LSA Functions

Each midwife is required by the UKCC to submit a Notification of Intention to Practise Midwifery every year. Such notification must be made to each LSA in which the midwife may practise. This process contributes to protection of the public from unsafe practitioners.

Midwives care for mothers and babies in a variety of settings that encompass cultural and social diversity, such as NHS and private hospitals, birth centres, clients’ homes, prisons and armed forces accommodation. Midwives may be directly employed by an organisation, sub-contracted through an agency or self-employed. Statutory supervision of midwives crosses all boundaries to uphold the highest standards of midwifery care wherever it is delivered. Secondary legislation in the form of the Midwives Rules and Code of Practice (UKCC 1998) clearly sets out a framework for midwifery practise to which public safety is central.

The setting and monitoring of standards is fundamental to maintaining and improving the quality of statutory supervision of midwives and to prevent abuse of professional status (R v Shipman 2000) thereby protecting the public. In addition, LSA are independent of employers and therefore provide external scrutiny of maternity care provision. They are accessible to the client group and can intervene to take necessary action to protect the public from unsafe practice. If shortfalls in practice are identified, supervisors of midwives provide support and guidance to midwives creating an opportunity to develop practice.

There is a mechanism to facilitate a period of supervised practice in order to ensure that the midwife has the necessary knowledge and skills and that continuous practice development takes place. In prima facie cases of professional misconduct, the LSA may suspend a midwife from practice with immediate effect, pending further investigation. Currently, midwifery is the only profession with the sanction to suspend from practice, this being a key aspect of public safety within the system.

It is notable that there has been a consistently lower proportion of midwives than those from other professions regulated by the UKCC referred to the Professional Conduct Committee of the UKCC. The ENB (1998) attributed this fact to the pro-active approach of LSA to supervision that has resulted in strategic and innovative leadership. Stapleton et al (1998) demonstrated that midwives respond positively to effective supervision emerging as confident practitioners responsive to their client group.

It is possible that proactive supervision may contribute to enhancing recruitment, return to practice and retention of midwives when they feel supported in their practice.

The scope and responsibility of midwives has increased to meet the challenges of woman centred, holistic care. Midwives make an important contribution to the public health agenda (DoH 1999) in achieving HimP and HAZ targets and participating in ‘Sure Start’ initiatives. Midwives are in a prime position to promote healthy life-styles to reduce health inequalities so that women enter labour in optimum health, thus reducing clinical risk to mother and baby. To facilitate midwives in this continuing role development, supervisors of midwives themselves require considerable professional knowledge, interpersonal and communication skills and personal professional support.