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Programme approval report
Section one
Programme provider name: Edge Hill University
In partnership with: (Associated practice learning partners and/or employer partners involved in the delivery of the programme)
Countess of Chester Hospital NHS Foundation Trust St Helens and Knowsley Teaching Hospitals NHS Trust Southport and Ormskirk Hospital NHS Trust Liverpool Women's NHS Foundation Trust Warrington and Halton Teaching Hospitals NHS Foundation Trust Bridgewater Community Healthcare NHS Foundation Trust Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust Wirral University Teaching Hospital NHS Foundation Trust Programme reviewed: Registered Midwife - 18M
Registered Midwife - 24M
Registered Midwife - 36M
Registered Midwife - degree apprentice
Title of programme(s): BSc (Hons) Midwifery
MSc Midwifery
Academic levels:
Registered Midwife - 18M
England, Wales, Northern Ireland Level 6 Level 7
SCQF Level 9 Level 10 Level 11
Registered Midwife - 24M
England, Wales, Northern Ireland Level 6 Level 7
SCQF
Level 9 Level 10 Level 11
Registered Midwife - 36M
England, Wales, Northern Ireland Level 6 Level 7
SCQF Level 9 Level 10 Level 11
Registered Midwife - degree apprentice
England, Wales, Northern Ireland Level 6 Level 7
SCQF Level 9 Level 10 Level 11
Date of approval visit: 10 March 2021
Programme start date:
Registered Midwife – 18M Registered Midwife – 24 M Registered Midwife – 36 M Registered Midwife – degree apprentice
27 September 2021
27 September 2021
QA visitor(s): Registrant Visitor: Nicola Clark Lay Visitor: Sandra Stephenson
Recognition of prior learning (RPL) isn’t available for pre-registration midwifery programmes. Students from other institutions can transfer into year two of the BSc (Hons) midwifery programme through credit transfer.
The Standards framework for nursing and midwifery education (SFNME) (NMC,
- isn’t met at programme level as conditions apply.
The SSSA are met at programme level.
The programmes are recommended for approval subject to two NMC specific conditions, two joint NMC and university conditions and one university condition being met. Visitors made one recommendation.
Updated 12 April 2021:
Evidence is provided to meet the NMC conditions. The conditions and related standards are now met. The university has confirmed that the university condition is now met.
The programmes are recommended to the NMC for approval.
Recommended outcome of the approval panel
Recommended outcome to the NMC:
Programme is recommended to the NMC for approval
Programme is recommended for approval subject to specific conditions being met
Recommended to refuse approval of the programme
Conditions: Effective partnership working: collaboration, culture, communication and resources: None identified.
Selection, admission and progression: Condition one: Provide evidence that the curriculum is structured and sequenced to enable students to manage their theory and practice learning effectively. (SFNME R5.7; SPMP R2.1, R2. 6 ) (NMC and university condition)
Condition three: Provide evidence of a robust process for equality and diversity (ED) training of all those involved in the decision making for recruitment to the programme. (SFNME R4.3; SPMP R1.4)
Condition four: Remove reference to ‘prior learning’ from all programme documentation. (SPMP R1.3) (NMC and university condition)
Practice learning: Condition two: Provide a contextual document to demonstrate how the MORA will be implemented, to include confirmation of the programme requirements for proficiencies students have to complete for each part of the programme and how students’ progress through the programme will be managed, including any flexibility on hours/proficiencies. (SFNME R5. 11 ; SPMP R4. 1 )
Assessment, fitness for practice and award: None identified.
Education governance: management and quality assurance: Condition five: Obtain written evidence of informed majority consent to support the transition of existing BSc level four students to the new level five. (University condition)
Date condition(s) to be met:
7 April 2021
Recommendations to enhance the programme delivery:
Recommendation one: The programme team should consider making transparent how the assessment of capability to develop digital literacy is carried out on entry to the programme. (SFNME R2.6; SPMP R1.5.8, R1.6)
Focused areas for future monitoring:
Adoption and assessment of newborn infant physical examination (NIPE) in the programme.
The adoption of the SSSA through implementation of the MORA.
