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The role of the PMA and barriers to the successful implementation of restorative clinical supervision

02 June 2019
Volume 27 · Issue 6


Recognition of systematic and structural areas of concern has led to significant changes to midwifery supervision to meet the needs of midwives and the service as a whole. The A-EQUIP (Advocating for Education and QUality ImProvement) model was created to enhance the emotional and physical wellbeing of those providing care and in turn the quality of care provided to women and their families. It is deployed by professional midwifery advocates (PMAs), who have undergone training to deliver restorative clinical supervision. This article aims to critically review the implementation of restorative clinical supervision in practice, examining the potential challenges to the successful implementation of the A-EQUIP model.

As a profession, there have been recent changes to improve the quality and effectiveness of care and learn from significant incidents. The need for change and improved support became apparent following significant failings in midwifery and the health profession as a whole. Reports including the Francis Report (2013), examining failings in care at Mid-Staffordshire NHS Foundation Trust, and the Kirkup Report (2015), investigating Morecambe Bay NHS Foundation Trust, emphasised the need for re-evaluation of midwifery services. Systematic problems and a collective and individual organisational failure to exercise an effective supervisory or regulatory function were identified (Kirkup, 2015). Both reports have given valuable insight into the health service, with the Francis Report concluding that:

‘All NHS Trusts and Foundation Trusts responsible for the provision of hospital services should review their standards, governance and performances in view of the report.’

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