Professional Aftercare Toolkit (PACT)

Process for Midwife Attendance at a Hearing Following a Serious Incident in Clinical Practice

The following process outlines the steps that should be taken when a midwife is asked to attend a hearing following a serious incident in clinical practice. This process is designed to support midwifery staff and NHS providers to ensure appropriate preparation, legal support, and emotional well-being during these challenging situations.

1. Notification and Initial Support

• Immediate Notification: The midwife should be informed promptly of the hearing details, including the date, time, location, and the nature of the incident under review.
• Informal Support: A designated line manager or supervisor should contact the midwife to offer emotional and professional support, ensuring they feel understood and supported. A trusted colleague or mentor should also be available to provide additional guidance.

2. Appointment of Support and Representation

• Legal Representation: The midwife should be advised of their right to legal representation. NHS providers should facilitate access to a solicitor or legal team who specialises in healthcare law and midwifery practice.
• Union Representation: If the midwife is a member of a professional union (e.g., the Royal College of Midwives), the midwife should be encouraged to inform the union. Union representatives can provide advice, advocate on their behalf, and offer guidance through the process.
• Support Person: The midwife can bring a colleague, family member, or support person to the hearing to provide emotional support. The support person should not actively participate in the hearing unless otherwise specified.

3. Preparation for the Hearing

• Review of Incident: The midwife should review all documentation related to the serious incident, including:
• Clinical notes and records
• Incident reports
• Statements from other team members involved
• Any relevant patient feedback or complaints
• Reflection and Support: The midwife should have a safe space to reflect on the incident, acknowledging any personal or professional challenges they may have faced. Reflection should be guided by a mentor or clinical supervisor to ensure constructive support.
• Preparing Statements and Evidence: In collaboration with legal or union representation, the midwife should prepare a clear, concise statement of their role in the incident. This should include:
• A timeline of events
• Actions taken during the incident
• Any mitigating factors
• Reflection on the outcome and lessons learned
• Simulation/Mock Hearing: If possible, NHS providers should offer the midwife the opportunity to participate in a mock hearing or practice session with their legal representative to ensure they feel confident and prepared.

4. Attending the Hearing

• Arriving at the Hearing: The midwife should be encouraged to arrive early to familiarise themselves with the environment and ensure they feel calm and prepared.
• Representation: If the midwife is accompanied by legal or union representation, this individual will act as the main spokesperson during the hearing, with the midwife providing personal testimony and responses when needed.
• Listening and Responding: The midwife should be advised to listen carefully to all questions and ensure they understand before responding. If needed, the midwife can request clarification before answering.
• Maintaining Professionalism: Throughout the hearing, it is essential that the midwife maintains professionalism, remains respectful, and avoids becoming defensive, even if faced with difficult or probing questions.

5. Post-Hearing Support and Debrief

• Debrief with Legal or Union Representative: Following the hearing, the midwife should debrief with their legal or union representative to discuss the outcome, next steps, and any further action required. This will help the midwife process the experience and clarify what happens next.
• Emotional Support: It is critical that the midwife is given time to reflect on the experience and access emotional support from a designated supervisor, mentor, or professional counselling service. NHS providers should facilitate these resources to address any emotional distress.
• Follow-up and Outcome Communication: The midwife should be kept informed about the outcome of the hearing, including whether further action is required, recommendations for practice improvement, or disciplinary actions. Clear and transparent communication is essential to alleviate any uncertainty or anxiety.

6. Learning and Development Post-Incident

• Clinical Reflection and Learning: The midwife should be encouraged to engage in a structured learning process following the incident. This could involve additional training, clinical supervision, or a reflective practice session to address any areas for development.
• Support for Workplace Practices: The midwife’s team should engage in a discussion about the broader clinical incident, assessing any systemic or team-based improvements that could prevent future similar events. Lessons learned from the incident should be shared within the team to ensure quality improvement in practice.
• Reintegration and Confidence Building: Following the hearing and any post-incident evaluations, it is important that the midwife feels supported in reintegrating into clinical practice. A gradual return, if required, and ongoing support in the workplace will help the midwife regain confidence.

7. Monitoring and Ongoing Support

• Follow-up Support: The NHS provider should offer ongoing emotional and professional support, including periodic check-ins with the midwife to monitor their well-being and professional development.
• Mentorship and Peer Support: The midwife should have continued access to mentorship programs and peer support networks to address any long-term emotional or professional impacts resulting from the serious incident.

Key Considerations:

• Confidentiality: All parties involved in the hearing process must maintain confidentiality regarding the incident, details of the hearing, and any personal or professional information shared.
• Cultural Competency: The process must be sensitive to the individual’s background and needs, ensuring that there is cultural and emotional awareness in all support mechanisms.
• Well-being: The well-being of the midwife throughout the process should remain a priority, with consideration for both their professional role and personal health.

By following this process, NHS providers can help ensure that midwives are well-supported during hearings following serious incidents, fostering an environment of transparency, learning, and emotional resilience.