Programme is recommended for approval subject to specific conditions being met
Commentary post review of evidence against conditions:
NMC Programme standards
Standards for student supervision and assessment (NMC, 2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2015 updated 2018 ) Quality assurance framework for nursing, midwifery and nursing associate education (NMC, 2020) QA Handbook (NMC, 2020)
Partnerships The AEI works in partnership with their practice learning partners, service users, students and all other stakeholders.
Please refer to the following NMC standards reference points for this section:
Standards framework for nursing and midwifery education (NMC, 2018) Standard 1: The learning culture: R1.12 ensure programmes are designed, developed, delivered, evaluated and co- produced with service users and other stakeholders R1.13 work with service providers to demonstrate and promote inter-professional learning and working
Standard 2: Educational governance and quality: R2.2 all learning environments optimise safety and quality taking account of the diverse needs of, and working in partnership with, service users, students and all other stakeholders R2.4 comply with NMC Standards for student supervision and assessment R2.5 adopt a partnership approach with shared responsibility for theory and practice supervision, learning and assessment, including clear lines of communication and accountability for the development, delivery, quality assurance and evaluation of their programmes R2.6 ensure that recruitment and selection of students is open, fair and transparent and includes measures to understand and address underrepresentation R2.7 ensure that service users and representatives from relevant stakeholder groups are engaged in partnership in student recruitment and selection
Standard 3: Student empowerment: R3.3 have opportunities throughout their programme to work with and learn from a range of people in a variety of practice placements, preparing them to provide care to people with diverse needs R3.16 have opportunities throughout their programme to collaborate and learn with and from other professionals, to learn with and from peers, and to develop supervision and leadership skills R3.17 receive constructive feedback throughout the programme from stakeholders with experience of the programme to promote and encourage reflective learning
R3.18 have opportunities throughout their programme to give feedback on the quality of all aspects of their support and supervision in both theory and practice
Standard 4: Educators and assessors: R4.7 liaise and collaborate with colleagues and partner organisations in their approach to supervision and assessment R4.9 receive and act upon constructive feedback from students and the people they engage with to enhance the effectiveness of their teaching, supervision and assessment R4.10 share effective practice and learn from others
Standard 5: Curricula and assessment: R5.4 curricula are developed and evaluated by suitably experienced and qualified educators and practitioners who are accountable for ensuring that the curriculum incorporates relevant programme outcomes R5.5 curricula are co-produced with stakeholders who have experience relevant to the programme R5.14 a range of people including service users contribute to student assessment
Standards for student supervision and assessment (NMC, 2018)
Standard 1: Organisation of practice learning: R1.4 there are suitable systems, processes, resources and individuals in place to ensure safe and effective coordination of learning within practice learning environments R1.7 students are empowered to be proactive and to take responsibility for their learning R1.8 students have opportunities to learn from a range of relevant people in practice learning environments, including service users, registered and non- registered individuals, and other students as appropriate
Standard 2: Expectations of practice supervisors: R2.2 there is support and oversight of practice supervision to ensure safe and effective learning
Standard 3: Practice supervisors: role and responsibilities: R3.3 support and supervise students, providing feedback on their progress towards, and achievement of, proficiencies and skills
Standard 4: Practice supervisors: contribution to assessment and progression: R4.3 have sufficient opportunities to engage with practice assessors and academic assessors to share relevant observations on the conduct, proficiency and achievement of the students they are supervising
Standard 7: Practice assessors: responsibilities:
selection with their ED training being part of their mandatory training, though evidence of this isn’t requested by EHU. The panel feel the evidence of current ED training needs to be more robust and a condition is applied. (Condition three)
SUCs contribute to the delivery, review and development of the curriculum and also participate in students’ theory sessions and assessments. They tell us how they deliver their lived experience to students and the positive impact this has on the students learning. They feel supported and valued in their role.
The MORA evidences the involvement of SUCs and students in the feedback, supervision and assessment processes. Opportunities for IPL for students within the practice learning setting is evidenced within the MORA documentation.
The SSSA is currently being implemented for all students on midwifery programmes at EHU following the adoption of the emergency standards. EHU and PLPs tell us how practice supervisors and practice assessors are supported and undergo training for their roles. EHU tell us they meet regularly with trust partners and other AEIs across Cheshire and Merseyside to collaboratively develop implementation plans for the SSSA and plan placement capacity. Lead midwives and continuity of carer leads in the local trusts are active in supporting placement capacity. EHU currently host a midwifery secondee to HEE whose remit is to increase student midwifery placement opportunities within the Cheshire and Merseyside region.
