monitoring of Schools of Midwifery
TheCouncilreviewedtheapprovedprogrammesofeducationinthetwoyearsafterthefirstgraduatesfromthecoursesagainstthe2007standardswereenteredontotheRegisterofMidwives.
ThereviewgavetheCouncilreassurancethatstudentsfromtheseprogrammesaremeetingtherequirementsforEntrytotheRegisterofMidwives.Further,therewaswidespreadfeedbackthattheprogrammesofeducationwhichhavebeendesignedtoensurethatthegraduatesareconfidentandcompetenttopractisemidwiferyintheNewZealandmaternityenvironmentarefulfillingthatexpectation.
Italsoconfirmedpreviousanecdotalreportingthatthereis:
• Increasedproficiencywithpracticalskills• Earlierintegrationoftheoryandpractice• Increasedconfidenceinfinalyearstudents• Perceptionofearlier‘readiness’forpractice
National Midwifery Examination
ApassintheNationalMidwiferyExaminationisoneoftherequirementsforEntrytotheRegisterofMidwives.InMarch2014,all44candidatesattainedapass;inJuly2014,all3candidatesattainedapassandinDecember2014,89studentssattheexamand87attainedapass.Thesuccessratesforeachschoolofmidwiferyfor2014areshowninTable2.
16 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Table 2National Midwifery Examination passes 2014
HPCAA Number Outcomes Section Registered Registered Not with registered conditions
Total 15 185 134 38 13*
Reasons for non-registration*
Qualificationsdidnotmeetrequiredstandard 15b 3 - - 3
Didnotmeetthecompetenciesforpractice 15c 3 - - 3
CommunicationincludingEnglishlanguagerequirements 16a,b - - -
Convictionbyanycourtfor3monthsorlonger 16c - - -
Mentalorphysicalcondition 16d - - -
ProfessionaldisciplinaryprocedureinNZoroverseas 16e,f,g - - -
Other–dangertohealthandsafety 16h - - -
School Numbers Numbers % passed sitting passed
AUT 42 42 100
WINTEC 30 28 93
CPIT 19 19 100
Otago 45 45 100
c. Registration
The Council has the responsibility to:
• setstandardsofcompetencerequiredforentrytotheRegisterofMidwives
• assessapplicationsandauthoriseregistration• setandmonitorindividualcompetence
programmesfornewlyregisteredinternationallyqualifiedmidwives
Midwivesapplytoregisterandmakepaymentonline.Allapplicationsareassessedtoensurethatapplicantssatisfytherequirementsforregistrationassetoutins16oftheHealthPractitionersCompetenceAssuranceAct2003.
Table 3Applications for registration decided in the 2014 – 2015 year
*In7cases,theapplicanteitherwithdrewordidnotcompletetheapplication.
*In7cases,theapplicanteitherwithdrewordidnotcompletetheapplication.
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17Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 15
Type/Year 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15
NewZealandgraduates 109 107 126 129 149 133 147 134
AustralianTTMRA* 17 11 13 7 12 8 13 15
Internationallyqualified 71 60 63 37 46 26 29 23
Total 197 178 202 173 207 167 189 172
Table 4Number of Midwives registered between 1 April 2014 and 31 March 2015 with comparisons with previous years
*TransTasmanMutualRecognitionAct1997
Table 5Percentage of registrations between 1 April 2014 and 31 March 2015 with comparisons with previous years: New Zealand graduates compared to all internationally qualified midwives
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 NZ Graduates 55.3% 60.1% 62.4% 74.6% 72.0% 79.6% 77.8% 77.9%
Overseas 44.7% 39.9% 37.6% 25.4% 28.0% 20.4% 22.2% 22.1%
18 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Midwifery First Year of Practice Programme
TheMidwiferyFirstyearofPracticeprogramme(MFYP),fundedbyHealthWorkforceNewZealandandprovidedbytheNewZealandCollegeofMidwives,wasimplementedin2007andasfrom1February2015,theCouncilhasmadeitmandatoryforallnewgraduatestoenrolinandsuccessfullycompletetheprogramme.
