standards for pre_registration midwifery education

Standards for

pre-registration

midwifery education

2

Foreword

The Nursing and Midwifery Council exists to safeguard the health and wellbeing of the public. We do this by maintaining a register of nurses and midwives, setting standards for education and practice, and giving guidance to professionals. We aim to inspire the FRQ¿GHQFH�RI�RXU�VWDNHKROGHUV�E\�HQVXULQJ�WKDW�QXUVHV�DQG�PLGZLYHV�RQ�RXU�UHJLVWHU�DUH�¿W�WR�SUDFWLVH�DQG�E\�GHDOLQJ�VZLIWO\�DQG�IDLUO\�ZLWK�WKRVH�ZKR�DUH�QRW�

Standards for pre-registration midwifery education updates and replaces Standards RI�SUR¿FLHQF\�IRU�SUH�UHJLVWUDWLRQ�PLGZLIHU\�HGXFDWLRQ��5HFHQWO\�SXEOLVKHG�European Directives have been incorporated into this edition, along with recently circulated NMC standards and guidance that relate to the outcome of two NMC consultations: Fitness for practice at the point of registration, and Pre-registration PLGZLIHU\�HGXFDWLRQ��,QFOXGHG�DOVR�DUH�WKH�(VVHQWLDO�6NLOOV�&OXVWHUV�IRU�PLGZLIHU\�HGXFDWLRQ��7KH�UHYLVHG�WLWOH�UHÀHFWV�WKH�VFRSH�RI�WKH�VWDQGDUGV�DQG�JXLGDQFH�IRU� pre-registration midwifery education.

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Contents

Introduction ....................................................................................................................� � The role of the Nursing and Midwifery Council .......................................................� � Midwifery – the guiding principles ...........................................................................� �

Standards for the lead midwife for education ................................................................ 8 Standard 1 – Appointment of the lead midwife for education ................................. 8 Standard 2 – Development, delivery and management of midwifery education programmes............................................................................................................ 9 Standard 3 – Signing the supporting declaration of good health and good character .................................................................................................................��

Standards for admission to, and continued participation in, pre-registration midwifery programmes .................................................................................................................. 11� 6WDQGDUG��±�*HQHUDO�UHTXLUHPHQWV�UHODWLQJ�WR�VHOHFWLRQ�IRU�DQG�FRQWLQXHG� participation in approved programmes, and entry to the register ........................... 11 Standard 5 – Interruptions to pre-registration midwifery education programmes ... 15 Standard 6 – Admission with advanced standing ................................................... 15 Standard 7 – Transfer between approved educational institutions ......................... 16 Standard 8 – Stepping off and stepping on to pre-registration midwifery education programmes............................................................................................................ 16

Standards for the structure and nature of pre-registration midwifery programmes ....... 17 Standard 9 – Academic standard of programme .................................................... 17� 6WDQGDUG��±�/HQJWK�RI�SURJUDPPH ...................................................................... 17 Standard 11 – Student support ............................................................................... 18 Standard 12 – Balance between clinical practice and theory ................................. 19 Standard 13 – Scope of practice experience .......................................................... 19� 6WDQGDUG��±�6XSHUQXPHUDU\�VWDWXV�GXULQJ�FOLQLFDO�SODFHPHQWV ..........................�� Standard 15 – Assessment strategy .......................................................................�� Standard 16 – Ongoing record of achievement ...................................................... 22

Achieving the NMC standards ....................................................................................... 22� 6WDQGDUG��±�&RPSHWHQFLHV�UHTXLUHG�WR�DFKLHYH�WKH�10&�VWDQGDUGV ................. 23� 7KH�(VVHQWLDO�6NLOOV�&OXVWHUV .................................................................................. 35

Annexe� 'LUHFWLYH��(&�RI�WKH�(XURSHDQ�3DUOLDPHQW�DQG�RI�WKH�&RXQFLO��RQ�WKH�� UHFRJQLWLRQ�RI�SURIHVVLRQDO�TXDOL¿FDWLRQV ................................................................ 68

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Introduction

The role of the Nursing and Midwifery Council

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7KLV�ERRN�GHWDLOV�WKH�VWDQGDUGV�RI�HGXFDWLRQ�DQG�WUDLQLQJ�UHTXLUHG�IRU�SUH�UHJLVWUDWLRQ�midwifery education programmes. Their status is mandatory and they gain their authority IURP�OHJLVODWLRQ��LQ�WKLV�FDVH��WKH�2UGHU�DQG�WKH�1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��(GXFDWLRQ��5HJLVWUDWLRQ�DQG�5HJLVWUDWLRQ�$SSHDOV��5XOHV��2��WKH�5HJLVWUDWLRQ�5XOHV��

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Midwifery – the guiding principles

The standards for pre-registration midwifery education have been guided by the LQWHUQDWLRQDO�GH¿QLWLRQ�RI�D�PLGZLIH�DQG�WKH�UHTXLUHPHQWV�RI�WKH�(XURSHDQ�8QLRQ�'LUHFWLYH�5HFRJQLWLRQ�RI�3URIHVVLRQDO�4XDOL¿FDWLRQV��(&�$UWLFOH��

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A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has DFTXLUHG�WKH�UHTXLVLWH�TXDOL¿FDWLRQV�WR�EH�UHJLVWHUHG�DQG�RU�OHJDOO\�OLFHQVHG�WR�practise midwifery.

The midwife is recognised as a responsible and accountable professional who ZRUNV�LQ�SDUWQHUVKLS�ZLWK�ZRPHQ�WR�JLYH�WKH�QHFHVVDU\�VXSSRUW��FDUH�DQG�DGYLFH�during pregnancy, labour and the post-partum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.

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5

7KH�PLGZLIH�KDV�DQ�LPSRUWDQW�WDVN�LQ�KHDOWK�FRXQVHOOLQJ�DQG�HGXFDWLRQ��QRW�RQO\�IRU�WKH�ZRPDQ��EXW�DOVR�ZLWKLQ�WKH�IDPLO\�DQG�WKH�FRPPXQLW\��7KLV�ZRUN�VKRXOG�LQYROYH�antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.

A midwife may practise in any setting including the home, community, hospitals, clinics or health units.

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Safe and effective practice

Education programmes must be designed to prepare students to practise safely and effectively so that, on registration, they can assume full responsibility and accountability for their practice as midwives.

7KH�IROORZLQJ�JXLGLQJ�SULQFLSOHV�UHODWH�WR�SURIHVVLRQDO�FRPSHWHQFH�DQG�¿WQHVV�IRU�practice, and the promotion and facilitation of the normal physiological process of childbirth. This includes competence in identifying any complications that may arise, accessing appropriate assistance, and implementing correct emergency measures.

Students must demonstrate competence in:

�� VRXQG��HYLGHQFH�EDVHG�NQRZOHGJH�RI�IDFLOLWDWLQJ�WKH�SK\VLRORJ\�RI�FKLOGELUWK�DQG�WKH�newborn, and be competent in applying this in practice

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�� being autonomous practitioners and lead carers to women experiencing normal childbirth and being able to support women throughout their pregnancy, labour, birth and postnatal period, in all settings including midwife-led units, birthing centres and the home

�� EHLQJ�DEOH�WR�XQGHUWDNH�FULWLFDO�GHFLVLRQ�PDNLQJ�WR�VXSSRUW�DSSURSULDWH�UHIHUUDO�RI�either the woman or baby to other health professionals or agencies when there is recognition of normal processes being adversely affected and compromised.

Note: childbirth in this context means the antenatal, intranatal and postnatal periods.

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Students must understand and practise competently:

Provision of women-centred care

Midwifery practice must be women-centred and responsive to the needs of women and WKHLU�IDPLOLHV�LQ�D�YDULHW\�RI�FDUH�VHWWLQJV��7KLV�ZLOO�EH�UHÀHFWHG�LQ�WKH�PLGZLIH¶V�DELOLW\�to assess the needs of women, and to determine and provide programmes of care and support for women throughout the pre-conception, antenatal, intrapartum and postnatal periods.

The education process will prepare the student to provide midwifery care. It will also SUHSDUH�WKHP�WR�DFFHSW�UHVSRQVLELOLW\�IRU�WKH�HIIHFWLYH�DQG�HI¿FLHQW�PDQDJHPHQW�RI�FDUH�for women by managing and prioritising competing demands. The student will develop WKH�FDSDFLW\�WR�ZRUN�FROODERUDWLYHO\�ZLWKLQ�WKH�PXOWL�GLVFLSOLQDU\�FDUH�WHDP��ZKLOVW�GHPRQVWUDWLQJ�RYHUDOO�FRPSHWHQFH�LQ�IXO¿OOLQJ�WKH�PLGZLIH¶V�UROH�

The emphasis must be on the provision of holistic care for women and their families, which respects their individual needs, contexts, cultures and choices. Principles RI�HTXLW\�DQG�IDLUQHVV�DUH�IXQGDPHQWDO�YDOXHV��ZKLFK�PXVW�EH�DGGUHVVHG�LQ�DOO�programmes of preparation.

Ethical and legal obligations

The Code: Standards of conduct, performance and ethics for nurses and midwives3 UHTXLUHV�DOO�PLGZLYHV�WR�FRQGXFW�WKHPVHOYHV�DQG�SUDFWLVH�ZLWKLQ�DQ�HWKLFDO�IUDPHZRUN�based on respect for the wellbeing of women and their families. While various rule-orientated and principle-based ethical models may assist in informing ethical decisions, many ethical dilemmas are complex. They may not easily be resolved by using one ethical approach. Midwives must recognise their moral obligations and the QHHG�WR�DFFHSW�SHUVRQDO�UHVSRQVLELOLW\�IRU�WKHLU�RZQ�HWKLFDO�FKRLFHV�ZLWKLQ�VSHFL¿F�VLWXDWLRQV�EDVHG�RQ�WKHLU�RZQ�SURIHVVLRQDO�MXGJPHQW��,Q�PDNLQJ�VXFK�FKRLFHV��PLGZLYHV�PXVW�EH�DZDUH�RI��DQG�DGKHUH�WR��OHJDO�DV�ZHOO�DV�SURIHVVLRQDO�UHTXLUHPHQWV�

Respect for individuals and communities

Midwives must always demonstrate respect for persons and communities, and not discriminate in any way against those in their care. No midwife should convey any allegiance to any individual or group which opposes or threatens the human rights, safety or dignity of individuals or communities, irrespective of whether such individuals or groups are recipients of midwifery care.

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Quality and excellence

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The changing nature and context of midwifery practice

As the nature and context of midwifery practice changes, it is essential that all midwives DUH�SUHSDUHG�IRU�DQG�XQGHUVWDQG�WKH�QHHG�WR�XSGDWH�DQG�HQKDQFH�WKHLU�NQRZOHGJH�DQG�VNLOOV��LQ�UHVSRQVH�WR�WKH�FKDQJLQJ�QHHGV�RI�ZRPHQ�DQG�WKHLU�IDPLOLHV��0LGZLYHV��ZRUNLQJ�ZLWKLQ�WKH�OLPLWDWLRQV�RI�WKHLU�RZQ�FRPSHWHQFH��PXVW�KDYH�WKH�FDSDFLW\�WR�DGDSW�to change, but also be able to identify the need for change and initiate it. Midwives need to adapt to changes in technology and new systems of care delivery as they are introduced.