Documentation shows that students receive feedback from their practice assessor and practice supervisor at specific stages as identified within the MORA. The assessment and feedback process indicates that it will take into account the student’s individual learning needs including reasonable adjustments and support needs.
Documentation shows all groups agree that the move away from a modular approach to a concept-based and spiral curriculum would bring about greater person-centred holistic care. The academic team is highly committed to and passionate about the non-modular structure of the years of study, an approach they tell us is used successfully in other programmes in the faculty.
Students have a range of ways of expressing their views and opinions acting as academic representatives through the student, staff consultative forum (SSCF) and pre-registration programmes board. Consultation with current BSc and MSc students has included their views on the structure, design and teaching and assessment within the new programme. Documentation shows that PLPs and current students express the need for complex care provision to be introduced to students at an earlier point in their theory and for skill and simulation blocks immediately before placements to support student midwives’ self-confidence. This is evidenced in the module descriptors.
The SUC forum includes student and academic representatives. All groups have been consulted about the design and delivery of the programmes. A ‘service user café’ has been introduced once per term for each cohort. SUCs involved provide their perspective and insight of their experiences and the academic staff encourage reflective discussion for students. SUCs tell us how successful this approach is by giving students just one topic for discussion and reflection and the importance of improving interpersonal skills for student midwives. Documentation shows regular meetings with SUCs to discuss all aspects of the programmes.
Assurance is provided that the AEI works in partnership with their practice learning partners, service users, students and all other stakeholders as identified in Gateway 1: Standards framework for nursing and midwifery education MET NOT MET
The programme team tell us that ED training is expected for all those involved in recruitment and selection for these programmes. The PLPs tell us that evidence of this being completed and remaining up to date isn’t requested by EHU.
Condition three: Provide evidence of a robust process for ED training of all those involved in the decision making for recruitment to the programme. (SFNME R4.3; SPMP R1.4)
Assurance is provided that the AEI works in partnership with their practice learning partners, service users, students and all other stakeholders as identified in Gateway 2: Standards for student supervision and assessment MET NOT MET
Post event review Identify how the condition(s) is met:
The process for ensuring PLPs have completed ED annual updates prior to engaging in recruitment has been updated. The admissions tutor will maintain a database of ED training which will be reviewed each recruitment cycle.
Condition three is now met.
Evidence: Annexe c PLP and SUCs engagement in recruitment, undated
Date condition(s) met: 12 April 2021
Revised outcome after condition(s) met: MET NOT MET
Student journey through the programme
Note: Education institutions and their practice learning partners may propose to transfer current students onto the new programme to meet the Standards for pre- registration midwifery programmes. If so, evidence must be provided to support this proposed transfer as part of the education institution’s mapping process at Gateway 3.
Proposed transfer of current students to the programme under review Demonstrate a robust process to transfer current students onto the proposed programme to ensure programme learning outcomes and proficiencies meet the Standards for pre-registration midwifery programmes (NMC, 2019).
Proposed transfer of current students to the Standards for student supervision and assessment (NMC, 2018). Demonstrate a robust process to transfer current students onto the Standards for student supervision and assessment (NMC, 2018).
