The Development and Delivery of a Pilot Programme for the Role of Maternity Care Assistant in Scotland

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1 The Development and Delivery of a Pilot Programme for the Role of Maternity Care Assistant in Scotland Executive Report November 2008 Susan Gibb Anne Marie Rennie Jenny McNicol Ann Mckay

2 Executive Summary Background This report sets out how the aims and outcomes of the NHS Education for Scotland (NES) commission to develop, deliver and pilot a national programme of preparation for the role of the Maternity Care Assistant (MCA) was addressed by the collaboration between The Robert Gordon University (RGU), Aberdeen and NHS Grampian. The programme was to prepare health care workers to undertake the role of the MCA using the Maternity Care Assistants in Scotland: A Competency Framework (NES 2006), know in this report as the Competency Framework. To support this initiative, NES committed to facilitate the recruitment of a minimum of 15 candidates from across all maternity care settings in Scotland. In November 2006, a collaborative partnership between RGU and NHS Grampian won the tender to develop, deliver and pilot a programme of preparation for the role of the MCA, as envisaged by NES and the Scottish Government, to commence in March This report sets out how the remit of the commission was achieved. The Course The title of the award is a Certificate of Higher Education: Maternity Care Assistant (Cert HE MCA), with the award equating to SCQF 7 (120 credits). The course aim is to produce MCAs with knowledge, skills and attitudes which will enable them to support women, their families and midwives working within the maternity services in Scotland, to improve health and healthcare delivery. The MCAs are required to demonstrate that they have achieved the competencies laid down in the Competency Framework. The Cert HE MCA course is 42 weeks in length. It is work-based in nature, with materials delivered face to face and via an online virtual learning environment (VLE). The course structure provides two face to face weeks followed by additional theory delivered via the VLE. The course content is set out in modules, both theory and clinical. There are four theory modules (each 15 credits) and two clinical modules (each 30 credits). The sequencing of the theory and practice modules is shown overleaf.

3 Semester 1 Semester 2 face to face to face week face week Module: The role of the maternity care assistant (24 weeks) Module: Communication and the maternity care assistant (24 weeks) Module: Maternity care assistants delivering holistic care (40 weeks) Practice Education 1 (25 weeks) Module: Maternity care assistants meeting the needs of women and their families (12 weeks) Practice Education 2 (15 weeks) The content of the modules are mapped against the Competency Framework and the Public Protection Standards in the National Standards Relating to Healthcare Support Workers in Scotland (SEHD 2006). Assessment of achievement of the competencies is via a Clinical Assessment Profile (CAP). The CAP is influenced by the Competency Framework and contains all the clinical competencies expected of the MCA. To complement the CAP a Skills Passport has been developed in conjunction with the students mentors and other midwives throughout Scotland. The Skills Passport aims to provide clarity and consistency to the clinical skills that can, or should not be undertaken by MCAs. Students who work within an integrated model are offered learning opportunities within their current place of work while students working within a larger unit are provided with a variety of placement opportunities, thus enabling them to achieve the competencies within the Competency Framework. Assessment of theory is by the production of a folder of evidence on completion of each theory module. The course team comprises a dedicated team of academic midwifery staff, practicing midwives, including a number of experts in elearning, and experts in teaching skills in the simulated clinical learning laboratory. All stakeholders are actively involved in this national development. The project is supported by a Steering Group, chaired by Monica Thompson. The course team, mentors, employers and students have explicit expectations of each others roles and responsibilities which are set out in a clinical education agreement.

4 Location Progress evaluation The 1st cohort commenced in April 2007 and completed in March The 2nd cohort commenced in April 2008 and will complete in March Students were drawn from the pool of existing health care assistants in maternity care settings and were nominated by Heads of Midwifery. Candidates were selected as being capable of studying at SCQF level 7 and having access to the internet. The geographical spread of students and course completions is detailed below. commenced in the 1 st cohort 2007 completed from the 1 st cohort in March 2008 Grampian Greater Glasgow Lothian Lanarkshire Borders Dumfries and Galloway Forth Valley Highland Tayside Ayrshire and Arran Fife Western Isles Orkney Shetland Total commenced in the 2 nd cohort 2008 All theory sessions in the 1 st cohort were evaluated positively and constructively and areas for improvement were addressed for the 2 nd cohort. The planned social sessions proved invaluable in generating the peer support necessary for continued good communication and interaction when they then returned to their own workplaces and could only communicate at a distance. The active involvement of mentors in the face to face weeks, via online discussion forums and through visits by the course team, ensured that the MCA students were properly supported. This was considered vital to the continued development and integration of the MCA within the maternity services. Module evaluation highlighted the inequity of study time allocated to the students in practice. Mentor feedback was detailed and without exception, highly complementary of the developing competence and skills of the MCA students. MCAs were seen as a reliable part of the multi-disciplinary team. Several MCAs had been given additional training in practice. The qualities of the caring role and how it compliments the role of the midwife were also commented upon positively.

5 The external examiner s report concluded that the course is commendable and that the students demonstrate a high level of reflective skills, empathy for the mother and her family and support for the midwife. Given the significance of this initiative at a national and UK-wide level every effort was, and is continuing, to be made to publicise the MCA role and raise issues for debate in a wide variety of forums. Reflections and recommendations 1. Student achievement and retention is high. 2. Providing the students with intensive face-to-face time is invaluable for building a community for ongoing peer support, being taught skills and for increasing the students' confidence with the use of e technologies. 3. The national approach to preparing MCAs should continue to be developed and delivered by midwives and midwifery educators. 4. The Skills Passport should remain dynamic with maternity care assistants, midwives and midwifery educators involved in the content. 5. Further research into the acceptability and impact of the use of MCAs in maternity services should be undertaken. 6. A system for the regulation of maternity care assistants should be put in place.