Lifelong learning

Midwives must be prepared for and understand the need for continuing professional DQG�SHUVRQDO�GHYHORSPHQW�WKURXJKRXW�WKHLU�FDUHHU��LQFOXGLQJ�WKH�DFTXLVLWLRQ�DQG�GHYHORSPHQW�RI�QHZ�NQRZOHGJH�DQG�VNLOOV��3URJUDPPHV�PXVW�SUHSDUH�WKH�PLGZLIH�ZLWK�WKH�FRPPXQLFDWLRQ�VNLOOV�ZLWK�ZKLFK�WR�GHOLYHU�HIIHFWLYH�FDUH�LQ�D�PXOWLFXOWXUDO�HQYLURQPHQW��0LGZLYHV�PXVW�EH�SUHSDUHG�IRU�SDUWQHUVKLS�ZRUNLQJ�ZLWK�RWKHU�PHPEHUV�RI�WKH�KHDOWKFDUH�WHDP��ZRUNLQJ�DFURVV�SURIHVVLRQDO�ERXQGDULHV�LQ�WKH�EHVW�LQWHUHVWV�RI�women and their families. They should be able to promote the principles of a self-regulating profession and statutory supervision in accordance with the NMC’s Midwives rules and standards� and The Code: Standards of conduct, performance and ethics for nurses and midwives.5

Evidence-based practice and learning

Within the complex and rapidly changing healthcare environment, it is essential that the best available evidence informs midwifery practice. This is achieved by searching WKH�HYLGHQFH�EDVH��DQDO\VLQJ��FULWLTXLQJ�DQG�XVLQJ�HYLGHQFH�LQ�SUDFWLFH��GLVVHPLQDWLQJ�UHVHDUFK�¿QGLQJV��DQG�DGDSWLQJ�DQG�FKDQJLQJ�SUDFWLFH�ZKHUH�DSSURSULDWH��7KLV�PXVW�EH�UHÀHFWHG�WKURXJKRXW�HGXFDWLRQ�SURJUDPPHV�

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8

Standards for the lead midwife for educationThis section provides standards and guidance relating to the lead midwife for education. 7KH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�LV�D�UHTXLUHPHQW�IRU�DSSURYDO�RI�PLGZLIHU\�HGXFDWLRQ�programmes that lead to application to the midwives’ part of the register or a recordable PLGZLIHU\�TXDOL¿FDWLRQ��7KH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�IRUPV�DQ�HVVHQWLDO�SDUW�RI�WKH�TXDOLW\�DVVXUDQFH�SURFHVV�DQG�VKH�PXVW�GHPRQVWUDWH�WR�WKH�10&�WKDW�WKH�VWDQGDUGV�leading to either registration or a recording on the midwives’ part of the register are being maintained.

Standard 1 – Appointment of the lead midwife for education

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�� appoint a lead midwife for education who is a practising midwife and has a recorded PLGZLIHU\�WHDFKLQJ�TXDOL¿FDWLRQ�RQ�WKH�10&�UHJLVWHU

�� FRQ¿UP�WKH�DSSRLQWPHQW�RI�D�OHDG�PLGZLIH�IRU�HGXFDWLRQ�ZLWK�WKH�10&

�� use the lead midwife for education for strategic liaison with external agencies such as purchasers of education provision for all matters affecting midwifery education.

Guidance

The lead midwife for education is a practising midwife and therefore must notify her LQWHQWLRQ�WR�SUDFWLVH�HDFK�\HDU��6KH�PXVW�DOVR�PHHW�WKH�10&�UHTXLUHPHQWV�IRU�XSGDWLQJ�and continuing professional development in order to remain on the register as a PLGZLIH��+DYLQJ�D�UHFRUGHG�WHDFKLQJ�TXDOL¿FDWLRQ�RQ�WKH�10&�UHJLVWHU�GHPRQVWUDWHV�that the lead midwife for education has met the NMC’s standards for teaching.

The approved educational institution should notify the NMC of the appointment of the OHDG�PLGZLIH�IRU�HGXFDWLRQ�RQ�WKH�DSSURSULDWH�IRUP��DFFHVVHG�YLD�WKH�10&�ZHEVLWH�www.nmc-uk.org��VR�WKDW�ZH�FDQ�JHW�LQ�FRQWDFW�ZLWK�WKHP�DV�DQG�ZKHQ�QHFHVVDU\�

Examples of external agencies with whom the lead midwife may need to communicate include the NMC and its strategic reference groups, local supervising authorities, commissioners and purchasers of education, maternity units, Departments of Health, other higher education institutions, professional organisations, and voluntary sector and private sector employers.

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Standard 2 – Development, delivery and management of midwifery

education programmes

The lead midwife for education shall lead the development, delivery and management of the midwifery education programmes provided by the approved educational institution, ensuring that they comply with the standards established by the NMC.

The approved educational institution will:

�� consult with the lead midwife for education on all matters that affect midwifery education

The lead midwife for education will:

�� FRQWULEXWH�WR�WKH�LQWHUQDO�V\VWHPV�WKDW�LQIRUP�WKH�TXDOLW\�DVVXUDQFH�RI�PLGZLIHU\�education programmes

�� collaborate with maternity services, service users and user groups in all matters that affect midwifery education

�� provide professional input at strategic and operational levels within the approved HGXFDWLRQDO�LQVWLWXWLRQ�WR�HQVXUH�WKH�10&¶V�UHTXLUHPHQWV�IRU�GXH�UHJDUG�DUH�PHW

�� ZRUN�DW�D�VWUDWHJLF�OHYHO�ZLWK�KHDGV�RI�PLGZLIHU\��ORFDO�VXSHUYLVLQJ�DXWKRULW\�PLGZLIHU\�RI¿FHUV��VXSHUYLVRUV�RI�PLGZLYHV�DQG�SXUFKDVHUV�RI�HGXFDWLRQ�SURYLVLRQ�in all matters that affect midwifery education

Guidance

The lead midwife for education is an expert in midwifery education and has the NQRZOHGJH�DQG�VNLOOV�WR�GHYHORS�SROLF\��DV�ZHOO�DV�WR�DGYLVH�RWKHUV�RQ�DOO�PDWWHUV�UHODWLQJ�to midwifery education. She should liaise directly with commissioning and purchasing agencies for midwifery education, as well as being involved in any decisions regarding midwifery education. It is essential that midwifery education programmes meet the needs of users of maternity services, as well as students. It is therefore important that women who use maternity services are involved in all stages of curriculum planning, development and programme evaluation. This will enable student midwives, at the point of registration, to meet the needs of women and their babies. Strategic collaboration is QHFHVVDU\�EHFDXVH�PLGZLIHU\�HGXFDWLRQ�LPSDFWV�RQ�PLGZLIHU\�FDUH��ZRUNIRUFH�SODQQLQJ�and commissioning of student numbers.

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Standard 3 – Signing the supporting declaration of good health and

good character

,Q�DFFRUGDQFH�ZLWK�UXOH��D��LL��RI�WKH�UHJLVWUDWLRQ�UXOHV��WKH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�shall be responsible, at her discretion, for signing the supporting declarations of good health and good character for all midwifery applications to the register.

The lead midwife for education will:

�� HQVXUH�SURFHVVHV�DUH�LQ�SODFH�WR�VDWLVI\�WKH�10&¶V�HQWU\�UHTXLUHPHQWV�IRU��D��DGPLVVLRQ�WR�D�PLGZLIHU\�SURJUDPPH�RI�HGXFDWLRQ�WKDW�OHDGV�WR�LQLWLDO�UHJLVWUDWLRQ�or readmission to the register following a return to practice programme�E��WKH�FRQWLQXHG�SDUWLFLSDWLRQ�RI�D�VWXGHQW�LQ�D�PLGZLIHU\�SURJUDPPH�RI�HGXFDWLRQ�that leads to initial registration or readmission to the register following a return to practice programme�F��DQ\�SHUVRQ�EHLQJ�DGPLWWHG�WR�WKH�PLGZLYHV¶�SDUW�RI�WKH�UHJLVWHU�IRU�WKH�¿UVW�WLPH�or readmission to the register following a return to practice programme

�� be accountable for her signature on the supporting declaration of good health and good character

�� have the right to refuse to sign any supporting declaration of good health and good FKDUDFWHU�ZKHUH�WKH�DYDLODEOH�HYLGHQFH�LGHQWL¿HV�WKDW�WKH�VWXGHQW�PD\�QRW�EH�RI�VXI¿FLHQW�JRRG�KHDOWK�DQG�RU�JRRG�FKDUDFWHU�WR�FDUU\�RXW�VDIH�DQG�HIIHFWLYH�SUDFWLFH�as a midwife.

Guidance

The lead midwife for education is accountable for her practice in accordance with The Code: Standards of conduct, performance and ethics for nurses and midwives6 and the Midwives rules and standards.7

If a lead midwife for education cannot be assured of a student’s good health and good FKDUDFWHU�VKH�PXVW�QRW�VLJQ�WKH�VXSSRUWLQJ�GHFODUDWLRQ�UHTXLUHG�E\�WKH�10&��7KH�student therefore cannot be recommended for admission to the midwives’ part of the UHJLVWHU��,Q�RUGHU�WR�UHDFK�WKLV�GHFLVLRQ��WKH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�PD\�QHHG�WR�VHHN�WKH�VXSSRUW�RI�WKH�XQLYHUVLW\¶V�)LWQHVV�WR�3UDFWLVH�SDQHO�RU�HTXLYDOHQW��LQIRUPDWLRQ�RQ�WKH�10&¶V�UHTXLUHPHQWV�IRU�ORFDO�)LWQHVV�WR�3UDFWLVH�SDQHOV�LV�VHW�RXW�LQ�*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��*XLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��8 In such cases, it would be regarded as good practice to inform the NMC why the student is not being UHFRPPHQGHG�IRU�DGPLVVLRQ�WR�WKH�UHJLVWHU�DQG�FRQ¿UP�WKDW�WKH�VWXGHQW�KDV�OHIW�WKH�midwifery programme.

This section describes standards and guidance on admission to and continued participation in NMC approved pre-registration midwifery education programmes, in DFFRUGDQFH�ZLWK�$UWLFOH��E��RI�WKH�2UGHU�

6�7KH�&RGH��6WDQGDUGV�RI�FRQGXFW��SHUIRUPDQFH�DQG�HWKLFV�IRU�QXUVHV�DQG�PLGZLYHV�� 1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ� 7�0LGZLYHV�UXOHV�DQG�VWDQGDUGV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPFXN�RUJ� 8�10&�JXLGDQFH��*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�

11

Standards for admission to, and continued participation in,

pre-registration midwifery programmes

Age of entry

7KHUH�LV�QR�ORQJHU�D�PLQLPXP�DJH�UHTXLUHPHQW��DOWKRXJK�WKH�IROORZLQJ�JXLGDQFH�remains relevant.

Guidance

Education providers must comply with:

�� $UWLFOH��D��E��RI�'LUHFWLYH��(&��7KH�5HFRJQLWLRQ�RI�3URIHVVLRQDO�4XDOL¿FDWLRQV��ZKLFK�UHTXLUHV�DFFHVV�WR�WUDLQLQJ�DV�D�PLGZLIH�WR�EH�GHSHQGHQW�XSRQ�HLWKHU�FRPSOHWLRQ�RI�DW�OHDVW�WKH�¿UVW��\HDUV�RI�JHQHUDO�VFKRRO�HGXFDWLRQ��IRU�a programme comprising of at least three years full-time theoretical and practical VWXG\��RU�SRVVHVVLRQ�RI�HYLGHQFH�RI�IRUPDO�TXDOL¿FDWLRQV�DV�D�JHQHUDO�QXUVH��IRU�D�IXOO�WLPH�SURJUDPPH�RI�D�PLQLPXP��PRQWKV¶�GXUDWLRQ��

�� +HDOWK�DQG�6DIHW\�DW�:RUN�$FW��ZKLFK�UHVWULFWV�WKH�PDQQHU�LQ�ZKLFK�\RXQJ�SHRSOH�PD\�EH�GHSOR\HG��,Q�WKLV�FRQWH[W�D�µ\RXQJ�SHUVRQ¶�LV�GH¿QHG�DV�µDQ\�SHUVRQ�who has not attained the age of 18 years’.