TheCouncilismindfulofitsroletoprotectthesafetyofthepublicbyensuringmidwivesarecompetenttopractiseandthatthepublicmusthaveconfidencethatthepracticeofnewgraduatesdoesnotputthematgreaterrisk.Itsanalysisofthecomplaintsithasreceivedaboutthepracticeofnewgraduatemidwivesshowstherehavebeen10between2004and31March2015.Ofthese,5havebeenfoundtohavecompetenceissues.Duringthistime,1351newgraduateshavebeenenteredontotheRegisterofMidwives.
TheCouncilwelcomedtheFebruary2015changeswhichwillfurtherenhancethesupportandguidancetonewgraduatemidwivesInadditiontomakingtheprogrammecompulsory,itnow:• Providesamechanismforimproved
regulatoryoversightbytheMidwiferyCouncilthroughestablishmentofreportinglinesbytheprovideroftheprogrammetotheCouncil
• Hasincreasedfundingtoenableclinicalattendancebyanexperiencedmidwifetosupportthenewgraduateinclinicalpracticewhenrequired
Theresearchproject“SteppingforwardintolifeasamidwifeinNewZealand/Aotearoa”concludedinearly2015,withareportbeingpresentedtotheCouncilandotherstakeholders.TheresearchwasananalysisoftheMidwiferyFirstYearofPracticecohorts2007-2010andwasundertakentoascertainiftheprogrammesupportedretentionofnewgraduatemidwives.
Theanalysisshowedatthetimeofdatacollection,94.1%ofparticipantsremainedinthemidwiferyworkforce.Therewasanalmostevensplitbetweenhospitalandcommunity-basedmidwiferypractice,theimportanceofnewgraduatesbeingabletoworkintheenvironmentthattheychosebeing
demonstrated.Practisingmidwivesprovidedclinicalsupporttonewgraduates,withbothclinicalandpracticereviewintheformofmentoring.Mostparticipantsadvisedthattheywereabletoattendtheelectiveeducationoftheirchoice.
OveralltheMFYPprogrammewasidentifiedasbeingflexibleandindividualisedandcontributedtotheretentionofgraduatemidwives.Internationalpublicationshavearisenfromthiswork.
Competence Programmes for internationally qualified midwives
AllinternationallyqualifiedmidwivesarerequiredtoundertakethiscompetenceprogrammewhichaddressesaspectsofmidwiferypracticewhichareuniquetoNewZealand.Theprogrammecomprisesthefollowingcomponents:• NZMidwiferyandMaternitySystems• PharmacologyandPrescribing• AssessmentoftheNewborn(theoryand
practice)• TreatyofWaitangi• CulturalCompetence
InAugust2014,theCouncilmadethefollowingchangestoitsInternationallyQualifiedMidwives(IQMs)RegistrationPolicyinordertoenhanceassurancearoundthecompetenceofIQMstopractisewithintheNewZealandmaternityenvironment:
1.Thatmidwivesseekingregistrationmustprovideevidenceoftwoyears’postregistrationmidwiferypractice,withintheimmediate5yearsprecedingapplication.Thismustincludepracticeacrossthescope.TheCouncilwillnolongerregisterInterna-tionallyQualifiedNewGraduatemidwives.ThisdoesnotapplytomidwivesregisteredundertheTransTasmanMutualRecognitionAgreement
2.Thatatthetimeofapplicationfortheirfirstprac-tisingcertificate,IQMsmustprovidetheirplantocompletetheOverseasCompetenceProgrammeatthetime.ThismustincludeevidenceofeithercompletionoforenrolmentintheNewZealandmaternityandmidwiferysystemsmodule
3.Thatthecondition“MaynotworkaloneasaLeadMaternityCarer”bechangedto“MustworkasanemployedmidwifeorasaLeadMaternityCarerinanestablishedgrouppractice*”.Atthetime
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Table 6: Applications for an annual practising certificate 2014/15
Reasons for non-issue of Practising Certificate
Total*
FailedtocomplywithaconditionNotcompletedrequiredcompetenceprogrammesatisfactorily**
Failedtodemonstraterequiredstandardofcompetence
Recencyofpractice
Notlawfullypractisingwithin3years***
Mentalorphysicalcondition
Falseormisleadingapplication
HPCAA Section
27(1)b
27(1)a
27(1)c
27(1)d
27(1)f
27(1)e
27(3)
Number Outcomes
APC no conditions
3077
-
-4
3
4
-
-
-
-
-
-
-
APC with conditions
88
-
-
-
-
-
-
-
Interim
476
-
-
-
-
-
-
-
No APC**
-
4
-
3
4
-
-
*Somemidwivesheldmorethanonepractisingcertificateduringtheperiod-oneormoreinterimpractisingcertificatesweregranted.3,571practisingcertificateswereissuedto3,129individualmidwivesduringtheperiod.**Inadditiontothereasonsabove,nineapplicationswerewithdrawnbytheapplicantandonewasdeclinedduetonon-paymentofthefee.
