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Quality at CM Health • Counties Manukau Maternal Mental Health team delivering a full day training programme to the maternity service providers. • Presence of midwife representative at the inpatient mother and baby unit multi-disciplinary meeting every week. • Working on First 2000 days project to develop resources that can be used widely by General Practice and maternity care providers in the Counties Manukau area. • Identifying gaps in the services and improving communication to consider ways of managing these limitations. • Development of the Vulnerable Infant Forum coordinated monthly by Manurewa Child Youth and Family, with representation from the CM Health Community Midwifery Service, Maternity Development Services Manager and Maternal Mental Health services. • Introduction of Te Ao Marama, a vulnerable women’s forum with representation from the CM Health Community Midwifery Service, CM Health Social Workers; CM Health Child Protection Team representative; CM Health CYF Liaison Social Worker and other services supporting the cases presented including Maternity Development Services Manager and CM Health Maternal Mental Health services.

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Understand the Variability of Primary Maternity Ultrasounds One of the NMMG’s priority areas is to investigate the national variability in equity in access to primary referred maternity ultrasounds, including cost, timing and quality. There are concerns that in some DHBs antenatal ultrasounds are provided through private providers and women are required to pay a co-payment. For women with limited financial resources, such as many women living in Counties, this is a significant barrier to accessing routine antenatal scans such as the 18 week anatomy scan. There are five private community based ultrasound scan providers covering the CM Health area. Anecdotally there is high demand for scanning services which has been driven by previously reported influences: • Referrals for secondary care consultations for suspected growth restriction require a completed GROW chart; • Clinical guidelines regarding managing obesity during pregnancy, post-maturity and suspected growth restriction; • Consumer demand; • Early pregnancy screening; • Routine requesting of dating scans; • Quality of Ultrasound visual (recall for further scan); • Interaction between ultrasonographer and woman (woman informed she will require further scans).

These factors have contributed to an increase in workload and therefore providers are employing more staff to cover the need. This overhead is being passed onto the consumer with the addition of a surcharge to all anatomy scans and nuchal translucency scans for women in the Counties Manukau area. The surcharge ranges from $20-$40. The introduction of a surcharge has caused anxiety among the self-employed LMC midwives who care for the families in Counties Manukau as many of the women giving birth live in the most deprived areas (52.7% Quintile 5 ) and do not have the financial resources to pay a surcharge. What has been done to address equity issues in ultrasound provision? Progress in this area has been slow due to the services being provided by private providers and the need to identify what can be done in this space to provide women with an improved service. We have recommenced quarterly meetings to develop a forum for communication with our providers so we can discuss issues as they arise and determine solutions. The meeting is attended by both a rural based and an urban based self-employed LMC midwife so they can provide their perspective on service quality and provision. Self-employed LMC midwives and senior medical officers have been requested to support the diligent ordering of ultrasound scans and advise the woman as to when her scan is to be undertaken and what

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...