7KH�NH\�GRFXPHQWV�UHODWLQJ�WR�WKLV�DUH�WKH�+HDOWK�DQG�6DIHW\��7UDLQLQJ�IRU�(PSOR\PHQW��5HJXODWLRQV��WKH�0DQDJHPHQW�RI�+HDOWK�DQG�6DIHW\�DW�:RUN�5HJXODWLRQV��DQG�WKH�0DQDJHPHQW�RI�+HDOWK�DQG�6DIHW\�DW�:RUN�5HJXODWLRQV��1RUWKHUQ�,UHODQG��

Standard 4 – General requirements relating to selection for and

continued participation in approved programmes, and entry to the

register

4.1 Selection

7KH�IROORZLQJ�UHTXLUHPHQWV�IRU�VHOHFWLRQ�VKRXOG�EH�UHDG�DQG�RSHUDWHG�DORQJVLGH�programme providers’ existing policies and procedures:

�� wherever practicable, the selection process should include a face-to-face meeting

�� SURJUDPPH�SURYLGHUV��DSSURYHG�HGXFDWLRQDO�LQVWLWXWLRQV�DQG�WKHLU�VHUYLFH�SDUWQHUV��are encouraged, wherever possible, to involve lay people and midwifery students in the selection process. Depending on local circumstances they may be involved directly or indirectly in selection, eg:

�� in planning for recruitment and selection

�� in assessing or determining interview and selection criteria

�� in monitoring the effectiveness of selection processes

�� in giving presentations or meeting with potential applicants

�� as part of the selection panel�� all individuals involved in the selection process should receive appropriate

12

WUDLQLQJ��SUHSDUDWLRQ�DQG�XSGDWLQJ�ZKLFK�LQFOXGHV�HTXDOLW\�DQG�GLYHUVLW\��&DUHIXO�FRQVLGHUDWLRQ�VKRXOG�EH�JLYHQ�WR�WKH�VXSSRUW�DQG�WUDLQLQJ�RI�OD\�SHRSOH��WKRVH�ZKR�DUH�QRW��DQG�QHYHU�KDYH�EHHQ�UHJLVWHUHG�ZLWK�WKH�10&��DQG�RU�PLGZLIHU\�VWXGHQWV�involved in the process

�� representatives of partner service provider organisations should be directly involved in the selection process

�� WKH�YLHZV�RI�WKH�LQGLYLGXDOV�GLUHFWO\�LQYROYHG�LQ�VHOHFWLQJ�DSSOLFDQWV�VKRXOG�EH�WDNHQ�LQWR�DFFRXQW�ZKHQ�PDNLQJ�¿QDO�GHFLVLRQV�RQ�ZKHWKHU�WR�DFFHSW�RU�UHMHFW�DQ�DSSOLFDQW�

4.2 Literacy and numeracy

$SSURYHG�HGXFDWLRQDO�LQVWLWXWLRQV�DUH�UHTXLUHG�WR�HQVXUH�WKDW�DSSOLFDQWV�IRU� pre-registration midwifery education programmes have provided evidence of literacy DQG�QXPHUDF\�WKDW�LQFOXGHV�SULRU�DFKLHYHPHQW�RI�EDVLF�VNLOOV�VXI¿FLHQW�WR�XQGHUWDNH�D�pre-registration midwifery programme of education to a satisfactory level of attainment.

For numeracy this includes evidence of ability to:

�� PDQLSXODWH�QXPEHUV�DFFXUDWHO\�DV�DSSOLHG�WR�YROXPH��ZHLJKW��DQG�OHQJWK��LQFOXGLQJ�addition, subtraction, division, multiplication, use of decimals, fractions and SHUFHQWDJHV��LQFOXGLQJ�XVLQJ�D�FDOFXODWRU�

For literacy this includes evidence of ability to:

�� UHDG�DQG�FRPSUHKHQG��LQ�(QJOLVK�RU�:HOVK��DQG�FRPPXQLFDWH�FOHDUO\�DQG�effectively in writing, including using a computer.

If a student has a disability, the above criteria can be met through the use of reasonable DGMXVWPHQWV��3URJUDPPH�SURYLGHUV�VKRXOG�DSSO\�ORFDO�SROLF\�LQ�DFFRUGDQFH�ZLWK�*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��*XLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��10&��9

)RU�TXDOLW\�DVVXUDQFH�SXUSRVHV��WKH�10&�UHTXLUHV�DFFHVV�WR�LQIRUPDWLRQ�DERXW��DQG�evidence of the application of systems and policies developed to assess the literacy and numeracy of applicants to pre-registration programmes of midwifery education.

Applicants who hold an existing NMC registration may be deemed to have met the 10&¶V�UHTXLUHPHQWV�DW�WKHLU�LQLWLDO�UHJLVWUDWLRQ�

Guidance

7KH�10&¶V�UHTXLUHPHQWV�KHOS�VDIHJXDUG�WKH�SXEOLF�E\�HQVXULQJ�WKDW�HQWUDQWV�WR pre-registration programmes have a foundation of literacy and numeracy from which WR�GHYHORS�FRPPXQLFDWLRQ�VNLOOV�DQG�FRPSHWHQF\�ZLWK�UHJDUG�WR�GUXJ�FDOFXODWLRQV��Evidence of literacy and numeracy may be determined from academic or vocational TXDOL¿FDWLRQV��WKURXJK�HYLGHQFH�VXFK�DV�NH\�VNLOOV�DELOLWLHV��RU�WKURXJK�WKH�DSSURYHG�educational institution’s own processes, which may include portfolios or tests.

9�10&�JXLGDQFH��*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�These examples are for guidance only. Approved educational institutions have the right

13

WR�VHW�WKHLU�RZQ�VWDQGDUGV�EXW�PXVW�VDWLVI\�WKH�10&�WKDW�WKHUH�LV�VXI¿FLHQW�HYLGHQFH�WR�PHHW�LWV�UHTXLUHPHQWV��,W�ZRXOG�EH�UHJDUGHG�DV�EHVW�SUDFWLFH�LI�WKH�HGXFDWLRQDO�HQWU\�UHTXLUHPHQWV�ZHUH�DJUHHG�MRLQWO\�E\�WKH�DSSURYHG�HGXFDWLRQDO�LQVWLWXWLRQ��VHUYLFH�providers and education commissioners.

:KHUHYHU�SRVVLEOH��WKH�PHDQV�RI�HYLGHQFLQJ�UHTXLUHPHQWV�IRU�OLWHUDF\�DQG�QXPHUDF\�VKRXOG�HQDEOH�IHHGEDFN�WR�EH�SURYLGHG�WR�DSSOLFDQWV�DQG�WKRVH�DGPLWWHG�WR�D�SURJUDPPH��7KLV�VKRXOG�DOORZ�GHYHORSPHQWDO�QHHGV�WR�EH�LGHQWL¿HG��DQG�ZKHUH�appropriate to be addressed as part of the programme.

:KHUH�WKH�,QWHUQDWLRQDO�(QJOLVK�/DQJXDJH�7HVWLQJ�6\VWHP��,(/76��LV�RIIHUHG�DV�evidence for overseas applicants outside of the EEA, programme providers should DSSO\�WKH�10&¶V�UHTXLUHPHQWV�IRU�RYHUVHDV�DSSOLFDQWV�WR�WKH�UHJLVWHU��)RU�WKHVH�DSSOLFDQWV��WKH�10&�DFFHSWV�,(/76�H[DPLQDWLRQ�UHVXOWV��DFDGHPLF�RU�JHQHUDO�YHUVLRQ��ZLWK�D�VFRUH�RI�DW�OHDVW��LQ�WKH�OLVWHQLQJ�DQG�UHDGLQJ�VHFWLRQV��DW�OHDVW��LQ�WKH�ZULWLQJ�DQG�VSHDNLQJ�VHFWLRQV��DQG�DQ�RYHUDOO�DYHUDJH�VFRUH�RI�DW�OHDVW��

4.3 Good health and good character

$SSOLFDQWV�PXVW�GHPRQVWUDWH�WKDW�WKH\�KDYH�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�VXI¿FLHQW�for safe and effective practice as a midwife, on entry to, and for continued participation in, programmes leading to registration with the NMC.��

$SSOLFDQWV�IURP�RYHUVHDV�PXVW�PHHW�WKH�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�DV�GH¿QHG�IRU�8.�DSSOLFDQWV�DQG�DGGLWLRQDOO\�WKRVH�UHTXLUHPHQWV�VHW�RXW�E\�WKH�8.�JRYHUQPHQW�IRU�KHDOWKFDUH�ZRUNHUV�IURP�RYHUVHDV�

If an applicant has a conviction or formal caution issued by the police, this must be declared.

Approved educational institutions must obtain evidence of the applicant’s good health and good character as part of their selection, admission and ongoing monitoring processes.

A student already registered with the NMC on a different part of the register is not H[HPSW�IURP�WKLV�UHTXLUHPHQW�

3URJUDPPH�SURYLGHUV�DUH�UHTXLUHG�WR�PRQLWRU�WKH�SURJUHVV�RI�DOO�VWXGHQWV�DQG�WR�WDNH�appropriate action if any issues relating to good health or good character arise. All SURJUDPPH�SURYLGHUV�DUH�UHTXLUHG�WR�KDYH�)LWQHVV�WR�3UDFWLVH�SDQHOV�IURP�-DQXDU\��WR�FRQVLGHU�DQ\�KHDOWK�RU�FKDUDFWHU�LVVXHV�DQG�WR�HQVXUH�WKDW�SXEOLF�SURWHFWLRQ�LV�maintained.

Further information on good health and good character can be viewed on the NMC website.

��10&�JXLGDQFH��*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�Guidance

��

7KH�10&�UHTXLUHV�SURJUDPPH�SURYLGHUV�WR�HQVXUH�WKDW�SURFHVVHV�DUH�LQ�SODFH�IRU�DVVHVVLQJ�HDFK�DSSOLFDQW¶V�VWXGHQW¶V�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�DW�DGPLVVLRQ�WR��during and on completion of pre-registration midwifery programmes. Such processes PD\�LQYROYH�D�FRPELQDWLRQ�RI�VHOI�DVVHVVPHQW�KHDOWK�TXHVWLRQQDLUHV��VHOI�GHFODUDWLRQ�of good character, routine health screening, occupational health assessment, character UHIHUHQFHV��&ULPLQDO�5HFRUG�%XUHDX�FKHFNV�DQG�RWKHU�PHDVXUHV�DJUHHG�EHWZHHQ�WKH�programme providers.

Students who declare on application that they have a disability should submit a IRUPDO�DVVHVVPHQW�RI�WKHLU�FRQGLWLRQ�DQG�VSHFL¿F�QHHGV��IURP�D�*3�RU�RWKHU�PHGLFDO�or recognised authority, to the relevant occupational health department. Programme providers should apply local policy in accordance with the Disability Discrimination Act ��11�IRU�WKH�VHOHFWLRQ�DQG�UHFUXLWPHQW�RI�VWXGHQWV�HPSOR\HHV�ZLWK�GLVDELOLWLHV��:KHUH�appropriate, the institution’s student support services should also be involved. The NMC ZRXOG�UHTXLUH�HYLGHQFH�RI�KRZ�VXFK�VWXGHQWV�ZRXOG�EH�VXSSRUWHG�LQ�ERWK�DFDGHPLF�DQG�SUDFWLFH�HQYLURQPHQWV�WR�HQVXUH�VDIH�DQG�HIIHFWLYH�SUDFWLFH�VXI¿FLHQW�IRU�IXWXUH�registration.

7KHVH�JXLGDQFH�QRWHV�QHHG�WR�EH�FRQVLGHUHG�DORQJVLGH�WKH�10&¶V�UHTXLUHPHQWV�IRU�ORFDO�)LWQHVV�WR�3UDFWLVH�SDQHOV�DV�VHW�RXW�LQ�*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��*XLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��10&��12

4.4 Entry to the register

7KH�10&�UHTXLUHV�D�VHOI�GHFODUDWLRQ�RI�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�IURP�DOO�WKRVH�HQWHULQJ�WKH�UHJLVWHU�IRU�WKH�¿UVW�WLPH��2Q�FRPSOHWLRQ�RI�WKH�PLGZLIHU\�SURJUDPPH�WKH�student will submit this self-declaration. The declaration is either supported by the OHDG�PLGZLIH�IRU�HGXFDWLRQ��ZKRVH�QDPH�KDV�EHHQ�QRWL¿HG�WR�WKH�&RXQFLO�DQG�ZKR�LV�responsible for midwifery education in the relevant approved educational institution, or by her designated registered midwife substitute. Approved educational institutions must EH�DEOH�WR�SURYLGH�HYLGHQFH�RI�KDYLQJ�IXO¿OOHG�WKLV�UHTXLUHPHQW�

Guidance

:KHQ�FRQ¿UPLQJ�D�VWXGHQW¶V�GHFODUDWLRQ�RI�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�RQ�FRPSOHWLRQ�RI�WKH�SURJUDPPH��WKH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�PXVW�KDYH�NQRZOHGJH�RI�that student. She is accountable for her decision to sign the declaration.

