Health & Families - Maternity Services Model

Introduction

In 2007 the Department of Health and Community Services (DHCS) initiated a comprehensive review of Maternity Services, including ante-, peri- and post-natal services across the Northern Territory .

One of the key outcomes for the review was to develop a Framework of the services required to optimise the accessibility, safety, effectiveness and efficiency of maternity services for Territorians.

The review process examined the views of a range of stakeholders and an Expert Reference Group, established to include representation from all Northern Territory Hospitals , remote health services, professional representative bodies and maternity-orientated organisations.

The key recommendation of the review - to establish an Integrated Maternity Service Framework is supported by the department. Mechanisms and resourcing will be established to lead this process, recognising the professional views of the key service providers, Obstetricians and Midwives, and the views of consumers.

The development of an Integrated Maternity Service Framework will continue the evolution and service development of Maternity Services, that in recent years has seen a range of new initiatives aimed at improving services and the health and well-being of mothers and babies, including:

Community Midwifery Program in Darwin
Birthing Centre at Royal Darwin Hospital
Home birth services in Darwin and Alice Springs
Maternal and Child Health Strategy
The proposed Introduction in 2008/09 of a Midwifery Group Practice for remote women who come into town for birth, under the Closing the Gap initiative.

A systematic approach will be taken to the development of this Framework, including considering models of best practice, the unique issues facing the Northern Territory , establishing agreed implementation timeframes, consolidation of available resources and visionary leadership to drive such a significant change.

This document provides an outline of the Integrated Maternity Framework as well as a response to all recommendations of the Maternity Services Review. This includes those recommendations not supported due to safety concerns, lack of supportive evidence, and the inability of this review process to secure consensus among the divergent views. These views all have legitimacy and the priority now is to establish a process to collectively work through these divergent positions to develop a service model that is underpinned by client-centred care that is inclusive, participatory, and provides improved continuity of care across the health system.

The Way Forward

The Department is committed to developing an Integrated Maternity Services Framework and will immediately establish two key leadership roles to drive this process.

Leadership:

A Director of Obstetric and Maternity Services, to be based at Royal Darwin Hospital, will lead and influence change at Royal Darwin Hospital in the provision of obstetric services and its links to hospitals across the Northern Territory, and lead the establishment of integrated maternity services across the Northern Territory. The position will be a specialist obstetrician and gynaecologist who will have experience in integrated maternity services in Australia or overseas.

A Midwifery leadership role will be established within the Health Services Division to work in partnership with the Director of Obstetric and Maternity Services to develop the new Framework. The position will be a midwife with significant experience in integrated maternity services.

Clinical Reference Group for Maternity Services:

A Clinical Reference Group (CRG) for Maternity Services across the Northern Territory will also be stablished to support the development of an integrated Framework.

The CRG will be led by the Director of Obstetrics and Maternity Services with membership drawn from key stakeholders and clinical experts within the Northern Territory, including consumer representation.

The key functions of the CRG will be to shape existing services into a more integrated service and to plan future services based upon the needs of the population and changes in the health system. The CRG will develop a Strategic Plan for Maternity Services in the Northern Territory. The CRG, via the Chair will make recommendations and provide advice and information to the Assistant Secretary Acute Care and the Assistant Secretary Health Services Divisions about the provision of maternity services.

The full range of individual recommendations, will be available to the CRG for consideration and where supported by that group, for further development or action.

Proposals for an Integrated Maternity Services

The following principles inform the development of the Integrated Maternity Services Framework.

The safety of the mother and fetus/newborn is paramount
A single maternity service spanning antenatal, birthing services and postnatal care
Women should have access to information about pregnancy and its more common complications
Women should have access to information about options for care to enable them to make informed choices about the provider and the location of care
Along the continuum of low to high risk the appropriate professional skills should be available to provide the care required
There should be continuity of care and carer where possible
Aboriginal women are entitled to consider the retention of traditional practices, where feasible, combined with the best evidence-based care.

Key elements of the Integrated Maternity Services Framework will include:

The new leadership model to develop the way forward
Defined referral pathways and protocols for care whether women are low or high risk
Continuity of carer through a designated team
eHealth Shared Care Record and/or hand held record
A skilled and supported workforce
Consumers and professionals working together
Recognise private options as a component of the Framework.

Maternity Services Model

On this page:

Introduction

Proposals for an Integrated Maternity Services

Downloadable documents