Forum
MERAS Report
Billie Bradford
Midwife Educator, MidCentral DHB
Midwifery Quality
and Leadership
Programme –
Encouraging the
Heart
The Midwifery Quality
and Leadership
Programme was rolled
out at MidCentral
District Health Board
in 2006 following the
release of the national
framework developed
by MERAS and NZNO
as part of the MECA.
I was optimistic of a good uptake, but in
the climate of the time, with a shiny new
Health Practitioners Competence Assurance
(HPCA), many midwives struggled to
see past the seemingly daunting list of
requirements for the Midwifery Council
recertification programme, to proving
their worth as Confident and Leadership
Domain Midwives.
Six years later, we had seen a total of 12
midwives at MidCentral successfully apply
for a QLP award – an average of just two
per year. With turnover and expiry we never
had more than six midwives at a time on
our staff with a QLP award. This represented
barely 15% of our staff midwives.
Despite our ample complement of highly
experienced midwives, we had not a single
midwife who worked exclusively on the
floor apply for Leadership Domain. This was
disappointing to say the least.
The poor uptake of QLP was discussed
regularly by our Director of Midwifery and
me, as well as nationally by MERAS and
the New Zealand College of Midwives and
by midwifery leaders. We knew midwives
were worth more but didn’t know how to
remove the barriers to achieving the award.
What I heard from midwives was that they
felt they were doing enough additional
work out of paid hours meeting the
numerous requirements of their employer
and their registering body. They told me
the money attached to the award wasn’t
enough, especially once pro-rated for a part
time person. And when it came to asking
senior midwives why they didn’t apply for
Leadership Domain they often answered
that they didn’t think they could pass as
they weren’t charge midwives.
Following attendance at the QLP meeting
held in Auckland, my colleague and coassessor felt reinvigorated to improve our
QLP uptake. On reviewing our tool and
process we realised the range of criteria we
had designated as suitable for evidence of
having met the standard was a little narrow,
no wonder midwives who we knew had
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“WE TRIED KEEPING IN MIND THE VISION OF
A LEADERSHIP MIDWIFE; THE EXPERIENCED
MIDWIFE THAT YOU ARE PLEASED TO SEE
WALK IN AHEAD OF A BUSY SHIFT, WHO IS
AN EXAMPLE TO OTHERS, AN ADVOCATE
FOR HER PROFESSION AND FOR WOMEN.
SOMEONE WHOSE THIRST FOR IMPROVING
HER KNOWLEDGE IS NEVER ABATED AND
WHO STEPS UP WHEN IT COMES TO PRACTICE
IMPROVEMENT IN THE WORKPLACE AND
SUPPORTING THE DEVELOPMENT OF OTHERS.”
the potential for Leadership Domain weren’t
putting themselves forward.
We tried keeping in mind the vision of
a Leadership Midwife; the experienced
midwife that you are pleased to see walk
in ahead of a busy shift, who is an example
to others, an advocate for her profession
and for women. Someone whose thirst
for improving her knowledge is never
abated and who steps up when it comes to
practice improvement in the workplace and
supporting the development of others.
Other strategies we employed included;
• Encouraging Midwifery First Year of
Practice midwives to apply for QLP as
soon as they have completed their 12
months. This put some of the more
experienced midwives’ noses out of joint.
But when it was pointed out that the new
midwives had demonstrated that they
met the standard and others could too if
they just applied, some were motivated
to action.
• Encouraging interested midwives to bring
their portfolios in, in whatever current
state. This session was used to point out
to midwives evidence they had already
as well as providing suggestions of what
to do next.
• Complaints about the monetary value of
the award I just won’t wear anymore. We
would all like to see midwives, employed
and LMC, better remunerated for the
important work we do. Pay rises are hard
won. Yet a midwife who successfully gets
Leadership Domain QLP award can get
a $4000 increase to her base pay level,
just like that, no lobbying, protesting
or protracted union negotiations. When
it comes to a pro-rated award I like to
point out that 0.5 of Confident Domain
payment works out at nearly $50 a
fortnight before tax. That will buy quite a
few coffees or café lunches. It’s WORTH it.
The Charge Midwives and I together
adopted a policy not just of asking
midwives to do QLP but telling them
that we believed they were Leadership
Midwives or Confident Midwives and
that getting the award was achievable.
In addition, that if they just gave their
portfolio a good shake they would find
the evidence was all there. We all like
being told we do a good job. And if it’s
true of others, why not tell them out
loud. Success in applying for QLP is not
about a minority achieving lofty heights,
but about recognition for all the fantastic
things midwives working on the floor are
already doing.
Today we have 18 midwives on QLP which
represents 42% of our staff midwives. Of
these five are on Leadership Domain. We
have another four applications expected
at the end of this month. We have set the
somewhat ambitious goal of 80% by this
time next year. Finally midwives our seeing
their worth.
Caroline Conroy, Auckland Organiser, page 23.
For MERAS Membership e-mail
[email protected]
or call Kim McCall 03 372 9738
Midwifery News March 2013 11