Findings against the standard and requirements
Evidence provides assurance that the following requirements are met:
R1.1 appoint a lead midwife for education who is responsible for midwifery education in the AEI YES NO
R1.2 inform the NMC of the name of the lead midwife for education YES NO
R1.3 ensure recognition of prior learning is not permitted for pre-registration midwifery programmes YES NO
R1.3 is not met. There’s reference to RPL in the programme documentation relating specifically to transfer of students onto the programme. The programme team confirm that this is credit transfer and not RPL. (Condition four)
R1.4 ensure selection, admission and progression comply with the NMC Standards framework for nursing and midwifery education YES NO
R1.4 is not met. SFNME R4.3 makes reference to relevant training which includes ED. The process for ensuring all those involved in student recruitment meet this requirement isn’t robust. The programme team tell us that ED training is expected for all those involved in recruitment and selection for these programmes. The PLPs tell us that evidence of this being completed and remaining up to date isn’t requested by EHU. (Condition three)
R1.5 confirm on entry to the programme that students:
R1.5.1 enrolled on pre-registration midwifery programmes are compliant with Article 40(2) of Directive 2005/36/EC regarding general education length or nursing qualification as appropriate outlined in Annexe 1 of this document YES NO
R1.5.2 demonstrate an understanding of the role and scope of practice of the midwife YES NO
R1.5.3 demonstrate values in accordance with the Code YES NO
R1.5.4 have capability to learn behaviours in accordance with the Code YES NO
R1.5.5 have capability to develop numeracy skills required to meet programme outcomes YES NO
R1.5.6 can demonstrate proficiency in English language YES NO
R1.5.7 have capability in literacy to meet programme outcomes YES NO
R1.5.8 have capability for digital and technological literacy to meet programme outcomes YES NO
Provide an evaluative summary from your documentary analysis and evidence AND discussion at the approval visit to demonstrate if assurance is provided that the requirement below is met or not met
R1.6 support students throughout the programme in continuously developing their abilities in numeracy, literacy and digital and technological literacy to meet programme outcomes MET NOT MET
R1.6 is met. EHU make explicit the entry requirements for literacy and numeracy. Numeracy skills are developed in simulation, formative tasks and in the practice learning environment. Online tools, such as the standardised numeracy assessment process (SN@P) are further used to support numeracy and medicine calculation skills. The numeracy 100 percent pass is assessed by objective structured clinical examination (OSCE). As part of the authentic assessment
programme complies with Article 40(1)(b) of Directive 2005/36/EC outlined in Annexe 1 of this document. YES NO
Proposed transfer of current students to the programme under review From your documentary analysis and your meeting with students, provide an evaluative summary to confirm how the Standards for pre-registration midwifery programmes and the Standards of proficiency for registered midwives will be met through the transfer of existing students onto the proposed programme.
Student midwives in year one of the current programme (September 20 20 intake) will transition to the proposed programme. It’s recognised that the new programme content and structure is different. Mapping of learning outcomes and indicative content has identified key areas where student midwives will need to have additional content. The programme team provide assurance that transitioning students will achieve the programme learning outcomes. The students tell us that discussions about the changes to their programme have taken place.
The September 2019 and January 2020 cohort students won’t transition to the new programme but will be able to engage with enhancements in their third year.
Proposed transfer of current students to the Standards for student supervision and assessment (SSSA) (NMC, 2018). From your documentary analysis and your meetings at the approval visit confirm if students will be transferring to the SSSA, and if so that they have informed choice and are fully prepared for supervision and assessment.
The SSSA have been embedded into the current programme as part of the NMC emergency standards (2020). The September 20 18, September 20 19 and January 20 20 cohorts transitioned to the SSSA in July 2020.
The September 2020 cohort was introduced to the SSSA and the concepts of practice supervisors and assessors during their induction weeks. The roles and responsibilities are clearly detailed throughout the MORA.
The students experienced the SSSA on first placement in January 2021.
Students tell us they’ve found the change to the SSSA difficult but that they’re supported in this both by EHU and PLPs.
Assurance is provided that Gateway 1: Standards framework for nursing and midwifery education relevant to selection, admission and progression are met YES NO
SFNME R4.3 refers to relevant training which includes ED. The process for ensuring all those involved in student recruitment meet this requirement isn’t
robust. The programme team tell us that ED training is expected for all those involved in recruitment and selection for these programmes. The PLPs tell us that evidence of this being completed and remaining up to date isn’t requested by EHU.
Outcome Is the standard met? MET NOT MET
PLPs tell us they support recruitment and selection with their ED training being part of their mandatory training, though evidence of this isn’t requested by EHU.
Condition three: Provide evidence of a robust process for ED training of all those involved in the decision making for recruitment to the programme. (SFNME R4.3; SPMP R1.4)
There’s reference to prior learning in the documentation which is linked to transfer from other institutions onto the programme. Transfer of credit is permitted if this can be mapped to the programme and evidence can be provided that the student will meet the requirements of the SPMP and SPM.
Condition four: Remove reference to ‘prior learning’ from all programme documentation. (SPMP R1.3) (NMC and university condition)
Date: 10 March 2021 Post event review
Identify how the condition(s) is met:
The process for ensuring PLPs have completed ED annual updates prior to engaging in recruitment has been updated. The admissions tutor will maintain a database of ED training which will be reviewed each recruitment cycle.