ofapplicationfortheirfirstpractisingcertificate,IQMsmustprovideevidenceofemploymentor,ifintendingtoworkasanLMC,ofdetailsofhowtheywillpractisewithinanestablishedgrouppractice.AllIQMmustalsoatthistimeinformtheCouncilofthenameofanominatedmen-tor.Areportwillbesoughtfromthementorattheendofeachyear,givingfeedbackontheIQM’sintegrationintotheNZmaternitysystem.*Establishedgrouppracticemeansformalprofes-sionalpracticearrangementswithstructuredbackupandregularpracticemeetings.NomidwivesinthepracticemaybeunderCouncilprocesses
4.ThattheassessmentofEnglishlanguageproficiencynowincludesOET,withapassmarkofeitherAorBineachsection.ApassineitherIELTSorOETmaybeachievedoveranumberofsittingsnotmorethan12monthsapart
d. Practising certificates
The Council has the responsibility to:
• issue annual practising certificates to those midwives who it is satisfied are competent to practise midwifery
Thenumberofmidwivesleavingtheworkforceintheyearending31March2015remainedstaticataround5%.Asthenumberofbirthshascontinuedtodecline,togetherwithanincreasednumberofnewgraduatemidwivesenteringtheworkforce,therearesufficientmidwivestoprovidecaretowomenandtheirfamilies.However,theCouncilrecognisestherecontinuestobemisdistributionissueswithsomeregionsstillfindingitdifficulttorecruitandretainmidwives.
3571 21
-
-
20 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Fees
TheCouncilhasmaintainedthefeeforanannualpractisingcertificateat$350,plusa$50disciplinarylevy.
Return to Practice Programme
The Council has the responsibility to:
• set and monitor individual competence programmes for midwives returning to midwifery after three years or more
MidwiveswhoseektoreturntoworkasamidwifeafteranabsenceofmorethanthreeyearsmustdemonstratetheircompetencetopractisebycompletingaformalReturntoPracticeProgrammeagreedwiththeCouncil.
ThecurrentReturntoPracticeprogrammerequirementsforallmidwiveswhohavetakenabreakofmorethanthreeyearsareavailableontheCouncilwebsitewww.midwiferycouncil.health.nz/return-to-practice-programmes/
Table 7: Comparative figures of midwives holding a practising certificate at the end of the year and at the beginning of the following year
UPDATE
2,200
2,300
2,400
2,500
2,600
2,700
2,800
2,900
3,000
3,100
3,200
2007 2008 2009 2010 2011 2012 2013 2014 2015 End of March 2,779 2,796 2,823 2,903 2,980 3,044 3,072 3,068 3,100
End of April 2,500 2,507 2,626 2,725 2,779 2,879 2,890 2,919 2,947
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Table 8: Number of formal Return to Practice programmes finished each year between 2005/2006 and 2014/2015
UPDATE0
5
10
15
20
25
30
35
2005/2006 2006/2007 2007/2008 2008/2009 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014 2014/2015 Completed 5 8 6 11 31 13 21 4 10 11
Did not complete 0 2 4 4 4 3 4 3 3 3
Photo: Milldove Birth and Newborn Photography www.birthandnewborn.co.nz
22 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
Competence reviews
Therewere7formalcompetencereviewsundertakenbytheCouncilin2014/15ThereviewtoolscommonlyincludeObjectiveStructuredClinicalAssessments(OSCAs)inwhichthecomponentsofclinicalcompetencesuchashistorytaking,physicalexamination,procedures,documentation,communication,multidisciplinaryworkingattitude,referencetostandards,referralguidelinesandprofessionalbehaviouraretestedagainstevidence-basedstandardsforpractice.
