Reform Local Supervising Authority for midwives
Morecambe Bay Investigation · Report of the Morecambe Bay Investigation · Issued 3 March 2015 · Addressed to: Department of Health and Social Care
Source — verbatim from the inquiry
●Inquiry recommendation
The Local Supervising Authority system for midwives was ineffectual at detecting manifest problems at the University Hospitals of Morecambe Bay NHS Foundation Trust, not only in individual failures of care but also with the systems to investigate them. As with complaints, our remit was not to examine the operation of the system nationally; however, the nature of the failures and the recent King's Fund review (Midwifery regulation in the United Kingdom) lead us to suppose that this is not unique to this Trust, although there were specific problems there that exacerbated the more systematic concern. We believe that an urgent response is required to the King's Fund findings, with effective reform of the system. Action: the Department of Health, NHS England, the Nursing and Midwifery Council.
Morecambe Bay Investigation, Report of the Morecambe Bay Investigation · 3 Mar 2015 Source PDF →
Published evidence summary
Publicly available evidence relating to this recommendation:
- The government stated its intention to legislate via an Order in Council under section 60 of the Health Act 1999 to remove the NMC's oversight of midwifery supervision (Learning Not Blaming, Cm 9113, Department of Health, July 2015).
- Statutory supervision of midwives was abolished on 31 March 2017 through the Nursing and Midwifery (Amendment) Order 2017 (SI 2017/321).
- A new employer-led model of midwifery supervision (A-EQUIP: Advocating for Education and Quality Improvement) was introduced in its place, separating professional supervision from regulatory oversight (NHS England).
Sources
Response — verbatim from government
●Department of Health and Social Care
83. We accept this recommendation. We will therefore modernise the regulatory
regime for midwifery.
84. The statutory supervision of midwives was designed in 1902 to protect the
public. It no longer meets the needs of current midwifery practice. Reports and
recommendations by the Parliamentary and Health Service Ombudsman and Kings
Fund found that midwifery regulation was structurally flawed as a framework for
public protection, and highlighted that statutory supervisory structures encourage
confidentiality in a way that does not always contribute to improving practice or
systems and can be perceived as protecting the midwife rather than women or
babies. This is borne out by the findings of the Morecambe Bay Investigation where
the process of statutory supervision was ineffective at identifying the root causes for
the many distressing incidents; at identifying and addressing poor practice amongst
midwifery staff; and most importantly in addressing the families concerns.
85. In addition, the Government committed in March to the removal of the Nursing
and Midwifery Council’s oversight of midwifery supervision, and will work with the UK
chief nursing officers to design a new system of supervision that is proportionate and
recognises the importance of managing risks and promoting safety, as well as the
professional development of midwives. Our intention is to act as swiftly as possible
to legislate, and we intend to do this by introducing an Order in Council made under
s60 of the 1999 Health Act.
86. Midwifery supervision is important for providing clinical supervision and
professional development for midwives resulting in high standards of safe care for
mothers and babies. Removing midwifery supervision from statute provides an
opportunity to design a new system that enables a clear separation between the
regulation of midwives (the role of the Nursing and Midwifery Council) and the
supervision of midwives. England, Scotland, Wales and Northern Ireland are already
working together to design this new system, which will include how the system will
operate in future and where responsibility for its oversight will go. However, statutory
supervision must continue until the law changes and a new system is in place and so
as the Nursing and Midwifery Council and Government nurse leaders in the four
countries have made clear, Trusts must not disestablish supervisor posts or other
structures until that time.
National protocols: 33-35
Department of Health and Social Care · 16 Jul 2015 Written response →
Evidence trail — what's actually happened since
- 31 Dec 2015 Statutory supervision of midwives abolished in 2017. New employer-led supervision model introduced through NMC. Source →
Each entry above links to a primary source — gov.uk written statement, consultation response document, or inspection report. The Index does not characterise government intent; it tracks what has been published.
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Source and Response are verbatim from primary documents. The Evidence trail records published activity since — written statements, consultation outcomes, inspection findings, parliamentary references. The Index does not paraphrase or characterise intent; it tracks what has been published. Where the evidence is the absence of action (a missed deadline, a slipped timetable), that absence is documented from primary sources rather than inferred.
This recommendation's data is verified periodically against primary sources. The Index is monitored for staleness weekly.