Throughout the programme the NMC would expect that students develop their practice in accordance with The Code: Standards of conduct, performance and ethics for nurses and midwives.13

11�'LVDELOLW\�'LVFULPLQDWLRQ�$FW��7KH�6WDWLRQHU\�2I¿FH��1RUZLFK��ZZZ�KPVR�JRY�XN� 12�10&�JXLGDQFH��*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ� 13�7KH�&RGH��6WDQGDUGV�RI�FRQGXFW��SHUIRUPDQFH�DQG�HWKLFV�IRU�QXUVHV�DQG�PLGZLYHV�� 1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�Standard 5 – Interruptions to pre-registration midwifery education

programmes

15

If there are interruptions to a three-year full-time midwifery programme of education, the SURJUDPPH�PXVW�EH�FRPSOHWHG�ZLWKLQ�¿YH�\HDUV��HTXLYDOHQW�WR��ZHHNV�IXOO�WLPH��RI�the commencement date. Where the student attends part time, the programme must be completed within seven years of the commencement date.

If there are interruptions to an 18-month full-time midwifery programme of education, WKH�SURJUDPPH�PXVW�EH�FRPSOHWHG�ZLWKLQ�WZR�\HDUV�DQG�VL[�PRQWKV��HTXLYDOHQW�WR��ZHHNV�IXOO�WLPH��RI�WKH�FRPPHQFHPHQW�GDWH��:KHUH�D�VWXGHQW�DWWHQGV�SDUW�time, the programme must be completed within three years and six months of the commencement date. If the interruption is due to maternity leave, the programme must be completed within three years and six months of the commencement date.

When a student returns to a programme it is recommended they have a period of orientation appropriate to the length of interruption. Programme providers must ensure WKDW�WKH�VWXGHQW¶V�DFTXLUHG�NQRZOHGJH�DQG�VNLOOV�UHPDLQ�YDOLG��HQDEOLQJ�WKHP�WR�DFKLHYH�WKH�QHFHVVDU\�VWDQGDUGV�UHTXLUHG�RQ�FRPSOHWLRQ�RI�WKH�FRXUVH�

Guidance

For the purpose of this standard, interruption means any absence from a programme of education other than annual leave, statutory or public holidays.

6HH�DOVR�6WDQGDUG��±�/HQJWK�RI�SURJUDPPH�

Standard 6 – Admission with advanced standing

$OO�DSSOLFDQWV��RWKHU�WKDQ�WKRVH�UHJLVWHUHG�DV�D�QXUVH�OHYHO��DGXOW��PXVW�FRPSOHWH�D�minimum three years full-time pre-registration midwifery programme of education.

:KHUH�D�VWXGHQW�LV�DOUHDG\�UHJLVWHUHG�ZLWK�WKH�10&�DV�D�QXUVH�OHYHO��DGXOW��WKH�length of the pre-registration midwifery education programme shall be no less than ��PRQWKV�IXOO�WLPH��HTXLYDOHQW�WR��ZHHNV�IXOO�WLPH��

Guidance

Advanced standing is where a student enters a pre-registration programme as a result RI�SULRU�UHJLVWUDWLRQ�ZLWK�WKH�10&��WKXV�EHLQJ�DEOH�WR�XQGHUWDNH�D�VKRUWHQHG�SURJUDPPH��7KLV�VWDQGDUG�FRPSOLHV�ZLWK�'LUHFWLYH��(&�$UWLFOH��E��ZKHUH�DSSOLFDQWV�DUH�HQWLWOHG�WR�XQGHUWDNH�D�VKRUWHQHG�SURJUDPPH�E\�YLUWXH�RI�SUHYLRXV�UHJLVWUDWLRQ�DV�D�QXUVH�OHYHO��DGXOW��ZLWK�WKH�10&��$SSOLFDQWV�ZKR�DUH�UHJLVWHUHG�ZLWK�WKH�10&�DV�D�QXUVH�OHYHO��LQ�RWKHU�EUDQFKHV�RI�QXUVLQJ��PHQWDO�KHDOWK��OHDUQLQJ�GLVDELOLWLHV�RU�FKLOGUHQ��DUH�QRW�HQWLWOHG�WR�XQGHUWDNH�D�VKRUWHQHG�PLGZLIHU\�SURJUDPPH�

16

Standard 7 – Transfer between approved educational institutions

It is the responsibility of educational institutions to decide whether or not to accept an application for transfer. Students may transfer their programme with credit for prior learning only where:

�� they transfer from one NMC approved pre-registration midwifery programme to another

�� WKH�UHOHYDQW�10&�UHTXLUHPHQWV�IRU�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU�DUH�PHW

�� the student’s prior learning can be mapped against the programme they wish to transfer to, enabling them to go on to meet all necessary outcomes and standards on completion of the course.

Standard 8 – Stepping off and stepping on to pre-registration

midwifery education programmes

Students can ‘step off’ a pre-registration midwifery programme of education if they have:

�� completed a period of study successfully

�� WDNHQ�OHDYH�IURP�D�SURJUDPPH�EHIRUH�LWV�FRPSOHWLRQ

�� been awarded education and practice credits from the original programme provider �WKLV�ZRXOG�EH�DW�WKH�GLVFUHWLRQ�RI�WKH�DSSURYHG�HGXFDWLRQDO�LQVWLWXWLRQ��

and

�� have not been discontinued from the programme by the education provider.

Students can ‘step on’ to a pre-registration midwifery programme of education when:

�� WKH\�KDYH�PHW�WKH�UHTXLUHPHQWV�IRU�µVWHSSLQJ�RII¶

and

�� the pre-registration midwifery programme they wish to join is comparable, be it at the same or another NMC approved educational institution

�� they are able to complete the outstanding part of the pre-registration programme within the time frame set out by the NMC, the commencement date being the date the student started the original programme

�� WKH\�KDYH�PHW�WKH�10&¶V�UHTXLUHPHQWV�IRU�JRRG�KHDOWK�DQG�JRRG�FKDUDFWHU

�� VDWLVIDFWRU\�UHIHUHQFHV�KDYH�EHHQ�WDNHQ�XS�IURP�WKH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�DW�the original approved educational institution

�� D�SHULRG�RI�RULHQWDWLRQ�LV�XQGHUWDNHQ�E\�WKH�VWXGHQW�DSSURSULDWH�WR�WKH�SHULRG�EHWZHHQ�VWHSSLQJ�RII�DQG�VWHSSLQJ�EDFN�RQ��7KH�OHDG�PLGZLIH�IRU�HGXFDWLRQ�DW�WKH�new approved educational institution will determine the length of this in relation to the length of time between the leaving of and starting again on the programme.

17

Guidance

The terms ‘stepping on’ and ‘stepping off’ refer to student midwives who decide to discontinue their pre-registration midwifery programme of education and then wish to recommence their studies at a later date.

7KH�DPRXQW�RI�FUHGLW�WKDW�PD\�EH�WDNHQ�LQWR�DFFRXQW�LQ�UHODWLRQ�WR�VWXGHQWV�VWHSSLQJ�EDFN�RQ�WR�D�SUH�UHJLVWUDWLRQ�SURJUDPPH�LV�IRU�WKH�10&�DSSURYHG�HGXFDWLRQDO�LQVWLWXWLRQ�to determine.

This section describes standards for pre-registration midwifery education programmes, LQ�DFFRUGDQFH�ZLWK�$UWLFOH��D��RI�WKH�2UGHU�

Standards for the structure and nature of pre-registration

midwifery programmes

Standard 9 – Academic standard of programme

6LQFH�6HSWHPEHU��WKH�PLQLPXP�DFDGHPLF�OHYHO�IRU�HQWU\�WR�WKH�PLGZLYHV¶�SDUW�RI�the register for those entering pre-registration midwifery programmes is degree level �10&�&LUFXODU��

Guidance

Degree level is a minimum of:

�� 6FRWODQG�±��DFDGHPLF�FUHGLWV��RI�ZKLFK�PXVW�EH�DW�OHYHO��

�� (QJODQG��:DOHV�DQG�1RUWKHUQ�,UHODQG�±��DFDGHPLF�FUHGLWV��RI�ZKLFK�PXVW�EH�at level H.

Programme providers may determine higher academic levels where appropriate. This should be done in consultation with education commissioners.

Standard 10 – Length of programme

The length of a pre-registration midwifery programme of education should be no less WKDQ�WKUHH�\HDUV��HTXLYDOHQW�WR��ZHHNV�IXOO�WLPH��DQG�HDFK�\HDU�VKDOO�FRQWDLQ� ��SURJUDPPHG�ZHHNV��:KHUH�WKH�SURJUDPPH�LV�GHOLYHUHG�IXOO�WLPH�LW�PXVW�EH�FRPSOHWHG�LQ�QRW�PRUH�WKDQ�¿YH�\HDUV��LQFOXGLQJ�LQWHUUXSWLRQV��RU�ZKHUH�WKH�VWXGHQW�attends part time in not more than seven years. Where the student is already registered ZLWK�WKH�10&�DV�D�QXUVH�OHYHO��DGXOW��WKH�OHQJWK�RI�WKH�SUH�UHJLVWUDWLRQ�PLGZLIHU\�SURJUDPPH�RI�HGXFDWLRQ�VKDOO�QRW�EH�OHVV�WKDQ��PRQWKV��HTXLYDOHQW�WR��ZHHNV�IXOO�WLPH��RU�DQ�HTXLYDOHQW�SUR�UDWD�SDUW�WLPH�SHULRG�

Guidance

$�IXOO�WLPH�SURJUDPPH�FRQWDLQLQJ�D�PLQLPXP�RI��ZHHNV�RU��ZHHNV�LQFOXGHV�DQ\�annual leave as part of the programme. It would be for the programme provider and UHOHYDQW�FRPPLVVLRQHU�V��WR�GHWHUPLQH�ZKHWKHU�D�JUHDWHU�PLQLPXP�OHQJWK�ZDV�UHTXLUHG�to meet local needs.

�6HH�DOVR�6WDQGDUG��±�,QWHUUXSWLRQ�LQ�SUH�UHJLVWUDWLRQ�PLGZLIHU\�HGXFDWLRQ�SURJUDPPHV��

18

Standard 11 – Student support

Midwife teachers and midwife mentors must meet the NMC’s standards to support learning and assessment in practice.��

Guidance

Student midwives should be supported in both academic and practice learning HQYLURQPHQWV��0LGZLIH�WHDFKHUV�DQG�PLGZLIH�PHQWRUV�KDYH�WKH�NQRZOHGJH��VNLOOV�DQG�expertise to provide appropriate support to student midwives. As such they should be able to identify appropriate learning opportunities for student midwives and offer advice and guidance to develop safe woman-centred practice that enables students to become midwives.

