The head of a midwifery course which has recently been re-approved by the Nursing and Midwifery Council (NMC), after three years of being unable to take on new students, has outlined what happened to get the programme back on track.
In 2022, Canterbury Christ Church University (CCCU)’s midwifery course for the 2022-23 academic year was rejected for re-accreditation by the NMC under its new standards for nursing and midwifery education.
“We need to be listening to the experience of the mothers and families that are going through the system”
Paul Driscoll-Evans
The following spring, “very serious concerns” over practice learning, quality control and assessments at CCCU led the regulator to take the unprecedented decision to strip the entire midwifery programme of NMC approval.
This meant that then-current students on midwifery courses at the university would, on graduation, not be permitted to practise as registered midwives.
After a period of uncertainty for some very distressed students, they were all transferred to the University of Surrey to complete their studies while CCCU began work to address the issues which led to the collapse of the programme.
The appointment of Dr Paul Driscoll-Evans as the new dean of the university’s School of Nursing, Midwifery, Allied and Public Health was part of this improvement journey.
Having joined the university in June 2024, once the dust had settled, Dr Driscoll-Evans set out to ensure the stripping of accreditation was a “never again event”, he told Nursing Times.
“There was a real appetite for us to redevelop the programme,” said Dr Driscoll-Evans, who had dozens of meetings with stakeholders including former students.
Dr Driscoll-Evans said, however, that the task was great: “The biggest takeaway [from ex-students] for me was that they had a reasonable level of understanding of the challenges that [the university] encountered.
“They held a lot of affection for a lot of the academic staff they had experience with, but they felt let down by the university and by staff because we didn’t communicate enough.
“They felt they were learning behind the curve, and while they did demonstrate an appreciation that [the difficulties the course was facing were] sometimes a difficult narrative to consistently communicate in a timely way, that’s one of the things we needed to get better at.”
He also met with academic staff, NHS representatives and local nursing and midwifery leaders.
The removal of the course impacted on the local supply of midwives to trusts such as East Kent Hospitals University NHS Foundation Trust, as many new graduates remain in the area in which they trained.
Canterbury Christ Church University
Dr Driscoll-Evans acknowledged that both the university, and the local trust, had in recent years been on “improvement journeys”.
The trust, at the time of the NMC’s decision to strip the CCCU course of accreditation, had not long been the subject of investigations into baby deaths due to poor care.
However, more recently, it has achieved a Care Quality Commission (CQC) rating of ‘good’.
Dr Driscoll-Evans said that the re-accreditation news will have been a “sigh of relief” to local midwifery providers.
“CCCU is a university that’s embedded in the community, and our graduates largely work in the community in which we train them when they qualify,” he said.
“They’re not migrating the same way as other universities are. That’s incredibly important. So it’s a sigh of relief.
“It’s a sign of all the hard work that the trusts have done to improve, it’s an external verification of the good work the trusts have been doing to get here.”
He attributed the success in re-accrediting the course to “co-production” – with former students, academic staff and NHS leaders all being involved in various ways.
Dr Driscoll-Evans added that he hoped the university and local trusts could be “critical partners” to one another in future, to help safeguard from standards slipping once more.
Improved staff-to-student ratios, with a cohort capped between 20 and 25 students, are among the measures Dr Driscoll-Evans ensured were taken to improve and future-proof the course.
“Growth is important, and the sector, at this moment in time, is experiencing real challenges, but we need to make sure that we give the students a great experience,” he said.
Alongside this, tighter admissions systems, better pastoral support and academic staff “fresh from practice” will, Dr Driscoll-Evans said, mean CCCU’s new revamped course is producing top-quality registered midwives.
The course is also emphasising coaching for students, with the Student-Led, Individually-Created Course (CLICC) model “embedded” into it.
Running through everything, Dr Driscoll-Evans added, was ensuring that ultimately the course serves the needs of pregnant women and their families in the local area.
He said that patient safety was the “golden thread” tying everything which has been changed about the course together, adding: “Most importantly, we need to be listening to the experience of the mothers and families that are going through the system, and keeping a really close eye on CQC reports or risk alerts that are raised.
“I am never shy in talking to commissioners at NHS England, to talking to [local NHS leaders] to make sure if they identify there being a problem or a concern, we’re open about it, that we have conversations early, and we resolve the issues as early as possible.”