Condition three is now met.
Evidence: Annexe c PLP and SUCs engagement in recruitment, undated
The reference to ‘prior learning’ has been removed from all programme documentation.
Condition four is now met.
Evidence: Annexe a part b institutional hybrid periodic review and validation document final, March 2021
Date condition(s) met: 12 April 2021
YES NO
R2.1 is not met. SFNME R5.7 requires the curriculum to be structured and sequenced to enable students to manage their theory and practice learning. This is unclear within the programme documentation. The modules don’t detail sufficient depth and breadth of indicative content, nor is there a clear timetable of where that content will be delivered throughout each year of the programme. (Condition one)
R 2 .2 comply with the NMC Standards for student supervision and assessment YES NO
R2.3 ensure that programme learning outcomes reflect relevant Standards of proficiency for midwives YES NO
Provide an evaluative summary from your documentary analysis and evidence AND discussion at the approval visit to demonstrate if assurance is provided that the requirement below is met or not met.
R2.4 involve women, partners, families and advocacy groups in the design, development, delivery and evaluation of programmes MET NOT MET
R2.4 is met. Documentation evidences engagement with SUCs to discuss their expectations of student midwives at different stages of the programme. These discussions also allow SUCs to share their experiences and input into the programme. SUCs provide their perspective of lived experiences to prepare students to consider and provide holistic care to all service users. SUCs are invited to the CAG to discuss their experiences within the curriculum and to suggest recommendations for change.
Documentation shows the CAGs oversee programme development and review and receive reports from SUCs, students and PLPs four times per year. The CAG monitors the content of the curriculum, including IPL opportunities and practice and allows SUCs, PLPs and students to maintain the ethos of co-production. A programme board meets three times a year and is chaired by the departmental head. Membership of the programme board is inclusive of PLPs, representation from the student community and from the faculty SUCs council.
SUCs tell us they’re involved in all aspects of the programme, that they’re listened to and their perspectives and opinions valued.
Evidence provides assurance that the following requirements are met
R2.5 ensure that programmes delivered in Wales comply with legislation which supports use of the Welsh language YES NO N/A
The programme is only delivered in England.
Provide an evaluative summary from your documentary analysis and evidence AND discussion at the approval visit to demonstrate if assurance is provided that the requirement below is met or not met.
R2.6 design and deliver programmes that support students and provide relevant and ongoing exposure to midwifery practice MET NOT MET
R2.6 is not met. Programme documentation and the MORA state that theory and practice learning are designed and delivered within the programme. Programme documentation shows the curriculum content is spiralled using horizontal and vertical integration to allow greater complexity of the topics through the year. Topics from previous years are revisited to deepen students’ knowledge. The programme team are able to articulate how the theoretical content is arranged, however this isn’t explicit within the module specifications. (Condition one)
Theory sessions for MSc and BSc student midwives are delivered separately.
The range of practice learning experiences cover antenatal, postnatal, labour ward and community settings. There are opportunities for specialist practice learning experiences such as neonatal unit, theatres and intensive care units. Students experience a range of practice learning opportunities. Academics tell us hub and spoke placements are being developed across the trusts. Students tell us they’re confident to ask for spoke opportunities on placement and that they experience a wide range of opportunities.
Consultation between PLPs and the midwifery team agree that home trust (the hub) placements will change each year of the programme to ensure a variety and wide scope of learning opportunities for all students. Student journey flowcharts show the range of placements expected to be experienced. For example, in year one placements will involve community, antenatal and postnatal wards, intrapartum area and spokes which may include antenatal clinics and gynaecology. When on practice learning placements, educational support is available to all student midwives from EHU practice education lecturers (PEL) and the academic team. This learning aims to strengthen the link between theory and practice. The principles of NIPE are threaded throughout the years of study of the BSc and MSc programmes, allowing students to build their knowledge and skills over time. Clear timescales are in place for the development of basic knowledge, in depth training and consolidation of learning.
R2.7 ensure technology-enhanced and simulated learning opportunities are used effectively and proportionately to support learning and assessment, including where clinical circumstances occur infrequently and a proficiency is required MET NOT MET