TheCouncilappointsreviewerswhoarerepresentativeofthepracticecontextofthemidwifeundertakingthecompetencereview.TheCouncilhasapoolofexperiencedmidwivesnominatedbytheprofessionfromwhichtodrawforcompetencereviewpanelsortoconductcasereviews.
Membersofcompetencereview/casereviewpanelsduringthe2014-2015yearwere:
SusanCrabtreeRobynCroninBerylDaviesElizabethNash
3 COmpETENCE, FITNESS TO praCTISE aNd QualITy aSSuraNCE
The Council has the responsibility to:
• providemechanismsforimprovingthecompetenceofmidwivesandforprotectingthepublicfromhealthpractitionerswhopractisebelowtherequiredstandardofcompetenceorwhoareunabletoperformtherequiredfunctions
a. Performance
TheCouncilencouragesthemidwiferyprofessiontoengageinaprocessofself-reflectionandprofessionaldevelopmentwhichwillimprovestandardsofmidwiferycareandcontributetoqualityimprovementinthemidwiferyworkforce.Thelevelofpublictrustandconfidenceisincreasedwhenthemidwiferyworkforcedemonstratescompetence,conscientiousnessandengagementintheprofession.
Insettingthecompetencestandardsandestablishingaprocessbywhichtodeterminetheon-goingcompetenceofmidwives,theMidwiferyCouncilrequiresallpractisingmidwivestoparticipateinitsRecertificationProgrammeinordertomeetthecompetencerequirementsnecessaryforapractisingcertificatetobeissued.
Source
HealthPractitioner(UnderRA) HealthandDisabilityCommissioner
Other
Employer
Total
HPCAA Section
34(1)
34(2)
34(3)
Number
10
13
8
-
31
Table 9: Competence referrals *
*Thesecompriseallnotificationsaboutamidwife’spracticereceivedbytheCouncil,withtheexceptionofhealth.Afterreceipt,theyarereferredasrequiredtotheHealthandDisabilityCommissionerunders64oftheHPCAA.TheCouncildecidesifthenotificationinvolvescompetenceorconductandwhatfurtheractionisrequired.
AdriennePridayJaneTownsendStephanieVagueNimishaWaller
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Notification of risk of harm to public
(Totalnumber)Initialinquiries
Nofurtheraction
Interimsuspension/conditions
Competenceprogramme
Ordersconcerningcompetence
Recertificationprogramme
Unsatisfactoryresultsofcompetenceorrecertificationprogramme
HPCAA Section
43
41
40
39
38
35
Number
NewExisting (at 1 April 2013)
-
-
11
-
11
-
27
NotApplicable NotApplicable
1
-
8
2
2
2
30
Closed
1
-
10
-
5
2
26
Still active
-
-
9
2
8
-
27
Outcomes
Table 10: Outcomes of competence referrals
b. Recertification/continuing competence
Recertification Programme
TheRecertificationProgrammerequiresmidwivestoundertakevariouscoursesandactivitiesoverathreeyearperiodinorderthattheycandemonstratetotheCouncilthattheyarecompetentandsafetopractise.
TheCouncilimplementedchangesintheRecertificationprogrammefrom1April2014.Thesechangeswere:• MidwiferyRefresherDay,formerlythree
yearly,isnowanannualrequirementcalledtheCombinedEmergencySkillsDayandincludesmaternityemergenciesaswellasthematernalandneonatalresuscitationupdates
• anadditionalbreastfeedingactivityeverythreeyears
• 5pointsannuallyineachofelectiveeducationandprofessionalactivities
Recertification audit
TheCouncilmonitorsallpractisingmidwives’engagementinrecertification.ThisismainlycarriedoutelectronicallyalthoughtheCouncilstillauditsportfolioswhenissuesaroundamidwife’scompetenceariseorifamidwifeappearstobeconsistentlynoncompliantwiththeprogramme.Throughitsregistrationdatabase,itlinkstheissuingofannualpractisingcertificatestodemonstratedengagementintheRecertificationProgramme.ThosemidwiveswhowereunabletosatisfytheCouncilofsubstantialengagementarerequiredtoundertakespecificactivitieswithindefinedtimeframes,withanumberbeingissuedwithinterimpractisingcertificatesuntilrequirementsaremet.ItispleasingtonotethatthenumberofIPCsissuedfornon-compliancehascontinuedtofall.