7KH�10&�SXEOLFDWLRQ�6WDQGDUGV�WR�VXSSRUW�OHDUQLQJ�DQG�DVVHVVPHQW�LQ�SUDFWLFH�� explains that the NMC expects midwife teachers to be able to support learning and assessment in both academic and practice learning environments. There is also the expectation that midwife teachers will have contemporary experience in order to support OHDUQLQJ�DQG�DVVHVVPHQW�LQ�SUDFWLFH�VHWWLQJV��6XFK�H[SHULHQFH�PD\�WDNH�D�YDULHW\�RI�forms, including:

�� DFWLQJ�DV�D�OLQN�WXWRU

�� supporting mentor development and updating

�� having a part-time clinical role

�� supporting clinical staff in their professional development in practice

�� being involved in practice development to support the evidence base from which students draw

�� contributing to practice-based research

Teachers are therefore expected to spend a proportion of their time supporting student OHDUQLQJ�LQ�SUDFWLFH��DQG�WKLV�VKRXOG�UHSUHVHQW�DSSUR[LPDWHO\��SHU�FHQW�RI�WKHLU�QRUPDO�WHDFKLQJ�KRXUV��7KLV�ZRXOG�EH�PRQLWRUHG�WKURXJK�WKH�10&¶V�TXDOLW\�DVVXUDQFH�IUDPHZRUN�

A range of members of the teaching and healthcare team may contribute to students’ learning, but to enable the application of theory to practice, the majority of the WHDFKLQJ�DFDGHPLF�LQSXW�PXVW�EH�IURP�D�PLGZLIH�WHDFKHU��,QWHU�SURIHVVLRQDO�OHDUQLQJ�PXVW�EH�LQ�WKH�FRQWH[W�RI�LWV�UHOHYDQFH�WR�PLGZLIHU\�NQRZOHGJH�DQG�VNLOOV�DQG�PXVW�HQVXUH�WKH�(8�'LUHFWLYHV�DUH�PHW�LQ�WHUPV�RI�PLGZLIHU\�KRXUV�DQG�FRQWHQW�

Approved educational institutions must carry out regular audits of the learning environments that students are placed in. One of the outcomes of these audits will be to identify the number of students that an environment can support effectively, from both the number of midwife mentors available and the amount of normal pregnancy and birth experience available.

��6WDQGDUGV�WR�VXSSRUW�OHDUQLQJ�DQG�DVVHVVPHQW�LQ�SUDFWLFH��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�

19

Standard 12 – Balance between clinical practice and theory

6LQFH�6HSWHPEHU��WKH�SUDFWLFH�WR�WKHRU\�UDWLR�RI�HDFK�SURJUDPPH�LV�UHTXLUHG�WR�EH�QR�OHVV�WKDQ��SHU�FHQW�SUDFWLFH�DQG�QR�OHVV�WKDQ��SHU�FHQW�WKHRU\��7KH�FOLQLFDO�SUDFWLFH�H[SHULHQFH�PXVW�EH�VXI¿FLHQW�WR�HQDEOH�VWXGHQWV�WR�DFKLHYH�WKH�VWDQGDUGV�UHTXLUHG�E\�WKH�10&�

The programme must have a variety of learning and teaching strategies, which may include simulation. All of the clinical practice part of the programme must involve direct contact with the care of women and babies. The application of theory to midwifery SUDFWLFH�LQ�WKH�DFDGHPLF�OHDUQLQJ�HQYLURQPHQW�PXVW�EH�XQGHUWDNHQ�E\�D�PLGZLIH�WHDFKHU��7KLV�ZRXOG�QRW�H[FOXGH�PLGZLYHV�XQGHUWDNLQJ�WHDFKHU�SUHSDUDWLRQ�SURJUDPPHV�

Guidance

$�PLQLPXP�RI��SHU�FHQW�RI�WKH�DYDLODEOH�FXUULFXOXP�KRXUV�PXVW�EH�VSHQW�LQ�FOLQLFDO�SUDFWLFH��7KLV�WDNHV�LQWR�DFFRXQW�WKH�YDULDEOH�KRXUV�SHU�ZRUNLQJ�ZHHN�WKDW�DSSURYHG�educational institutions apply to the programme.

Clinical practice is that part of the midwifery programme of education where the student midwife is under the direct or indirect supervision of a midwife when providing care to women and babies. The student is in direct contact with women and babies, planning, providing and assessing the need for and extent of midwifery care on the basis of their DFTXLUHG�NQRZOHGJH�DQG�VNLOOV�

Direct supervision is where the practising midwife would normally be in close proximity WR�WKH�VWXGHQW��HLWKHU�E\�ZRUNLQJ�GLUHFWO\�ZLWK�WKHP�RU�FORVH�HQRXJK�WR�GLUHFWO\�PRQLWRU�WKHLU�DFWLYLWLHV��:KHUHDV�LQGLUHFW�VXSHUYLVLRQ�HQDEOHV�VWXGHQWV�WR�GHYHORS�FRQ¿GHQFH�DQG�LQGHSHQGHQFH��WKLV�DSSURDFK�VKRXOG�RQO\�EH�WDNHQ�WR�VXSSRUW�VWXGHQWV�ZKR�DUH�more senior and where there is evidence that complex activities can be safely and UHVSRQVLEO\�GHOHJDWHG��(YHQ�VR��LQGLUHFW�VXSHUYLVLRQ�UHTXLUHV�WKDW�WKH�PLGZLIH�LV�HDVLO\�contactable and can provide the level of support needed to ensure public protection and maintain the safety of both the women and the student.

Standard 13 – Scope of practice experience

Where the opportunity is available, students should be involved in supporting women birthing in a variety of settings.

Student midwives must be involved in the care of a small group of women throughout their childbirth experience, including antenatal, intrapartum and postnatal care. The VNLOOV�UHTXLUHG�IRU�WDNLQJ�RQ�WKH�UROH�RI�OHDG�FDUHU�IRU�ZRPHQ�ZLWK�FRPSOH[�PHGLFDO�DQG�or obstetric needs is developmental and competence is to be achieved after initial registration.

Guidance

Women experience normal childbirth in a variety of settings. Students should gain experience of supporting women birthing in settings other than acute maternity units, such as at home, at birth centres and at midwife-led units. In exceptional circumstances, it is accepted that this may not be possible. However, the NMC would expect all opportunities to be utilised to support students in obtaining a breadth of experience.

��

Clinical practice should provide students with the opportunity to experience ��KRXU�VHYHQ�GD\�FDUH��HQDEOLQJ�WKHP�WR�GHYHORS�DQ�XQGHUVWDQGLQJ�RI�WKH�QHHGV�DQG�H[SHULHQFHV�RI�ZRPHQ�DQG�EDELHV�WKURXJKRXW�D��KRXU�SHULRG�

Whilst it is essential that students are able to access a full range of practice experiences to achieve the necessary standards, it is for the midwife to decide whether delegation RI�WDVNV�LV�DSSURSULDWH�LQ�WKH�FDUH�RI�D�ZRPDQ�RU�KHU�EDE\��7KH�PLGZLIH�UHPDLQV�accountable for the appropriateness of any delegation of care.

The primary focus of pre-registration midwifery programmes is to ensure that students are safe and effective in practice when supporting women experiencing normal FKLOGELUWK��7KH�SURJUDPPH�PXVW�GHYHORS�WKH�NQRZOHGJH�DQG�VNLOOV�RI�VWXGHQW�PLGZLYHV��VR�WKDW�DW�WKH�SRLQW�RI�UHJLVWUDWLRQ�WKH\�DUH�FRPSHWHQW�DQG�FRQ¿GHQW�LQ�VXSSRUWLQJ�ZRPHQ�LQ�QRUPDO�FKLOGELUWK��,QFOXGHG�LQ�WKLV�IRFXV�PXVW�EH�VNLOOV�LQ�FULWLFDO� GHFLVLRQ�PDNLQJ�WR�VXSSRUW�DSSURSULDWH�UHIHUUDO�WR�RWKHU�KHDOWK�SURIHVVLRQDOV�RU�agencies when there is recognition of normal processes being adversely affected and FRPSURPLVHG��0LGZLYHV�PXVW�NQRZ�ZKHQ�LW�LV�QHFHVVDU\�WR�UHIHU�ZRPHQ�RU�WKHLU�EDELHV�to other health professionals, such as obstetricians or paediatricians, to ensure they UHFHLYH�WKH�DSSURSULDWH�FDUH��:KHQ�ZRPHQ�UHTXLUH�UHIHUUDO��PLGZLYHV�PXVW�DOVR�EH�VNLOOHG�LQ�ZRUNLQJ�DV�SDUW�RI�DQ�LQWHU�SURIHVVLRQDO�PXOWL�DJHQF\�WHDP��&RPSHWHQFH�LQ�WKH�role of lead midwife carer for women with complex medical or obstetric needs is to be achieved after initial registration.

7KH�VWXGHQW�PLGZLIH�LV�ZRUNLQJ�WRZDUGV�DXWRQRPRXV�SUDFWLFH�DW�WKH�SRLQW�RI�UHJLVWUDWLRQ��6KH�VKRXOG�EH�DVVLVWHG�WR�GHYHORS�WKH�VNLOOV�QHHGHG�WR�ZRUN�DV�DQ�HIIHFWLYH�PHPEHU� RI�DQ�LQWHUSURIHVVLRQDO�PXOWL�DJHQF\�WHDP�LQ�ZKLFK�VKH�ZLOO�SURYLGH�WKH�OHDG�IRU�midwifery care.

Students must provide care and support to a group of women from early in their pregnancy, throughout the antenatal period, during the labour and birth and then into WKH�SRVWQDWDO�SHULRG�XQWLO�FDUH�E\�WKH�PLGZLIH�LV�FRPSOHWH��7KLV�PD\�WDNH�WKH�IRUP�RI�caseload holding. Providing this experience to all student midwives enables them to better understand the impact of pregnancy, birth and the integration of a new baby into family life, as well as learning about the practicalities of planning, implementing and evaluating midwifery care in a way that is relevant to women.

Standard 14 – Supernumerary status during clinical placement

6WXGHQWV�XQGHUWDNLQJ�SUH�UHJLVWUDWLRQ�PLGZLIHU\�HGXFDWLRQ�SURJUDPPHV�FDQQRW�EH�employed to provide midwifery care during their training – all clinical experience should be education-led with students having supernumerary status for the duration.

Standard 15 – Assessment strategy

Clinical practice must be graded and be counted as part of the academic award.

$OO�RXWFRPHV�ZLWKLQ�D�SURJUHVVLRQ�SRLQW�SHULRG��IRU�H[DPSOH�DQ�DFDGHPLF�\HDU��KDYH�WR�EH�DFKLHYHG�DQG�FRQ¿UPHG�ZLWKLQ��ZHHNV�RI�HQWHULQJ�WKH�QH[W�DFDGHPLF�OHYHO��$OO�assessments must be completed and have been passed prior to successful completion RI�WKH�SURJUDPPH��7KLV�LV�GHVLJQHG�WR�FRQ¿UP�WKDW�WKH�VWXGHQW�KDV�WKH�WKHRUHWLFDO�NQRZOHGJH��SUDFWLFDO�VNLOOV�DQG�DWWLWXGH�WR�DFKLHYH�WKH�VWDQGDUGV�UHTXLUHG�IRU�HQWU\�WR�WKH�midwives’ part of the register.

21

A student midwife shall achieve these standards under the supervision of a sign-off PHQWRU��ZKRVH�UROH�LW�ZLOO�EH�WR�FRQ¿UP�ZKHQ�WKH�VDLG�VWDQGDUGV�KDYH�EHHQ�PHW��7KH�sign-off mentor must be a practising midwife.

Guidance

7KH�OHDUQLQJ�VWXGHQWV�XQGHUWDNH�LQ�SUH�UHJLVWUDWLRQ�PLGZLIHU\�HGXFDWLRQ�SURJUDPPHV�occurs in the university and in clinical practice. Assessment of practice, which is direct hands-on care, must be graded. The grades achieved must contribute to the outcome RI�WKH�¿QDO�DFDGHPLF�DZDUG��,I�WKH�DVVHVVPHQW�RI�FOLQLFDO�SUDFWLFH�LQYROYHV�D�YDULHW\�RI�components and the student fails to achieve competence in one of the components, then the student must fail.

