Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines)
Te Whatu Ora – Health New Zealand has published an update of the Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines) to be implemented within maternity services and professional practice.
There are a number of changes that have been made and we advise all practitioners to read the guidelines to comprehensively understand the implications they have on practice.
In summary the main changes to the Referral Guidelines include:
• The inclusion and acknowledgement of Te Tiriti o Waitangi and cultural safety
• Recognition of Ngā Paerewa Health and Disability Services Standards
• Amendments to the guiding principles
• Additive language (throughout) and terminology changes
• Updated table of conditions and referral categories
• Updated process maps and the addition of a sixth process map/flow chart, “When a woman/person declines a referral, consultation, transfer of clinical responsibility for care, emergency treatment or emergency transport”.
You can find the Referral Guidelines here: https://www.tewhatuora.govt.nz/publications/guidelines-for-consultation-with-obstetric-andrelated-medical-services-referral-guidelines/
The Referral Guidelines provide health practitioners with a list of conditions and criteria to guide the referral of pregnant, birthing and postnatal women/people and babies for consultations with other clinicians; transferring clinical responsibility for care to a specialist; as well as transferring care in emergency situations.
This Guideline also outlines the process for referral to a primary health care provider; guidelines for emergency transport; and what to do when a woman/person or parents decline referral, consultation or transfer of clinical responsibility. The document outlines the categories of referral and provides process maps detailing referral pathways.
The Referral Guidelines are based on best practice and were updated by Te Whatu Ora (formerly the Ministry of Health) and a technical advisory group with input from an expert steering group that included midwifery, obstetrics, paediatrics, general practice and anaesthetics.
The aim is to improve the safety and quality of maternity care and to ensure women/people and babies are referred by their lead maternity carer/health practitioner to the most appropriate level of care.
The Referral Guidelines sit alongside other relevant clinical guidelines. They should be used in conjunction with Ngā Paerewa Health and Disability Services Standard 8134:2021 (Ngā PaerewaSector Guidance for Ngā Paerewa Health and Disability Services Standard (NZS 8134:2021) | Ministry of Health NZ) and the corresponding Sector Guidance for Birthing Units and in-patient hospital services (both public and private).
The Health and Disability Commissioner (Code of Health and Disability Services Consumer Rights Code of Health and Disability Services Consumers' Rights - Health and Disability Commissioner
(hdc.org.nz)) Regulations 1996 is also relevant. Together, these documents provide a suite of information about best practice maternity service provision.
To support the implementation of the Referral Guidelines, Te Whatu Ora will be releasing a webinar in the coming months. The maternity sector will be notified when the webinar is live, with details of where to access it.
Please note - there is a temporary document published alongside the Referral Guidelines regarding changes that pertain to fetal growth restriction (FGR). It is critical that you familiarise yourself with this document when interpreting and implementing the Referral Guidelines.
If you have any queries, please contact Stacey Gillard-Tito at stacey.gillard-tito@health.govt.nz