Midwifery Standards Review
TheCouncilhascontractedtheCollegeofMidwivestoconductMidwiferyStandardsReviewsaspartofitsRecertificationProgrammesince2005.Allmidwivesare expected to undertake Midwifery StandardsReview biennially although this timeframe may bevariedtothreeyearlyorshortenedtoafurtherreview
24 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
c. Health/fitness to practise
The Council has the responsibility to:
• protect the public by ensuring midwives are fit to practise
being required in six or twelvemonths, dependingontheoutcomesofthereview.Thepurposeofthereview is to assist midwives with their on-goingprofessional development by reflecting on theirpracticewithmidwiferyandconsumerreviewers.
UKresearchcarriedoutbythePickerInstitute*hasshownthatconsumerfeedbackisanimportantpartofthehealthprofessionalcompetenceassessmentprocess.Ithasbeenshownthatconsumerscanusefullycommenton(provideconstructivefeedbackonpracticeareas):
• Interpersonalskills• Communicationinformation• Engagementandenablement• Aspectsoftechnicalcompetence
*Chisholm,A.&Sheldon.H.(2011).Serviceuserfeedback:anevidencereviewandDelphiconsultationandtheirapplicationtocontinuingfitnesstopractise.Oxford,UK.PickerInstituteEurope
Statement on Cultural Competence
TheStatementonCulturalCompetencewhichexplainshowculturallycompetentmidwivesmustdrawonthethreeframeworksofMidwiferyPartnership,CulturalSafetyandTurangaKaupapainbuildingandmaintainingrelationshipswiththeirclients,wasformallyadoptedbytheCouncilin2011.In2012,OtagoPolytechnicmadeavailableaculturalcompetencecourseforinternationallyqualifiedmidwivestoprovidethemwiththeknowledgeandskillsrequiredtoachievetheCompetenciesforEntrytotheRegisterofMidwivesthatrelatetoculturalcompetenceintheNewZealandcontext.CompletionofboththiscourseandaTreatyofWaitangiworkshopiscompulsoryforallinternationallyqualifiedmidwiveswithintwoyearsofcommencingpracticeinNewZealand.
TheCouncilreceived44newnotificationsofconcernaboutamidwife’shealthwhichhadaffectedherpractice.AllmidwiveswerereferredtotheHealthCommitteewhichhasdelegatedauthorityfromtheCounciltomakedecisionsrelatingtomidwives’health.
ElevenmidwivesremainedunderHealthCommitteemonitoringfollowingreferralsinpreviousyears.
Employer
Healthpractitioner
Healthservice
Anyperson
Personinvolvedwitheducation
Medicalofficerofhealth
HPCAA Section
45(3)
45(1)d
45(1)c
45(1)b
45(1)a
Number
NewExisting ( at 1 April 2014)
-
7
-
1
2
1
38
3
2
Closed
--
13
--
1
-
-1
Still active
-
32
-
4
2
2
Source
Table 11: Notifications of inability to perform required functions due to mental or physical (health) condition
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25Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015 23
OutcomesNofurtheraction
Ordermedicalexamination
Interimsuspension*
Total
Conditions
Restrictionsimposed
HPCAA Section
49
48
48
50
Number of practicioners
4
16
1
18
9
12
Table 12: Outcomes of health notifications
d. Quality assurance activities
WhiletheCouncilconductedanumberofqualityassuranceactivitiesduringtheyear,itdidnotmakeanyapplicationsfortheactivitiestobeprotectedunders54oftheHPCAAct.