1HZ�SURJUDPPHV�DSSURYHG�VLQFH��6HSWHPEHU��PXVW�EH�FRPSOLDQW�ZLWK�WKH�VWDQGDUGV�WR�JUDGH�SUDFWLFH��$OO�SURJUDPPHV�DSSURYHG�SULRU�WR�6HSWHPEHU��PXVW�EH�FRPSOLDQW�ZLWK�WKH�VWDQGDUG�E\��6HSWHPEHU��

$�SURJUHVVLRQ�SRLQW�LV�GH¿QHG�DV�µD�SRLQW��RU�SRLQWV��HVWDEOLVKHG�IRU�WKH�SXUSRVH�RI�PDNLQJ�VXPPDWLYH�MXGJPHQWV�DERXW�VDIH�DQG�HIIHFWLYH�SUDFWLFH�LQ�D�SURJUDPPH¶��7KH��ZHHN�WLPH�OLPLW�LQFOXGHV�ERWK�WKHRU\�DQG�SUDFWLFH��,W�DSSOLHV�HTXDOO\�WR�IXOO��DQG� SDUW�WLPH�SURJUDPPHV�DQG�SUH�UHJLVWUDWLRQ�VKRUW�DQG�ORQJ�SURJUDPPHV��7KH��ZHHN�SHULRG�DOVR�LQFOXGHV�KROLGD\V��1R�H[WHQVLRQV�WR�WKH��ZHHN�SHULRG�DUH�SHUPLWWHG�

$�UDQJH�RI�DVVHVVPHQW�VWUDWHJLHV�VKRXOG�EH�XVHG�WR�DVVHVV�PLGZLIHU\�NQRZOHGJH��SUDFWLFDO�VNLOOV�DQG�DWWLWXGH��7KLV�VKRXOG�LQFOXGH�DW�OHDVW�RQH�XQVHHQ�H[DPLQDWLRQ��$Q�H[DPLQDWLRQ�LV�GH¿QHG�DV�DQ�XQVHHQ�SLHFH�RI�ZRUN�FRPSOHWHG�XQGHU�VXSHUYLVHG�FRQGLWLRQV�WKDW�WHVWV�WKH�VWXGHQW¶V�WKHRUHWLFDO�NQRZOHGJH��SUDFWLFDO�VNLOOV�DQG�DWWLWXGH��7KH�IRUP�PD\�YDU\��IRU�H[DPSOH�IRU�VWXGHQWV�ZLWK�VSHFL¿F�OHDUQLQJ�QHHGV�VXFK�DV�dyslexia, or to meet subject needs, eg through the use of objective structured clinical examinations.

Both midwife teachers and midwife mentors shall be involved in assessing the student’s ability to enter the midwives’ part of the register. Although other members of the teaching and health team may contribute to the assessment of student midwives’ theory DQG�SUDFWLFH��WKH\�VKRXOG�QRW�XQGHUWDNH�VXPPDWLYH�DVVHVVPHQWV�RI�WKH�VWDQGDUGV�UHTXLUHG�IRU�HQWU\�WR�WKH�PLGZLYHV¶�SDUW�RI�WKH�UHJLVWHU��7KH�SULQFLSOHV�RI�GXH�UHJDUG�must be adhered to. The challenges of applying due regard to learning and assessment LQ�SUDFWLFH�IRU�VWXGHQW�PLGZLYHV��DQG�ZD\V�LQ�ZKLFK�WKLV�FDQ�EH�DSSOLHG�PRUH�ÀH[LEO\�without compromising the assessment of student competence, are the subject of 10&�&LUFXODU��ZKLFK�FDQ�EH�YLHZHG�RQ�WKH�10&�ZHEVLWH�

A student who is unsuccessful in passing all elements of the assessment strategy approved by the NMC, including the agreed processes for re-testing, will not be eligible to register as a midwife at the end of the programme.

22

Standard 16 – Ongoing record of achievement

An ongoing record of achievement, including comments from mentors, must be passed from one placement to the next to enable judgments to be made on the student’s progress.

Guidance

The ongoing record of achievement forms part of the Assessment of Practice document DQG�QHHGV�WR�EH�VXI¿FLHQWO\�GHWDLOHG�WR�HQDEOH�WKH�PLGZLIH�VLJQ�RII�PHQWRUV�WR�FRQ¿UP�WKDW�D�VWXGHQW�LV�SUR¿FLHQW�DW�GHVLJQDWHG�SRLQWV�LQ�WKH�SURJUDPPH��$OO�DFWLRQV�PXVW�EH�WDNHQ�ZLWK�WKH�IXOO�NQRZOHGJH�RI�WKH�VWXGHQW��0HQWRUV�VKRXOG�QRW�NHHS�WKHLU�own separate student progress records; everything should be contained within the Assessment of Practice document.

Education providers must ensure that:

�� WKH\�REWDLQ�WKH�VWXGHQW¶V�FRQVHQW�WR�WKH�SURFHVVLQJ�RU�VKDULQJ�RI�FRQ¿GHQWLDO�GDWD�between successive mentors and with relevant education providers in the process RI�DVVHVVLQJ�¿WQHVV�IRU�SUDFWLFH

�� robust processes are in place to ensure that where there are issues or concerns about a student’s progress these are promptly and appropriately dealt with

�� where there are serious concerns about a student’s health or character, these should be reported promptly using established university procedures

�� students are actively supported in addressing issues and concerns through a well GH¿QHG�DQG�WLPH�OLPLWHG�GHYHORSPHQW�SODQ��HLWKHU�ZLWKLQ�D�SODFHPHQW�RU�DFURVV�successive placements

�� disabled students are appropriately assessed and supported in addressing the UHTXLUHPHQWV�RI�DQ\�GHYHORSPHQW�SODQ�

6HH�DOVR�*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQ�LQVWLWXWLRQV��15

15�10&�JXLGDQFH��*RRG�KHDOWK�DQG�JRRG�FKDUDFWHU��JXLGDQFH�IRU�HGXFDWLRQDO�LQVWLWXWLRQV��1XUVLQJ�DQG�0LGZLIHU\�&RXQFLO��/RQGRQ��ZZZ�QPF�XN�RUJ�

23

Achieving the NMC standards

6WXGHQWV�QHHG�WR�EH�SUR¿FLHQW�LQ�DOO�VWDQGDUGV�E\�WKH�HQG�RI�WKHLU�WUDLQLQJ�LQ�RUGHU�WR�practise safely and effectively as a midwife without the need for direct supervision. A student must demonstrate competence in these standards to enter the register as a midwife. Each of the following statements is followed by some examples of outcomes that must go towards the achievement of these standards. The examples used are not an exhaustive list.

Standard 17 – Competencies required to achieve the NMC standards

These are divided into four domains:

�� effective midwifery practice

�� professional and ethical practice

�� developing the individual midwife and others

�� DFKLHYLQJ�TXDOLW\�FDUH�WKURXJK�HYDOXDWLRQ�DQG�UHVHDUFK�

Each category under these headings should be read in conjunction with the relevant (VVHQWLDO�6NLOOV�&OXVWHUV��(6&V��DV�OLVWHG��7KH�(6&V�WKHPVHOYHV�IROORZ�WKLV�VHFWLRQ��beginning on page 36.

Domain: Effective midwifery practice

Communicate effectively with women and their families throughout the pre-conception, antenatal, intrapartum and postnatal periods. Communication will include:

�� listening to women and helping them to identify their feelings and anxieties about their pregnancies, the birth and the related changes to themselves and their lives

�� HQDEOLQJ�ZRPHQ�WR�WKLQN�WKURXJK�WKHLU�IHHOLQJV

�� HQDEOLQJ�ZRPHQ�WR�PDNH�LQIRUPHG�FKRLFHV�DERXW�WKHLU�KHDOWK�DQG�KHDOWK�FDUH

�� DFWLYHO\�HQFRXUDJLQJ�ZRPHQ�WR�WKLQN�DERXW�WKHLU�RZQ�KHDOWK�DQG�WKH�KHDOWK�RI�WKHLU�babies and families, and how this can be improved

�� communicating with women throughout their pregnancy, labour and the period following birth.

ESC – Communication, Initial consultation between the woman and the midwife,

Normal labour and birth, Initiation and continuance of breastfeeding, Medicines

management

��

Diagnose pregnancy and assess and monitor women holistically throughout the pre-conception, antenatal, intrapartum and postnatal period using a range of assessment methods and reaching valid, reliable and comprehensive conclusions. The different assessment methods will include:

�� KLVWRU\�WDNLQJ

�� observation

�� physical examination

�� biophysical tests

�� social, cultural and emotional assessments.


Normal labour and birth, Initiation and continuance of breastfeeding

Determine and provide programmes of care and support for women which:

�� are appropriate to the needs, contexts, culture and choices of women, babies and their families

�� are made in partnership with women

�� are ethical

�� are based on best evidence and clinical judgment

�� involve other healthcare professionals when this will improve health outcomes.

This will include consideration of:

�� plans for birth

�� place of birth

�� plans for feeding babies

�� needs for postnatal support

�� preparation for parenthood needs.



management

25

Provide seamless care and, where appropriate, interventions, in partnership with women and other care providers during the antenatal period which:

�� are appropriate for women’s assessed needs, context and culture

�� promote their continuing health and wellbeing

�� are evidence based

�� DUH�FRQVLVWHQW�ZLWK�WKH�PDQDJHPHQW�RI�ULVN

�� GUDZ�XSRQ�WKH�VNLOOV�RI�RWKHUV�WR�RSWLPLVH�KHDOWK�RXWFRPHV�DQG�UHVRXUFH�XVH�

These will include:

�� acting as lead carer in normal pregnancies

�� FRQWULEXWLQJ�WR�SURYLGLQJ�VXSSRUW�WR�ZRPHQ�ZKHQ�WKHLU�SUHJQDQFLHV�DUH�LQ�GLI¿FXOW\��VXFK�DV�ZRPHQ�ZKR�ZLOO�QHHG�RSHUDWLYH�RU�DVVLVWHG�GHOLYHU\�

�� providing care for women who have suffered pregnancy loss

�� GLVFXVVLRQ�QHJRWLDWLRQ�ZLWK�RWKHU�SURIHVVLRQDOV�DERXW�IXUWKHU�LQWHUYHQWLRQV�ZKLFK�are appropriate for individual women, considering their wishes, context and culture

�� HQVXULQJ�WKDW�FXUUHQW�UHVHDUFK�¿QGLQJV�DQG�RWKHU�HYLGHQFH�DUH�LQFRUSRUDWHG�LQWR�practice

�� WHDP�ZRUNLQJ�LQ�WKH�EHVW�LQWHUHVWV�RI�LQGLYLGXDO�ZRPHQ�


Medicines management

26

5HIHU�ZRPHQ�ZKR�ZRXOG�EHQH¿W�IURP�WKH�VNLOOV�DQG�NQRZOHGJH�RI�RWKHU�LQGLYLGXDOV�

�� WR�DQ�LQGLYLGXDO�ZKR�LV�OLNHO\�WR�KDYH�WKH�UHTXLVLWH�VNLOOV�DQG�H[SHULHQFH�WR�DVVLVW

�� at the earliest possible time

�� supported by accurate, legible and complete information which contains the UHDVRQLQJ�EHKLQG�PDNLQJ�WKH�UHIHUUDO�DQG�GHVFULEHV�WKH�ZRPDQ¶V�QHHGV�DQG�preferences.

5HIHUUDOV�PLJKW�UHODWH�WR�

�� women’s choices

�� health issues

�� social issues

�� ¿QDQFLDO�LVVXHV

�� psychological issues

�� child protection matters

�� the law.



Care for, monitor and support women during labour and monitor the condition of the fetus, supporting spontaneous births. This will include:

�� communicating with women throughout and supporting them through the experience

�� ensuring that the care is sensitive to individual women’s culture and preferences

�� using appropriate clinical and technical means to monitor the condition of mother and fetus

�� providing appropriate pain management.

�� providing appropriate care to women once they have given birth.

