Friday 10 August 2018
Southern DHB Integrated Primary Maternity System of Care sees emphasis on sustainable LMC workforce
Southern DHB has released its final plan for its Integrated Primary Maternity System of Care with a strong emphasis on
greater sustainability of the LMC midwifery workforce, as it seeks to provide greater support for women and their
families across the district.
The new system of care has the following key features:
· Introduction of a new layer of maternity support, named Maternal and Child Hubs, to extend the reach of services
across the district and provide greater infrastructure support for LMC midwives
· Funding support package for LMC midwives working in remote rural locations, to recognise the additional duties they
perform
· Investment in technology to support access to specialist care, reducing the need to travel
· Dedicated positions and resources to provide leadership support to promote quality and safety, recruitment and
retention of LMC midwives, and communication.
In the plan, maternal and child hubs will be developed in Wanaka, Te Anau, Lumsden, Tuatapere and Ranfurly. These are
non-birthing units (except in urgent situations) that bring together resources to better support antenatal and postnatal
care.
Primary birthing units are maintained at Lakes District Hospital in Queenstown, Gore Health, Oamaru Hospital and Clutha
Health First in Balclutha, Winton Maternity Centre; and will continue at Charlotte Jean Maternity Hospital in Alexandra
while the best long-term location of a primary birthing unit in Central Otago is explored.
Birthing units also continue alongside secondary and tertiary maternity services at Dunedin and Southland hospitals. The
feasibility of a primary birthing unit in Dunedin will also be considered.
In all, 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.
The development of the plan has been a two-year process that has been necessary to catch up with changes to population
and workforce needs.
“The current system had evolved through a range of circumstances and historical situations. Over time, some gaps and
inequities had developed, with resources not well distributed across the district,” says Southern DHB Chief Executive
Chris Fleming.
“There had long been calls for developing a more strategic and principles-based view of the system of care from women
and care providers alike. Addressing this became urgent as the concerns about the sustainability of the LMC midwifery
workforce that had been present from the beginning of the process became critical in some parts of the district. While
LMC midwives are paid directly by the Ministry of Health, rather than DHBs, there are steps we can take to provide a
more supportive environment for them.”
Ensuring the new primary maternity system of care is aligned with the DHB’s wider Primary and Community Care Strategy
was also essential, says Executive Director Strategy, Primary and Community, Lisa Gestro.
“We now have a wide-reaching vision for the future of primary and community health care services, including maternity
services, across the district.
“Southern DHB covers the largest geographic area of any DHB, and our climate and geography add further challenges. So we
have needed to think differently about how to expand the reach of the care we provide. Developing a new layer of support
to LMCs and women through the maternal and child hubs, investing in technology and above all taking steps to support our
remote rural LMC midwives to have their work better remunerated as they carry out their all-important roles has been
fundamental to this.”
Southern DHB would continue to work with the Ministry of Health on addressing LMC payments to reflect the work of those
in remote rural areas, Fleming says.
“Importantly, we are creating a system that has built-in flexibility, so we can adapt to ongoing changes in our
populations and community and workforce needs.
“We thank everyone who has contributed to this project over the past two years, including the authors of the more than
200 written submissions, and the people who took time to attend community meetings or participate in focus group
discussions. This input was listened to and has helped shape the decisions that have been made, and ensure the system of
care is robust, sustainable, and addresses the needs of the community.
“We look forward now to moving ahead to implement a system of care that works for women and families across the
district.”
ends