NOTICE OF UNSAFE CONDITIONS OF PRACTICE
TO:
FROM:
Name:
Job Title:
Name of Unit:
Name of Employer:
Date:
Name:
Job Title:
Name of Unit:
Name of Employer:
Time:
It is my duty as a midwife to point out that I consider that standards of care were sub optimal today. Whilst not abdicating in
any way my responsibilities as a midwife, I must inform you that I will not be held responsible for untoward incidents caused or
exacerbated by * unsafe numbers of staff /* the lack of qualified staff/*inappropriate skill mix/*environmental factors affecting
care.
* Please delete if not applicable.
My personal accountability is referred to in the following Nursing and Midwifery Council (NMC) documents:
- NMC (2008) The Code– Standards of conduct, performance and ethics for nurses and midwives
- NMC (2004) Midwives rules and standards
- NMC (2010) Raising and escalating concerns – Guidance for nurses and midwives
I have read the wording on the reverse of this notice. The circumstances that require me to complete this record are shown as
follows:
CLINICAL AREA:
NO OF MOTHERS:
NO OF BABIES:
STAFF ON DUTY AND Bands:
DATE:
SPECIAL NOTES:
EG HIGH DEPENDENCY MOTHERS/BABIES
TIME:
MINIMUM STAFF NEEDED, WHY AND FOR HOW LONG:
TELEPHONE REPORT: TIME:
DATE:
WITNESSED BY:
NAME AND STATUS OF MANAGER TELEPHONED AND ACTION TAKEN:
I am sending a copy of this notice to:
1. My statutory Supervisor of Midwives (if not already identified)*
2. The Maternity Services Manager (if other than the person to whom it is addressed)*
3. My local RCM Workplace Representative
4. My RCM Regional/National Officer/RCM Board Secretary*
* Please delete if not applicable/ to photocopy the forms if you are sending it to more than one person (please be aware that there is a
guidance note attached to the form)
In view of the potential seriousness of this issue, a written response is requested.
NAME**:
WITNESS**:
** WHERE MORE THAN ONE MIDWIFE IS AFFECTED, EACH
ONE SHOULD GIVE HER/HIS NAME:
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SIGNATURE**:
GUIDANCE REGARDING ‘NOTICE OF UNSAFE CONDITIONS OF PRACTICE
This notice is designed to satisfy the practitioners’ professional obligations in meeting the
statutory requirement of NMC (2008) The Code - Standards of conduct, performance and
ethics for nurses and midwives (Managing Risk Sections 32-34):
32. You must act without delay if you believe that you, a colleague or anyone else may be putting
someone at risk
33. You must inform someone in authority if you experience problems that prevent you working within
this Code or other nationally agreed standards
34. You must report your concerns in writing if problems in the environment of care are putting people
at risk
This notice should only be completed after the manager on duty at the time and/or the supervisor of midwives, has
been informed of the problem. If there is insufficient space on the form to give the necessary detail, attach an
additional sheet of paper with that information. It is recommended that, where possible, you show the completed
form to your RCM Workplace Representative so that she/he can ensure that sufficient detail has been given to
accurately reflect the seriousness of the situation.
In the event of an allegation of professional misconduct being made against a midwife, the only circumstances in
which inadequate staffing is regarded by the Conduct and Competence Committee of the NMC as a defence is where
the midwife can prove that she took every possible step to inform management at the time about the problem and
its seriousness.
In the section headed ‘Special notes e.g. high dependency patients’ you should list any woman for whom a midwife
is the only appropriate care-giver.
You should ensure that a copy of the completed form goes to the Head of Midwifery (HOM) for your unit as well as
your Statutory Supervisor of Midwives. Two copies should also go to your RCM Workplace Representative: one for
her/him and one for the RCM Regional/National Officer for your country/region. Clearly you should keep a copy
yourself.
A form should be completed on each and every occasion even when that means on consecutive shifts or days.
Please ensure that you have followed Trust policy regarding risk which may include completing a Trust Incident
Reporting Form (IR1).
If you have any questions or concerns regarding professional accountability, please contact your local Supervisor of
Midwives or your line manager.
Further information regarding advice about unsafe conditions of practice is available from the RCM country boards.
England
Leeds 01132 444310
Wales
02920 228111
Scotland
01312 251633
Northern Ireland
02890 241531
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