*6Midwivesremainedunfittopractise
Photo: Milldove Birth and Newborn Photography www.birthandnewborn.co.nz
26 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
4 COmplaINTS aNd dISCIplINE
The Council has the responsibility to:
• actoninformationreceivedaboutthecompetenceandconductofmidwives• monitormidwiveswhoaresubjecttoconditionsfollowingdisciplinaryaction
a. Complaints
Table 13: Complaints re conduct from various sources and outcomes during 2014 – 2015 year
HealthPractitioner(UnderRA)
HealthandDisabilityCommissioner
Consumers
Courtsnoticeofconviction
Employer
Other
OtherHealthPractitioner
Number
3
-
1
1
-
Outcome
Referred to Professional
Conduct Committee
No further disciplinary
action**
-
-
-
1
-
3
-
Referred to the Health and Disability
Commissioner
--
-
--
NotApplicable
5
--
Source
2
-
-
-
-
b. PCC
TheCouncilhasapoolofexperiencedmidwivesnominatedbytheprofessionfromwhichtodrawasrequiredforProfessionalConductCommittees.Thetwochairsarelaymembersofthecommittee.
Members of Professional Conduct Committees during the 2014-2015 year were:
SandyGill(Chair)BernardKendall(Chair)KerryAdamsKayFaullsYvonneMorganJennyWoodley
- 2
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5 appEalS aNd JudICIal rEvIEwS
TherewerenoappealsorjudicialreviewsofdecisionsmadebytheCouncilin2014/15.
25
Notificationofconviction
Concernsaboutstandardsofpractice
Fraudulentclaiming
Conduct
Practisingoutsidescope
Practisingwithoutannualpractisingcertificate
Other
Theft
DHB
Court
OutcomeNumberSourceNature of issue
1
3
1 Stillinprogress
-
-
-
-
-
ChargeslaidatHPDT
NFA
-
-
-
-
-
Court
-
-
-
-
Table 14: Professional Conduct Committee cases
c. Health Practitioners Disciplinary Tribunal
TherewasonehearinginvolvingamidwifebeforetheTribunalduring2014/15.Thechargeofprofessionalmisconductwasproven.
TheTribunal,whenhearingachargeinvolvingamidwife,comprisesachairpersonwhoisalawyer,threemidwivesandalayperson.AllTribunalmembersareappointedbytheMinisterofHealth.
d. Code of Conduct
TheCouncilhasthestatutoryresponsibilitytosetstandardsofethicalconduct.TheCounciladoptedaCodeofConductin2011.ItisintendedtoformallyreviewtheCodein2016-17.
-
28 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
6 lINKING wITH STaKEHOldErS
The Council has the responsibility to:
• Communicatewiththemidwiferyprofession• Liaisewithhealthregulatoryauthoritiesand
otherstakeholdersovermattersofmutualinterest
• PromotepublicawarenessoftheCouncil’srole
National forum - TheCouncilholdsannualforatoprovideanopportunityfortheCounciltodiscusspoliciesandprocessesandfortheprofession,stakeholdersandconsumerstogiveinformalfeedbacktoCouncil.Duringtheyear,theforawereheldinAucklandandChristchurch.
eMidpoint - TheCouncilpublisheditselectronicnewslettereMidpointmonthly.Aswellasbeingsentbyemailtoallmidwivesandotherstakeholders,thenewsletterisalsopublishedontheCouncil’swebsite.
New Zealand College of Midwives - TheInternationalConfederationofMidwivesstatestherearethreepillarsnecessarytocreateandmaintainahighqualitymidwiferyworkforce–midwiferyeducationprogrammes,regulatoryframeworksandprofessionalassociation.TheCouncilunderstandsallthreepillarsneedtobestrongandtothisend,maintainsacollegialworkingrelationshipwiththeCollegeofMidwivesastheprofessionalassociation.TheCouncilalsohadformalmeetingswithCollegetodiscussmattersofmutualinterest.TheChiefExecutiveandtheMidwiferyAdvisorattendedtheannualmidwiferyeducators’workshop,hostedbytheCollege.
Ministry of Health - TheCouncilhasmetwiththeMaternityAdvisorsonanumberofoccasionsduringtheyear.
District Health Boards – TheCouncilmaintainsgoodworkingrelationshipswithDHBmidwiferyleaders,women’shealthmanagersandmidwiferyeducators.
