Working with service-users in midwifery education Annabel Jay Senior Lecturer, University of Hertfordshire Maastricht, 2013.

Background Tradition of involving service users (SUs) in planning health care in the UK (DH, 2007) Recently extended to pre-registration midwifery programmes of education (NMC, 2009) University of Hertfordshire (UH) has links with local SUs for teaching purposes Since 2011 extended to the recruitment of midwifery students

Why involve service-users? The needs of women and their families MUST be central to midwifery education Academic staff - too focused on academic issues? SUs identify the “caring potential” within a candidate Demonstrates rigour in assessing characteristics highlighted by The Francis Report e.g. compassion, caring, kindness, (Mid Staffs. NHS Foundation Trust, 2013)

But.. How do we define a Service- User?

Exclusions Midwifery team definition: “Any person currently expecting a baby or with a child under three years” …and able to make an informed decision to participate. Current applicants to UH midwifery programmes People in dispute with local maternity services Discontinued midwifery students Current or former health care practitioners (NMC requirement)

The role of service-users Selection of students Interviewing candidates alongside a lecturer or clinical midwife* Participating in discussions on selection criteria Evaluating the selection process * We use the Multiple Mini Interviews (MMI) system Other activities Participating in classroom activities e.g. teaching and assessing communication skills Curriculum development Programme evaluation

Recruiting service-users First sought from UH staff via appeal. Positive responders sent further information and invited to meet with admissions tutor for full briefing First batch of SUs a fairly homogenous group (ethnically and socio-economically) Needed to widen participation.

Recruiting Definition of SU widened to include members of local organisations and user-groups Further recruitment by word of mouth Wider demographic mix, but still mainly white, female professionals Current bank of around 12 SUs How to include under-represented groups? –Obstacles: - lack of payment, transport, childcare. Recruitment is on-going

To pay or not to pay? Initially, no payment or expenses offered UH now pays out-of-pocket expenses but no fee Regular SUs from outside UH can apply for Visiting Lecturer contracts (but rationed) However, payment may adversely affect those in receipt of maternity pay (i.e. most current SUs) Payment remains a controversial issue.

Issues arising from working with SUs DBS screening? Potential applicants to midwifery programmes as SUs SUs working with clinical midwives SUs interviewing alone? Regular SUs – do they become institutionalized? SUs with their own agenda? Baby on board!

Evaluation of SUs in student recruitment 2012 working party evaluated use of SUs in student recruitment Comprised of tutors, SUs, students and clinicians Electronic survey* sent to all current SUs in summer of 2012 and repeated in 2013 – response rate 75% and 66.7% * Bristol Online Survey©

Results of questionnaire All but one respondent in each survey felt well informed about their SU role All respondents felt well treated by academic staff All but one (2012) felt that their opinion was given equal weighting to that of the other interviewer All felt able to provide a valid contribution to the selection process

All but one respondent in each survey felt able to make a good assessment of candidates Suggestions for amending or adding to interview questions were made All but one* (2012) willing to participate in future * returning to work so unable to participate further

Comments: “I feel that the experience has been of great benefit to me personally and professionally and I would love to participate in more selection days.” “Thank you for allowing me to participate in this process it was an interesting and enjoyable experience” “Perhaps one of the values that including services users has is that it demonstrates from the outset of a midwife's career that midwives must be women-focussed, and service users must be at the heart of a modern midwifery service.”

Summary Childbearing women and families must be at the heart of midwifery education Service-Users bring a fresh perspective to the recruitment of student midwives Student midwives value the use of service-users within their curriculum Midwifery educators and clinicians generally find the involvement of service-users a positive experience.

References DH (2007). Patient and public involvement in the NHS: third report of session London. The stationery office. Jay, A. M. (2013). Parents, we need your views. The Practising Midwife. 15(8) Mid Staffordshire NHS Trust (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry Executive summary. Chair: Robert Francis QC. London. The stationery office NMC (2009). Standards for pre-registration midwifery education. London. NMC

Questions?