ESC – Communication, Normal labour and birth, Medicines management

27

8QGHUWDNH�DSSURSULDWH�HPHUJHQF\�SURFHGXUHV�WR�PHHW�WKH�KHDOWK�QHHGV�RI�ZRPHQ�and babies. Emergency procedures will include:

�� manual removal of the placenta

�� manual examination of the uterus

�� managing post-partum haemorrhage

�� UHVXVFLWDWLRQ�RI�PRWKHU�DQG�RU�EDE\

�� undiagnosed breech.


Examine and care for babies immediately following birth. This will include:

�� FRQ¿UPLQJ�WKHLU�YLWDO�VLJQV�DQG�WDNLQJ�DSSURSULDWH�DFWLRQ

�� carrying out a full assessment and physical examination.


28

:RUN�LQ�SDUWQHUVKLS�ZLWK�ZRPHQ�DQG�RWKHU�FDUH�SURYLGHUV�GXULQJ�WKH�SRVWQDWDO�SHULRG�to provide seamless care and interventions which:

�� are appropriate to the woman’s assessed needs, context and culture

�� promote her continuing health and wellbeing

�� are evidence based

�� DUH�FRQVLVWHQW�ZLWK�WKH�PDQDJHPHQW�RI�ULVN

�� DUH�XQGHUWDNHQ�E\�WKH�PLGZLIH�EHFDXVH�VKH�LV�WKH�SHUVRQ�EHVW�SODFHG�WR�GR�WKHP�and is competent to act

�� GUDZ�RQ�WKH�VNLOOV�RI�RWKHUV�WR�RSWLPLVH�KHDOWK�RXWFRPHV�DQG�UHVRXUFH�XVH�

Care will include:

�� providing support and advice to women as they start to feed and care for the baby

�� providing any particular support which is needed to women who have disabilities

�� providing post-operative care for women who have had Caesarean and operative deliveries

�� providing pain relief to women

�� WHDP�ZRUNLQJ�LQ�WKH�EHVW�LQWHUHVWV�RI�ZRPHQ�DQG�WKHLU�EDELHV

�� facilitating discussion about future reproductive choices

�� providing care for women who have suffered pregnancy loss, stillbirth or neonatal death.

ESC – Communication, Normal labour and birth, Initiation and continuance of

breastfeeding, Medicines management

([DPLQH�DQG�FDUH�IRU�EDELHV�ZLWK�VSHFL¿F�KHDOWK�RU�VRFLDO�QHHGV�DQG�UHIHU�WR�RWKHU�professionals or agencies as appropriate. These needs will include:

�� child protection

�� congenital disorders

�� birth defects

�� low birth weight

�� SDWKRORJLFDO�FRQGLWLRQV��VXFK�DV�EDELHV�ZLWK�YHUWLFDO�WUDQVPLVVLRQ�RI�+,9�DQG�GUXJ�DIIHFWHG�EDELHV��


breastfeeding

29

Care for and monitor women during the puerperium, offering the necessary evidence-based advice and support regarding the baby and self-care. This will include:

�� providing advice and support on feeding babies and teaching women about the importance of nutrition in child development

�� providing advice and support on hygiene, safety, protection, security and child development

�� enabling women to address issues about their own, their babies’ and their families’ health and social wellbeing

�� monitoring and supporting women who have postnatal depression or other mental illnesses

�� providing advice on bladder control

�� advising women on recuperation

�� providing advice on contraception

�� VXSSRUWLQJ�ZRPHQ�WR�FDUH�IRU�LOO�SUH�WHUP�EDELHV�RU�WKRVH�ZLWK�GLVDELOLWLHV�

ESC – Communication, Initiation and continuance of breastfeeding, Medicines

management

6HOHFW��DFTXLUH�DQG�DGPLQLVWHU�VDIHO\�D�UDQJH�RI�SHUPLWWHG�GUXJV�FRQVLVWHQW�ZLWK�OHJLVODWLRQ��DSSO\LQJ�NQRZOHGJH�DQG�VNLOOV�WR�WKH�VLWXDWLRQ�ZKLFK�SHUWDLQV�DW�WKH�WLPH��Methods of administration will include:

�� oral

�� intravenous

�� intramuscular

�� topical

�� inhalation.


breastfeeding, Medicines Management

��

Complete, store and retain records of practice which:

�� are accurate, legible and continuous

�� GHWDLO�WKH�UHDVRQLQJ�EHKLQG�DQ\�DFWLRQV�WDNHQ

�� contain the information necessary for the record’s purpose.

5HFRUGV�ZLOO�LQFOXGH�

�� biographical details of women and babies

�� DVVHVVPHQWV�PDGH��RXWFRPHV�RI�DVVHVVPHQWV�DQG�DFWLRQ�WDNHQ�DV�D�UHVXOW

�� outcomes of discussions with women and advice offered

�� any drugs administered

�� action plans and commentary on their evaluation.



management

Monitor and evaluate the effectiveness of programmes of care and modify them to improve the outcomes for women, babies and their families. This will include:

�� FRQVLGHUDWLRQ�RI�WKH�HIIHFWLYHQHVV�RI�WKH�DERYH�DQG�PDNLQJ�WKH�QHFHVVDU\�PRGL¿FDWLRQV�WR�LPSURYH�RXWFRPHV�IRU�ZRPHQ�DQG�WKHLU�EDELHV�


breastfeeding, Medicines Management

Contribute to enhancing the health and social wellbeing of individuals and their communities. This will include:

�� planning and offering midwifery care within the context of public health policies

�� contributing midwifery expertise and information to local health strategies

�� identifying and targeting care for groups with particular health and maternity needs and maintaining communication with appropriate agencies

�� involving users and local communities in service development and improvement

�� informing practice using the best evidence which is shown to prevent and reduce maternal and perinatal morbidity and mortality

�� utilising a range of effective, appropriate and sensitive programmes to improve sexual and reproductive health.


Initiation and continuance of breastfeeding

31

Domain: Professional and ethical practice

Practise in accordance with The Code: Standards of conduct, performance and ethics IRU�QXUVHV�DQG�PLGZLYHV��10&��16 within the limitations of the individual’s own FRPSHWHQFH��NQRZOHGJH�DQG�VSKHUH�RI�SURIHVVLRQDO�SUDFWLFH��FRQVLVWHQW�ZLWK�WKH�legislation relating to midwifery practice. This will include:

�� using professional standards of practice to self-assess performance

�� FRQVXOWLQJ�ZLWK�WKH�PRVW�DSSURSULDWH�SURIHVVLRQDO�FROOHDJXHV�ZKHQ�FDUH�UHTXLUHV�expertise beyond the midwife’s current competence

�� consulting other health care professionals when the woman’s and baby’s needs fall outside the scope of midwifery practice

�� identifying unsafe practice and responding appropriately.



management

Practise in a way which respects, promotes and supports individuals’ rights, interests, preferences, beliefs and cultures. This will include:

�� offering culturally sensitive family planning advice �� ensuring that women’s labour is consistent with their religious and cultural beliefs

and preferences

�� WKH�GLIIHUHQW�UROHV�DQG�UHODWLRQVKLSV�LQ�IDPLOLHV��DQG�UHÀHFWLQJ�GLIIHUHQW�UHOLJLRXV�and cultural beliefs, preferences and experiences.



management

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32

Practise in accordance with relevant legislation. This will include:

�� SUDFWLVLQJ�ZLWKLQ�WKH�FRQWHPSRUDU\�OHJDO�IUDPHZRUN�RI�PLGZLIHU\

�� GHPRQVWUDWLQJ�NQRZOHGJH�RI�OHJLVODWLRQ�UHODWLQJ�WR�KXPDQ�ULJKWV��HTXDO�RSSRUWXQLWLHV��HTXDOLW\�DQG�GLYHUVLW\��DQG�DFFHVV�WR�FOLHQW�UHFRUGV

�� GHPRQVWUDWLQJ�NQRZOHGJH�RI�OHJLVODWLRQ�UHODWLQJ�WR�KHDOWK�DQG�VRFLDO�SROLF\�UHOHYDQW�to midwifery practice

�� GHPRQVWUDWLQJ�NQRZOHGJH�RI�FRQWHPSRUDU\�HWKLFDO�LVVXHV�DQG�WKHLU�LPSDFW�RQ�midwifery practice

�� managing the complexities arising from ethical and legal dilemmas.



management

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�� HQVXULQJ�WKH�FRQ¿GHQWLDOLW\�DQG�VHFXULW\�RI�ZULWWHQ�DQG�YHUEDO�LQIRUPDWLRQ�DFTXLUHG�in a professional capacity

�� disclosing information about individuals and organisations only to those who have D�ULJKW�DQG�QHHG�WR�NQRZ�WKLV�LQIRUPDWLRQ��DQG�RQO\�RQFH�SURRI�RI�LGHQWLW\�DQG�ULJKW�to disclosure has been obtained.



management

33

:RUN�FROODERUDWLYHO\�ZLWK�WKH�ZLGHU�KHDOWKFDUH�WHDP�DQG�DJHQFLHV�LQ�ZD\V�ZKLFK�

�� value their contribution to health and care

�� enable them to participate effectively in the care of women, babies and their families

�� DFNQRZOHGJH�WKH�QDWXUH�RI�WKHLU�ZRUN�DQG�WKH�FRQWH[W�LQ�ZKLFK�LW�LV�SODFHG�

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�� health care

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�� advice, guidance and counselling

�� child protection

�� the law.



Manage and prioritise competing demands. This will include:

�� deciding who is best placed and best able to provide particular interventions to women, babies and their families

�� DOHUWLQJ�PDQDJHUV�WR�GLI¿FXOWLHV�DQG�LVVXHV�LQ�VHUYLFH�GHOLYHU\�



Support the creation and maintenance of environments that promote the health, safety and wellbeing of women, babies and others. This will include:

�� preventing and controlling infection

�� promoting health, safety and security in the environment in which the midwife LV�ZRUNLQJ��ZKHWKHU�LW�EH�DW�D�ZRPDQ¶V�KRPH��LQ�WKH�FRPPXQLW\��D�FOLQLF��RU�LQ�D�hospital.



management

��

&RQWULEXWH�WR�WKH�GHYHORSPHQW�DQG�HYDOXDWLRQ�RI�JXLGHOLQHV�DQG�SROLFLHV�DQG�PDNH�recommendations for change in the interests of women, babies and their families. Evaluating policies will include:

�� consideration of best available evidence

�� SURYLGLQJ�IHHGEDFN�WR�PDQDJHUV�RQ�VHUYLFH�SROLFLHV

�� representing the midwife’s own considered views and experiences within the context of broader health and social care policies in the interests of women, babies and their families.

ESC – Communication

Domain: Developing the individual midwife and others

5HYLHZ��GHYHORS�DQG�HQKDQFH�WKH�PLGZLIH¶V�RZQ�NQRZOHGJH��VNLOOV�DQG�¿WQHVV�WR�practise. This will include:

�� PDNLQJ�HIIHFWLYH�XVH�RI�WKH�IUDPHZRUN�IRU�WKH�VWDWXWRU\�VXSHUYLVLRQ�RI�PLGZLYHV

�� meeting the NMC ’s continuing professional development and practice standards

�� UHÀHFWLQJ�RQ�WKH�PLGZLIH¶V�RZQ�SUDFWLFH�DQG�PDNLQJ�WKH�QHFHVVDU\�FKDQJHV�DV�D�result

�� attending conferences, presentations and other learning events.


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�� effective collaboration and communication

�� VKDULQJ�VNLOOV

�� multi-professional standard-setting and audit.



35

Domain: Achieving quality care through evaluation and research

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�� FULWLFDO�DSSUDLVDO�RI�NQRZOHGJH�DQG�UHVHDUFK�HYLGHQFH

�� critical appraisal of the midwife’s own practice

�� JDLQLQJ�IHHGEDFN�IURP�ZRPHQ�DQG�WKHLU�IDPLOLHV�DQG�DSSURSULDWHO\�DSSO\LQJ�WKLV�WR�practice

�� disseminating critically appraised good practice.


