Giving babies the best start in life and ensuring birthing and expectant mothers are safe and well-cared for is at the heart of the new Southern Maternity System of Care proposed by Southern DHB today.
The new model for community-based maternity services would see Maternal and Child Hubs created in Wanaka, Te Anau, and Lumsden, and existing primary maternity supports enhanced at Tuatapere and Ranfurly. These are non-birthing units that bring together resources to better support antenatal and postnatal care.
Primary Maternity Birthing Units are maintained in Alexandra and Winton, as well as at Lakes District Hospital, Gore Health, Oamaru Hospital and Clutha Health First in Balclutha. Birthing units would also continue alongside secondary and tertiary maternity services at Dunedin and Southland hospitals.
Lumsden Maternity Centre will change from being an in-patient primary birthing unit to becoming a maternal and child hub.
In all, under the proposal, the Southern district maternity system will have eight birthing units and five primary maternal and child hubs to support women and their babies, working with other complementary community and primary care services.
“Our aim is to provide district-wide primary maternity services which are clinically sound, sustainable, and support safe primary birthing,” says Lisa Gestro, Executive Director, Strategy, Primary and Community Directorate, Southern DHB.
“The hubs don’t have to be exactly the same in all locations. There is flexibility to adjust the services they provide and we’re committed to working with maternity service providers, trusts, communities and women to co-design services, so they are the best fit for their communities. We need to ensure we have the infrastructure in place that can adapt as needs change.”
It is possible, for example, that maternal and child hubs could be scaled up to become primary birthing units if birth numbers and workforce availability change.
The development of the primary maternity network across the district will further enhance access to specialist services by providing more facilities and support for visiting specialist services and telehealth consultations.
Southern DHB will also work with the Ministry of Health to ensure their model for resourcing midwives is appropriate and ensures a sustainable midwifery workforce.
The plan for the new system of care is being shared with primary maternity providers and others who participated in engagement opportunities over the past 18 months. Feedback is open until Wednesday March 28 before the new model is finalised. Feedback can be sent to email@example.com
Configuration of Services
The configuration of maternity facilities and services has been designed based on women’s birthing, antenatal and postnatal care preferences, population and demographic predictions for the district. The arrangement builds on the Southern DHB’s Primary Maternity Services Project Report, released last June, and the information gathered from a series of district-wide public engagement sessions, which followed in October and November 2017.
These processes involved extensive engagement with maternity care providers, lead maternity carers (LMCs), midwives and mothers, their families, other healthcare professionals and stakeholders.
It has also been created within the context of the recently launched Primary and Community Strategy and Action Plan which is improving overall coordination of health services and enhancing access to healthcare across the Southern district.
Promoting Primary Maternity
Southern DHB will work with the maternity community and educators to help promote primary-based maternity services as the best option for healthy women with low-risk pregnancies, and encourage the uptake of primary maternity services for women for whom it is appropriate.
The DHB is equally committed to supporting the LMC and midwifery community to support a sustainable workforce and will continue to work closely with a range of other healthcare services, including local doctors, nurses and St John – to ensure the safety of pregnant women when transport, transfer or other medical assistance is required.
“The health and safety of mothers and their babies is always our paramount concern,” says Jane Wilson, Southern DHB Chief Nursing and Midwifery Officer. “A strong, integrated network of primary maternity services is the best way to provide safe and effective care and ensures services are equitable and sustainable for the future.”
The initial focus of implementation will be creating the maternity hubs in Wanaka and Te Anau, followed by the transitioning of Lumsden to a maternal and child hub. Later this year, a feasibility study will be undertaken to determine whether a Primary Birthing Unit for Dunedin is warranted in the future, in the context of the rebuild of Dunedin Hospital.
Southern Maternity System of Care
- Maternal and Child Hubs established in Te Anau, Lumsden and Wanaka; existing services in Tuatapere and Ranfurly enhanced. Facilities provide antenatal and postnatal care, but no birthing or postnatal inpatient care. Potential to co-locate with other complementary services, such as breastfeeding support and Plunket.
- Primary Maternity Birthing Units at Queenstown, Oamaru, Alexandra, Gore, Balclutha and Winton. Birthing units provide antenatal, birthing and postnatal care and inpatient support.
- Secondary and tertiary care is available in Dunedin and Invercargill and provided by telehealth in other areas.
- Flexibility and the ability to adapt to changing needs is central to the system of care.
- The primary maternity care is integrated with other primary and community healthcare services, including reliable transfer and transport system and emergency services.
- Need for promotion and encouragement of primary birthing services as is planning and coordination of a strong and sustainable primary maternity care workforce.
- Feasibility study in 2018 to determine whether a primary birthing unit in Dunedin is appropriate.
Primary Maternity Birthing Units
- Clutha Health First
- Gore Hospital
- Lakes District Hospital Maternity Unit
- Oamaru Hospital Maternity Centre
- Winton Maternity and Healthcare
- Dunedin Hospital
- Southland Hospital
Maternal and Child Hubs
- Te Anau