❓ Mr. Cook inquires about maternity services, particularly midwifery care at Kaleeya Hospital and the implementation of the National Maternity Services Plan (NMSP) in WA. The Minister provides detailed responses regarding support for the NMSP, current midwifery programs, and future plans.
AnsweredQoN 1548Legislative Assembly
QuestionView source ↗
I refer to Maternity Services and Kaleeya Hospital, and ask: (a) what are the current number and proportion of women who give birth under the supervision of a midwife; (b) does the Government support the National Maternity Services Plan (NMSP); (c) does the Government support Action 1.2 of the NMSP which is “to increase access for Australian women and their family members to local maternity care by expanding the range of models of care"; (d) what has the Government done in terms of setting targets in line with the NMSP; (e) what is the target for Western Australia; (f) which hospitals currently have a midwifery program for women to access; (g) does or did Kaleeya hospital have a Midwifery Group Practice (MGP); (h) was it the intention for the Midwifery Group Practice (MGP) to transfer to the Fiona Stanley Hospital: (i) if yes to (h), is it still intended for the MGP to transfer to Fiona Stanley Hospital; and (ii) if no to (h), why has the MGP at Kaleeya been cancelled; and (i) what will models of care will be available to women who are birthing at Fiona Stanley Hospital?
AnswerView source ↗
Answered
4 December 2013
Responded by
Minister for Health
Response time
34 days
(a) There are 1450 per year deliveries at Kaleeya Hospital (KH). Approximately 65% are delivered by midwives without medical intervention.
(b) The Hon Kim Hames MLA, Minister for Health, along with all Australian Health Ministers endorsed the National Maternity Services Plan (NMSP) in November 2010. Minister Hames was the Chair of the Australian Health Ministers' Advisory Council at the time of release of the NMSP and fully supports the facilitation of the actions of the NMSP in Western Australia.
(c) WA Health supports increased access for women to a variety of models of care, including midwifery-led models of care. The Department of Health's (DOH) Women's and Newborns Health Network and the DOH Nursing and Midwifery Office have together convened a Continuity of Care Working Group with representation and participation from all metropolitan maternity sites, the WA Country Health Service (WACHS), clinical planners and consumers. The purpose of the Group is to lead, support and facilitate the identification and implementation of safe, high quality, sustainable maternity continuity of care/r models in all health services across WA Health.
The South Metropolitan Health Service (SMHS) is in the process of developing a Maternity Services Plan for the SMHS area. This project includes determining the level and type of service delivery models provided at each site. Kaleeya Hospital established a working group to develop a strategy to support the implementation of a Midwifery Group Practice by April 2013. Armadale Health Service is developing a pathway for women to access midwifery led care in the antenatal period.
The North Metropolitan Health Service (NMHS) is currently developing a service delivery model for the NMHS area. This will encompass midwifery led care as one of a range of service delivery models to meet the needs of all women regardless of risk.
WACHS has developed the WACHS Maternity and Newborns Services Policy that informs clinicians, service managers and communities about where services can be delivered and the standards that apply to these services.
(d) The initial year's action of the NMSP recommends
jurisdictions facilitate increased access to midwifery managed models of care for low risk women
. The middle years actions recommend
jurisdictions establish the baseline for the number of women accessing midwifery managed care
. WA Health proposes to use the following measures:
· number of women accessing midwifery led models of care;
· type of model women are accessing (i.e. caseload, group practice, team or shared care); and
· percentage of increase over a defined period of time.
This data will be captured annually using the National Maternity Care Classification System, a list of consistent descriptors and definitions for the range of models of maternity care available. This will be linked with the information collected by WA Health, through the Statewide Obstetric Support Unit; from all WA public maternity units as part of the Maternal and Newborn Services Inventory.
(e) The DOH has endorsed the proposed performance indicators as a process to benchmark the existing and expanding midwifery led continuity models of care provided across WA Health maternity services. This will align with other jurisdictions and ensure WA is benchmarked against the other states and territories as part of the evaluation process of the NMSP.
(f) WA currently has four publicly funded models of midwifery continuity of care:
Family Birth Centre (FBC), King Edward Memorial Hospital (KEMH)
· planned birth at FBC
· provides services to 700 women per annum
Community Midwifery Program, NMHS
· planned birth at home or hospital
· provides services to 270 women per annum
South West Midwifery Group Practice, South West Region, WACHS
· planned birth at home or hospital
· commenced in November 2012 and currently has the capacity to provide care for 84 women per year
Kimberley Midwifery Group Practice, Kimberley Region, WACHS
· planned birth at hospital
· commenced in December 2012 and currently has the capacity to provide care for 160 women per year.