Inform and develop the midwife’s own practice and the practice of others through XVLQJ�WKH�EHVW�DYDLODEOH�HYLGHQFH�DQG�UHÀHFWLQJ�RQ�SUDFWLFH��7KLV�ZLOO�LQFOXGH�

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�� applying evidence to practice

�� alerting others to new evidence for them to apply to their own practice.


0DQDJH�DQG�GHYHORS�FDUH�XWLOLVLQJ�WKH�PRVW�DSSURSULDWH�LQIRUPDWLRQ�WHFKQRORJ\��,7��systems. This will include:

�� recording practice in consistent formats on IT systems for wider-scale analysis

�� using analysis of data from IT systems and applying this to practice

�� evaluating practice based on data analysis.



Contribute to the audit of practice in order to optimise the care of women, babies and their families. This will include:

�� auditing the individual’s own practice

�� contributing to the audit of team practice.


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om

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d

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ticip

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ater

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ld

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inue

s to

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car

e to

wom

en

unde

rgoi

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ompl

icat

ions

��

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rm

al la

bo

ur a

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th

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men

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st/

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ect

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ly r

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iste

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mid

wif

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o:


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Fo

r e

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eg

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6. S

up

po

rt

wo

men

an

d

their

partn

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th

e b

irth

of

their

bab

ies.

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choi

ces

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ted

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en o

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ir pr

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ss

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birth

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l and

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eing

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esse

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cura

tely

the

prog

ress

of l

abou

r an

d sh

ares

this

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rmat

ion

with

wom

en,

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the

abili

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cuss

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furth

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Pre

pare

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en s

ensi

tivel

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at

tent

ive

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e ‘m

omen

t of b

irth’

, cre

atin

g an

env

ironm

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hat i

s re

spon

sive

to th

e w

oman

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eeds

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ports

wom

en s

afel

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the

birth

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heir

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such

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tim

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rral

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en

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ompl

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51

No

rm

al la

bo

ur a

nd

bir

th

Wo

men

can

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st/

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ect

a n

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ly r

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iste

red

mid

wif

e t

o:


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Fo

r e

ntr

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o t

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iste

r

Ass

ess

and

mon

itor t

he w

oman

’s c

ondi

tion

thro

ugho

ut th

e th

ird s

tage

of l

abou

r fa

cilit

atin

g sa

fe d

eliv

ery

of th

e pl

acen

ta

and

mem

bran

es b

y ph

ysio

logi

cal o

r act

ive

man

agem

ent

7. F

acilit

ate

th

e m

oth

er

an

d b

ab

y t

o r

em

ain

tog

eth

er.

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ists

in a

sses

sing

the

wel

lbei

ng o

f the

ba

by

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ports

feed

ing

whe

n th

e ba

by is

read

y,

mon

itorin

g cl

ose

prox

imity

of t

he m

othe

r to

the

baby

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ays

any

unne

cess

ary

sepa

ratio

n of

m

othe

r and

bab

y, a

void

ing

early

rout

ine

proc

edur

es s

uch

as w

eigh

ing

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esse

s ac

cura

tely

the

heal

th a

nd

wel

lbei

ng o

f the

new

born

bab

y

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In a

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tura

lly s

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tive

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ner,

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tes

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nviro

nmen

t tha

t is

prot

ectiv

e of

the

mat

erna

l inf

ant a

ttach

men

t pro

cess

, su

ch a

s m

inim

al h

andl

ing

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e ba

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over

ing

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en

tify

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afe

ly

man

ag

e a

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ro

pria

te

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erg

en

cy

pro

ced

ures.

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rela

ted

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resu

scita

tion

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call

proc

edur

es re

leva

nt to

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l pol

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ates

em

erge

ncy

mea

sure

s in

bot

h pr

imar

y an

d se

cond

ary

care

set

tings

Sus

tain

s em

erge

ncy

mea

sure

s un

til h

elp

arriv

es

52

No

rm

al la

bo

ur a

nd

bir

th

Wo

men

can

tru

st/

exp

ect

a n

ew

ly r

eg

iste

red

mid

wif

e t

o:


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Fo

r e

ntr

y t

o t

he r

eg

iste

r

9. W

orks c

ollab

orati

vely

wit

h o

ther p

racti

tio

ners.

Act

s in

acc

orda

nce

with

The

Cod

e:

Sta

ndar

ds o

f con

duct

, per

form

ance

and

et

hics

for n

urse

s an

d m

idw

ives

Is a

n ad

voca

te fo

r wom

en

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otia

tes

with

oth

ers

in re

latio

n to

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expe

rtise

bey

ond

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wife

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urre

nt

prac

tice,

or t

he n

eeds

of t

he w

omen

or b

aby

fall

outs

ide

the

scop

e of

mid

wife

ry p

ract

ice

Pra

ctic

es in

acc

orda

nce

with

the

NM

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wiv

es ru

les

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dard

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rate

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rd

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legi

ble

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Essen

tial S

kills

Clu

ste

rs (

ES

Cs)

for p

re-r

eg

istr

ati

on

mid

wif

ery e

du

cati

on

4. In

itia

tio

n a

nd

co

nti

nu

an

ce o

f b

reastf

eed

ing

Init

iati

on

an

d c

on

tin

uan

ce o

f b

reastf

eed

ing

Wo

men

can

tru

st/

exp

ect

a n

ew

ly r

eg

iste

red

mid

wif

e t

o:


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Fo

r e

ntr

y t

o t

he r

eg

iste

r

1. U

nd

ersta

nd

an

d s

hare

info

rm

ati

on

th

at

is c

lear,

accu

rate

an

d m

ean

ing

ful

at

a level w

hic

h w

om

en

,

their

partn

ers a

nd

fam

ily

can

un

ders

tan

d.

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ticip

ates

in c

omm

unic

atin

g se

nsiti

vely

th

e im

porta

nce

of b

reas

tfeed

ing,

and

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Obs

erve

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varie

ty o

f for

ums

whe

re

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rmat

ion

is s

hare

d in

resp

ect o

f the

ad

vant

ages

and

dis

adva

ntag

es o

f diff

eren

t in

fant

feed

ing

met

hods

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al a

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l cue

s

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info

rmat

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shar

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wom

en

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ble

to le

ad a

var

iety

of f

orum

s w

here

in

form

atio

n is

sha

red

with

wom

en a

bout

the

adva

ntag

es a

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isad

vant

ages

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iffer

ent

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nt fe

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ardi

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ly a

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re a

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otio

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entio

ns

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how

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ate

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68

Annexe

From the Directive 2005/36/EC of the European Parliament and of the Council

(2005) RQ�WKH�UHFRJQLWLRQ�RI�SURIHVVLRQDO�TXDOL¿FDWLRQV�

$QQH[H�9��3RLQW��

�� 7KH�(XURSHDQ�8QLRQ�DQG�$UWLFOH��WUDLQLQJ�RI�PLGZLYHV��RI�'LUHFWLYH��(8

�� DGYLVLQJ�RI�SUHJQDQW�ZRPHQ��LQYROYLQJ�DW�OHDVW��SUHQDWDO�H[DPLQDWLRQV

�� VXSHUYLVLRQ�DQG�FDUH�RI�DW�OHDVW��ZRPHQ�LQ�ODERXU

�� WKH�VWXGHQW�VKRXOG�SHUVRQDOO\�FDUU\�RXW�DW�OHDVW��GHOLYHULHV��ZKHUH�WKLV�QXPEHU�FDQQRW�EH�UHDFKHG�RZLQJ�WR�WKH�ODFN�RI�DYDLODEOH�ZRPHQ�LQ�ODERXU��LW�PD\�EH�UHGXFHG�WR�D�PLQLPXP�RI��SURYLGHG�WKDW�WKH�VWXGHQW�SDUWLFLSDWHV�DFWLYHO\�LQ��IXUWKHU�GHOLYHULHV

�� active participation with breech deliveries. Where this is not possible because RI�ODFN�RI�EUHHFK�GHOLYHULHV�SUDFWLFH�PD\�EH�LQ�D�VLPXODWHG�VLWXDWLRQ

�� performance of episiotomy and initiation into suturing. Initiation shall include theoretical instruction and clinical practice. The practice of suturing includes suturing of the wound following an episiotomy and a simple perineal laceration. This may be in a simulated situation if absolutely necessary

�� VXSHUYLVLRQ�DQG�FDUH�RI��ZRPHQ�DW�ULVN�LQ�SUHJQDQF\��RU�ODERXU�RU�SRVWQDWDO�period

�� VXSHUYLVLRQ�DQG�FDUH��LQFOXGLQJ�H[DPLQDWLRQ��RI�DW�OHDVW��SRVWQDWDO�ZRPHQ�and healthy newborn infants

�� REVHUYDWLRQ�DQG�FDUH�RI�WKH�QHZERUQ�UHTXLULQJ�VSHFLDO�FDUH�LQFOXGLQJ�WKRVH�born pre-term, post-term, underweight or ill

�� FDUH�RI�ZRPHQ�ZLWK�SDWKRORJLFDO�FRQGLWLRQV�LQ�WKH�¿HOGV�RI�J\QDHFRORJ\�DQG�obstetrics

�� LQLWLDWLRQ�LQWR�FDUH�LQ�WKH�¿HOG�RI�PHGLFLQH�DQG�VXUJHU\��,QLWLDWLRQ�VKDOO�LQFOXGH�theoretical instruction and clinical practice.

69

The standards for pre-registration midwifery education have been set at the point RI�UHJLVWUDWLRQ��VR�WKDW�WKH�VWXGHQW�ZLOO�EH�DEOH�WR�IXO¿O�WKH�UHTXLUHPHQWV�RI�D�PLGZLIH�DV�ODLG�GRZQ�LQ�WKH�GH¿QLWLRQ�RI�D�PLGZLIH�DQG�ZLOO�FRPSO\�ZLWK�$UWLFOH��RI�'LUHFWLYH��(8�ZKLFK�VWDWHV�

0HPEHU�6WDWHV�VKDOO�HQVXUH�WKDW�PLGZLYHV�DUH�DW�OHDVW�HQWLWOHG�WR�WDNH�XS�DQG�pursue the following activities:

�� to provide sound family planning information and advice

�� to diagnose pregnancies and monitor normal pregnancies; to carry out examinations necessary for the monitoring of the development of normal pregnancies

�� to prescribe or advise on the examinations necessary for the earliest possible GLDJQRVLV�RI�SUHJQDQFLHV�DW�ULVN

�� to provide a programme of parenthood preparation and a complete preparation for childbirth including advice on hygiene and nutrition

�� to care for and assist the mother during labour and to monitor the condition of the fetus in utero by the appropriate clinical and technical means

�� WR�FRQGXFW�VSRQWDQHRXV�GHOLYHULHV�LQFOXGLQJ�ZKHUH�UHTXLUHG�DQ�HSLVLRWRP\�DQG��in urgent cases, a breech delivery

�� to recognise the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and to assist the latter where appropriate; to WDNH�WKH�QHFHVVDU\�HPHUJHQF\�PHDVXUHV�LQ�WKH�GRFWRU¶V�DEVHQFH��LQ�SDUWLFXODU�the manual removal of the placenta, possibly followed by a manual examination of the uterus

�� WR�H[DPLQH�DQG�FDUH�IRU�WKH�QHZERUQ�LQIDQW��WR�WDNH�DOO�LQLWLDWLYHV�ZKLFK�DUH�necessary in case of need and to carry out where necessary immediate resuscitation

�� to care for and monitor the progress of the mother in the postnatal period and to give all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the newborn infant

�� to carry out treatment prescribed by a doctor

�� to maintain all necessary records.

��

Contact usNursing and Midwifery Council23 Portland Place/RQGRQ�:�%��3=��www.nmc-uk.org

This edition of Standards for pre-registration midwifery education was published in ��,W�UHSODFHV�6WDQGDUGV�RI�SUR¿FLHQF\�IRU�SUH�UHJLVWUDWLRQ�PLGZLIHU\�HGXFDWLRQ��

standards for pre_registration midwifery education

Documents

midwifery council

academic standard of

point of registration

approved programmes

circulated nmc standards

standards european directives

clinical practice

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