The West Midlands LSA ANNUAL REPORT 2011-2012

1. The West Midlands LSA ANNUAL REPORT 2011-2012

2. The West Midlands LSA Team The LSA Team • Barbara Kuypers LSAMO • Lisa Wilkes P.A. to LSAMO Supported by Link Supervisors • Ann Kingscott • Toni Martin • Carmel McCalmont

3. Role of the LSA & Midwifery Officer • Implementing the legislation from Nursing and Midwifery Order • Compliance with the Midwives rules and standards (54) • Guidance for LSAs around Audit and compliance with standards • Receiving the Annuals Reports (Rules 16) • Recognising excellence and sharing good supervisory practice • Assessing risk and providing support and guidance.

4. West Midlands LSA 15 Acute Trusts providing maternity services 17 Acute Hospital Sites 12 Midwifery Led Units 3100+ Midwife ITPs 230+ Supervisor of Midwives 1/14 LSA SoM to Midwife Ratio

5. West Midlands Clusters

6. Communications Annually: 4 combined meetings with: • Link Supervisors • Contacts • Lead Midwives for Education Annual meetings with new Supervisors 6 Heads of Midwifery meetings Student POSOMs throughout the programme Adhoc policy review work

7. LSA Event Calendars • Supervision workshops – NMC Standard of Investigation • Practice Forum – Case Reviews • Maternal Mortality and Morbidity study days • Bond Solon • Annual Academic Day at University • Annual LSA Conference • National LSAMO Bi-annual Conference • Mediation & reconciliation • Attitude & bullying • Child Safeguarding • Advocacy for Normal Birth • The ‘business’ of midwifery

8. Preparation of Supervisors of Midwives Programme (POSOM) • 32 Places to take up annually at Birmingham Universities • Ballot and selection process reviewed • Peer & Panel discussions as part of selection • LSAMO as part of the curricula & planning • Looking to host spring and autumn programmes at Birmingham • Degree and Master’s Programmes • Support and reflection at 6 months post appointment for new SoMs

9. 2007/8 – Benchmark against 5 LSA Standards 2008/9 – NMC Standards of Investigation & Supervised Practice 2009/10 – Web based questionnaires Electronic collation of activity and trends. 2010-2011 – Audit of impact of Supervision on: Women’s Choice Student Learning Pre-ceptorship (1st three years of registration Review of Incident Investigation and Supervisory Practice Audit Themes

10. Supervision continues to support extra-ordinary births at home Supporting choices for women and their families. • Twins at home • VBAC at Home • Home births without monitoring or intervention (No FH & no VE’s) • Lotus births • Women with previous history of post partum haemorrhage • Women with prescriptive requirements • Complex social family environments with involvement of LA • Women with dominant partners and isolated proposed place of birth • Women with history of living with domestic violence • Women with previous history of sexual assault • Previous poor experience of obstetric or midwifery care • Families new to the area reluctant to register with GP • Request for attendance but obstructing in provision of care.

11. Pre-ceptorship • For the Trust to consider for the Maternity Pre-ceptorship Packs to integrate pages for supervisory communications or to provide a separate booklet. These can be noted with the LSA Logo for all discussions held between the registrant and their Supervisor of Midwives and also on the pages used for the Reflective Diary. • For the Supervisors to provide guidance at Supervisory Annual Reviews with regard to ensuring all midwives understand and take on their full role as teachers of the profession as described in The code (2008) so that student midwives received excellent clinical support and assessment whilst undertaking their training in the clinical placement.

12. Table to demonstrate the ratio of Midwives per Supervisor with each Trust, and the ratio for the whole LSA. In addition provides numbers of midwives with Universities and the West Midlands Perinatal Institute.

13. Table to demonstrates the numbers of midwives working in managerial or specialist roles at Band 7 to 9.

14. Table to demonstrates the total staff of midwives, nurses and non-qualified staff working in maternity services giving direct care to mothers and babies. Non-qualified staff, includes maternity support workers, auxiliary staff and nursery nurses.

15. Table to demonstrates midwives working in community settings

16. Table to demonstrate birth to midwife ratio over 3 year trend

17. Table to demonstrate Births over a 3 year trend 2008 - 2012

18. Table to demonstrate the Confinements by place of birth during 2010 -2012

19. Table to demonstrate Elective and Emergency Caesarean Section Rates

20. Table to demonstrate rates of Instrumental Delivery

21. Tables to show 3 Year Clinical Trends

22. Table to demonstrate the outcomes for babies born in West Midlands

23. Analysis of Supervisory Investigations 108 Supervisory Investigations. 123 Local Action 44 Developmental Support 25 Supervised Practice 0 Referrals to the NMC Issues: Regulation: Failure to comply with PREP requirements Operating and working out side of usual sphere of practice and competency Clinical: Failure to recognise abnormal progression of labour Failure to recognise abnormal CTG or signs of fetal distress Failure to act Failure to refer to appropriate physician Failure to document and record appropriately Failure to administrate correctly and record medicines Colleagues Failure to provide a safe environment for practice Failure to check equipment required for safe and effective care Failure to support students or newly qualified colleagues

24. www.lsa.westmidlands.nhs.ukLSA Database