Additionally, KEMH has a Team Midwifery Model. This model features a larger team of midwives (6-8 maximum) who provide care to 35-40 women per midwife per year. There is no primary midwife and care is provided to the women by any member of the team. The women meet all the midwives working in the model.
(g) No. Kaleeya Hospital never had a Midwifery Group Practice, so it is not being transferred to Fiona Stanley Hospital (FSH) nor was it cancelled (see answer to (h)).
(h) Not applicable.
(i-ii) Not applicable.
(i) The proposed model of care for maternity services at FSH is a collaborative model between midwifery and obstetrics to provide continuity of care to patients.
Within this model of care there are many teams to provide Obstetric and Midwifery services:
· Obstetric led standard care
· Midwifery led standard care
· Complex care for med/high risk obstetric women
· Midwifery Group Practice model
(b) The Hon Kim Hames MLA, Minister for Health, along with all Australian Health Ministers endorsed the National Maternity Services Plan (NMSP) in November 2010. Minister Hames was the Chair of the Australian Health Ministers' Advisory Council at the time of release of the NMSP and fully supports the facilitation of the actions of the NMSP in Western Australia.
(c) WA Health supports increased access for women to a variety of models of care, including midwifery-led models of care. The Department of Health's (DOH) Women's and Newborns Health Network and the DOH Nursing and Midwifery Office have together convened a Continuity of Care Working Group with representation and participation from all metropolitan maternity sites, the WA Country Health Service (WACHS), clinical planners and consumers. The purpose of the Group is to lead, support and facilitate the identification and implementation of safe, high quality, sustainable maternity continuity of care/r models in all health services across WA Health.
The South Metropolitan Health Service (SMHS) is in the process of developing a Maternity Services Plan for the SMHS area. This project includes determining the level and type of service delivery models provided at each site. Kaleeya Hospital established a working group to develop a strategy to support the implementation of a Midwifery Group Practice by April 2013. Armadale Health Service is developing a pathway for women to access midwifery led care in the antenatal period.
The North Metropolitan Health Service (NMHS) is currently developing a service delivery model for the NMHS area. This will encompass midwifery led care as one of a range of service delivery models to meet the needs of all women regardless of risk.
WACHS has developed the WACHS Maternity and Newborns Services Policy that informs clinicians, service managers and communities about where services can be delivered and the standards that apply to these services.
(d) The initial year's action of the NMSP recommends
jurisdictions facilitate increased access to midwifery managed models of care for low risk women
. The middle years actions recommend
jurisdictions establish the baseline for the number of women accessing midwifery managed care
. WA Health proposes to use the following measures:
· number of women accessing midwifery led models of care;
· type of model women are accessing (i.e. caseload, group practice, team or shared care); and
· percentage of increase over a defined period of time.
This data will be captured annually using the National Maternity Care Classification System, a list of consistent descriptors and definitions for the range of models of maternity care available. This will be linked with the information collected by WA Health, through the Statewide Obstetric Support Unit; from all WA public maternity units as part of the Maternal and Newborn Services Inventory.
(e) The DOH has endorsed the proposed performance indicators as a process to benchmark the existing and expanding midwifery led continuity models of care provided across WA Health maternity services. This will align with other jurisdictions and ensure WA is benchmarked against the other states and territories as part of the evaluation process of the NMSP.
(f) WA currently has four publicly funded models of midwifery continuity of care:
Family Birth Centre (FBC), King Edward Memorial Hospital (KEMH)
· planned birth at FBC
· provides services to 700 women per annum
Community Midwifery Program, NMHS
· planned birth at home or hospital
· provides services to 270 women per annum
South West Midwifery Group Practice, South West Region, WACHS
· planned birth at home or hospital
· commenced in November 2012 and currently has the capacity to provide care for 84 women per year
Kimberley Midwifery Group Practice, Kimberley Region, WACHS
· planned birth at hospital
· commenced in December 2012 and currently has the capacity to provide care for 160 women per year.
Additionally, KEMH has a Team Midwifery Model. This model features a larger team of midwives (6-8 maximum) who provide care to 35-40 women per midwife per year. There is no primary midwife and care is provided to the women by any member of the team. The women meet all the midwives working in the model.
(g) No. Kaleeya Hospital never had a Midwifery Group Practice, so it is not being transferred to Fiona Stanley Hospital (FSH) nor was it cancelled (see answer to (h)).
(h) Not applicable.
(i-ii) Not applicable.
(i) The proposed model of care for maternity services at FSH is a collaborative model between midwifery and obstetrics to provide continuity of care to patients.
Within this model of care there are many teams to provide Obstetric and Midwifery services:
· Obstetric led standard care
· Midwifery led standard care
· Complex care for med/high risk obstetric women
· Midwifery Group Practice model
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