Australian Nursing – Nursing and Midwifery Board of Australia –TheCouncilhasaMemorandumofUnderstandingwiththeNMBAtoworkclosely
overpolicyandprofessionalissuesrelatingtotheregulationofmidwives.InAugusts,ithostedadelegationfromNMBAtodiscussissuesandprojectsofmutualinteresttobothcountries.TheChairandRegistrarattendedaNMBABoardmeetinginMelbourneinAugustwhenattendingtheNationalRegulatoryAuthoritiesSchemeConference.
Australian Nursing and Midwifery Accreditation Council - TheCouncilhasaMemorandumofUnderstandingwithANMACtocooperateandliaiseoverTrans-Tasmanmidwiferymattersrelatingtotheeducation,accreditationandassessmentofmidwives.TheCouncilagreedtoparticipateinaprojecttodevelopanAssessmentFrameworkforinternationally-qualifiedmidwives.
International Consultative Committee – TheChiefExecutiveistheCouncilrepresentativeonthisANMACcommitteewhichmeetstwiceyearlyinCanberratoconsiderissuesrelatingtotheassessmentofthequalificationsofinternationalnursingandmidwiferyapplicantstoensurethatpolicies,proceduresandinformationmanagementmeetbestpracticeandthusthehealthandsafetyofthepublicareprotected.
South Pacific Chief Nursing and Midwifery Officers Alliance - TheChiefExecutive participatesinthebimonthlyteleconferencesofSPCNMOAwhichbringtogethernursingandmidwiferyleadersinregulationandeducationtodiscussandplaneffectiveprogrammesforthePacificinregulation,education,legislationandservicedelivery.InNovember,theCEOandChairattendedinTongatheSPCNMOAmeeting,heldinconjunctionwiththeSouthPacificNursesandMidwivesForum.
Health Regulatory Authorities New Zealand Collaborations - HRANZprovidesaforumforallthehealthregulatoryauthoritiestoshareinformationandtoworkonmattersofcommoninterestincarryingoutourrolesundertheAct.TheCouncilhasactivelyparticipatedinHRANZ,bothintheoperationalandstrategicmeetings.SeveralCouncilmembersandstaffattendedtheinauguralHRANZregulatoryconferenceheldinWellingtoninMay.
1. Finance
a. Audited accounts
To be included here
2. Contact details
SECRETARIAT
StaffmembersoftheMidwiferyCouncilat31March2015were:
ChiefExecutiveandRegistrar: SharronColeDeputyRegistrar: NickBennieMidwiferyAdvisor: SusanCalvertAccountsandRegistration: MarilynPiersonProgrammesManager: AndyCrosbyAdministrator:ChristineWhaangaAssistantAdministrator:JudithNorman
Legal AdvisorsMatthewMcClellandHarbourChambersPOBox10-242TheTerraceWellington6143
AndrewS.McIntyre(forPCC)BeachcroftNZPOBox5530Wellington6145
ClaroLawPOBox11-455Wellington6142
AccountantsCroweHorwath(NZ)LtdPOBox11976MannersStWellington6142
BankersWestpacPOBox691Wellington6011
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Photo: Milldove Birth and Newborn Photography www.birthandnewborn.co.nz
30 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
8 FINaNCE
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9 CONTaCT dETaIlS
SECRETARIAT
Staff members of the Midwifery Councilat 31 March 2015 were:Chief Executive and Registrar: Sharron ColeDeputy Registrar: Nick BennieMidwifery Advisor: Susan CalvertAccounts and Registration: Marilyn PiersonProgrammes Manager: Andy CrosbyAdministrator: Christine WhaangaAssistant Administrator: Judith Norman
LEGAL ADVISORS
Matthew McClellandHarbour ChambersPO Box 10-242The TerraceWellington 6143
Andrew S. McIntyre (for PCC)Beachcroft NZPO Box 5530Wellington 6145
All correspondence to the Council should be addressed to:
Midwifery CouncilPO Box 24-448Manners StreetWellington 6142
Email: [email protected]: (04) 499 5040Fax: (04) 499 5045
ACCOUNTANTS
Crowe Horwath (NZ) Ltd (formerly WHK Wellington)PO Box 11 976Manners StWellington 6142
BANKERS
WestpacPO Box 691Wellington 6011
KiwibankWellington
40 Annual Report of the Midwifery Council of New Zealand for the year ended 31 March 2015
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