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Concerns raised over quality of education for nursing students in North Wales

NMC inspection flags up lack of compliance with rules, standards and guidance

Serious concerns about the provision of education for nursing and midwifery students at Bangor University have been raised as part of a Nursing and Midwifery Council (NMC) review.

An inspection of education for the students and of the Local Supervising Authority (LSA) function provided by Health Inspectorate Wales (HIW) found there were a lack of resources; unsustainable levels of input from teaching staff; lack of compliance with rules, standards and guidance set out by NMC and failure of one LSA midwife to maintain their registration.

The NMC has published the results of its joint extraordinary review that was launched after concerns were raised with the NMC by the university in May.  On June 4 HIW notified the NMC about its concerns over midwifery services at Glan Clwyd Hospital and on June 18 a decision was made by Bangor University to remove all student midwives from the hospital.

The NMC visited three hospital midwife departments overseen by the HIW during its subsequent investigation in July. These were Glan Clwyd, Wrexham Maelor Hospital and Ysbyty Gwynedd in Bangor. Inspectors met students, service users, programme team members and Local Supervising Authority representatives.

One of the biggest areas of criticism of Betsi Cadwaladr University Health Board – which oversees Bangor University – was lack of resources.

The inspectors’ report says: ‘We found the teaching resource for the delivery of the pre-registration midwifery programme is below that which is required to deliver the programme at the level of quality that was specified at the programme approval.

‘The current level of input by teaching staff appears unsustainable. We have serious concerns that the current resources cannot guarantee that knowledgeable, safe and competent practitioners can be achieved at the end of the programme.’

The role of the lead midwife for education did not meet the standards for pre-registration midwifery, said inspectors. They ruled that Betsi Cadwaladr University Health Board must take immediate action to remedy both failings.

The biggest areas of concern were failures by the Local Supervising Authority midwifery officer to comply with rules, standards and guidance set out by NMC and the failure of one of its midwives to maintain their registration.

NMC registrar Jackie Smith said: 'The reports from our extraordinary review show that there are serious concerns around the nursing and midwifery education programmes and the Local Supervising Authority function in North Wales.

‘We need to be assured that our standards for education and for the supervision of midwives are being met, and that the public’s safety is protected.

‘It is essential that all the relevant organisations collaborate to address the issues raised by the review. We will work closely with Bangor University, HIW and other stakeholders to improve the situation and strengthen public protection.’

In response, an HIW spokesperson said: 'The Local Supervising Authority responded immediately to the issues raised by the NMC by developing and implementing an action plan that addressed the report’s recommendations.

'Following an annual audit of the provision of statutory supervision in Betsi Cadwaladr University Health Board on October 13-14, all standards set by NMC and recommendations made in the report have now been met.'

Betsi Cadwaladr University Health Board said it welcomed the publication of the NMC report and that most of the recommendations it made had already been addressed.

'The health board has been working closely with Bangor University and the Local Supervising Authority (HIW) to address findings and to develop an action plan which ensures that the standard of training provided to student nurses and student midwives, together with the supervision provided to midwives, is of the highest standard, which all three organisations have as a priority,' said executive director of nursing and midwifery Angela Hopkins.

'We would like to reassure our patients regarding the quality and standard of education for student nurses and midwives in North Wales, and to advise that issues reaised regarding the supervision of midwives have been fully addressed,' she added.

The reports of both organisations are available here