Background

• The Midwifery Quality and Leadership Programme has been in place since 2005
• In 2013 the DHB Midwifery Leaders undertook a review of the programme, overall there was general support however midwives felt that there was poor alignment between QLP, DHB performance appraisal/review and Midwifery Standards Review, and that duplication of effort acted as a barrier to uptake.
• DHB Midwifery Leaders, the New Zealand College of Midwives (the College), MERAS and NZNO representatives decided to undertake a review of the programme to increase alignment and national consistency. In 2015 the new programme was agreed as part of the MECA negotiations

The Three Domains of Practice

Competent – New graduate, new staff member, return to practice midwife. A midwife who is competent to practise but needs to develop skills and experience to function effectively in the role.

Confident – Midwives with the necessary skills and experience to function confidently within their employed practice area. They will have a minimum of 12 months’ clinical practice experience and will be using evidence informed practice.

Leadership – Midwives with significant midwifery experience and a role model and resource within the maternity service. The take a lead role in quality improvement, innovation and practice development in their practice area.

Applying for domains

Midwives will be appointed onto the competent domain until completion of the orientation/familiarisation programme.

Midwives may apply for domain progression at any time, providing they are able to demonstrate the requirements of the domain. Confident and Leadership domains now require annual revalidation, which occurs at the time of the annual performance review. However, some leadership domain requirements only need 3-year re-submission.

Implementing the programme

The DHBs have agreed in the MECA to implement the programme as described below:

• The DHB will appoint a Midwife QLP Co-ordinator
• The QLP will be implemented in a nationally consistent manner
• Domains will be transportable across DHBs
• There will be no quotas or built in barriers to prevent midwives progressing to the appropriate domain
• A local Midwifery Leadership Group including MERAS representatives will be established to monitor uptake, consistency and manage any local implementation difficulties
• Any structural changes needed in the programme will only be implemented by agreement between DHBs and MERAS.

For the programme to work effectively and efficiently DHB employers must ensure that the following requirements are met:

• Provide every midwife with a structured orientation/familiarisation programme
• Provide every midwife with an annual performance appraisal
• Provide every midwife with the minimum study/professional development leave as agreed in the MECA, including domain leave (1 day for confident and 2 days for leadership per year)
• Ensure there are QLP assessors available to meet the demand for portfolio assessment within a 6 -8 week timeframe (Where portfolios travel across DHB boundaries for assessment then up to 8 weeks is allowed)