Midwifery Leaders Information

Midwifery Leaders live and work within midwifery communities and all practise settings, which means they play an important role as a link between the Council and practising midwives.
As the regulator of the midwifery profession, the Midwifery Council has responsibilities which are specified in the Health Practitioners Competence Assurance Act 2003 (HPCAA). The principle purpose of the HPCA Act is to protect the health and safety of the public by ensuring all health practitioners are competent and fit to practise.

Part 3 of the HPCA Act sets out the requirements for a notification to be made to the Council if there are concerns regarding a midwife’s health or competence. Part 4 of the Act refers to matters of conduct and complaints about practice.

The ‘Competencies for Entry to the Register of Midwives 1 provides the minimum skills, knowledge, and attitudes expected of a midwife. This plus the code of conduct and the statement on cultural competence form the regulatory framework that sits around midwifery practice and against which midwives are assessed.

Guidance Tools

This tool is designed to assist Midwifery Leaders, and other professional colleagues, on appropriate actions regarding any concerns related to a midwife’s practice. The following guiding documents may assist you in your decision to make a notification to Council:

Having received a notification, it is the role of Council to undertake a formal review process. When making a notification you are not asked or expected to identify specific competencies that the midwife may have breached in the notification. This role is carried out in the Council processes.

If you decide that you will make a notification to the Council, then you should advise the midwife and provide her with a copy of your notification. This should provide the Council with sufficient detail so that it can make an initial triage and assessment of the matters raised.

Concerns regarding health:

The HPCA Act makes it mandatory for you to make a notification if you believe a midwife may be unable to practise because of a mental or physical condition. The Council recently published the Be Safe paper on the topic of midwife’s health which can be found here. If you want to make a notification about a midwife then please refer here.

Concerns about competence:

If you have concerns about a colleague’s competence including their cultural competence, You may wish to ring to discuss this matter with either the Registrar or Midwifery Advisor. Notifications about competence may refer to a single incident that demonstrates a significant departure from accepted standards, a pattern of practice recognised over time, or an apparent decline in practise or professional isolation.

If it comes to your attention that a colleague’s competence may pose a possible risk of harm, you may choose to raise your concerns directly with the midwife in the first instance. If you have concerns of a possible risk of serious harm, you should immediately submit a notification to the Council.

Concerns about conduct:

The Council has identified expectations for midwives’ professional conduct in the Code of Conduct(2010). It is important to recognise and manage unprofessional behaviour, or breaches of conduct and where appropriate inform the Council in order to protect the health and safety of women and babies and the integrity of the profession.

Conduct matters are dealt with in a different way to notifications regarding competence and health and the Council is required to refer to an independent professional conduct committee to investigate the complaint and decide what if any further action needs to occur. Action can range from no action, to referring to the Council for a competence review or some cases charges are laid at the Health Practitioner Disciplinary Tribunal.

Concerns about a particular case:

If you have a complaint about the care provided to an individual woman or baby, then you should follow your usual DHB processes which may include contacting the Health and Disability Commissioners Office (HDC). Any complaint that the Council receives regarding care provided to a named consumer is automatically referred to the HDC.

While the Council cannot take action under the disciplinary part of the Act until the matter is referred back from the HDC, it can explore matters and does consider the midwife’s competence to practise. In reality this can mean that the Council has looked at and addressed issues of competence while an HDC investigation is underway. It also means that if the matter is referred back from the HDC without an investigation being undertaken that the Council can refer to a PCC.

If you want any advice please do not hesitate to contact the secretariat.