Primary maternity options in the Morrinsville/Te Aroha area
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Transcript of Primary maternity options in the Morrinsville/Te Aroha area
Introduction
This presentation follows on from the presentation to the community in December about the feasibility study carried out by reviewers late last year. It will take about 20 minutes to complete.
The presentation is a summary of: – What the reviewers found– What the issues are– What we’ve been told– Some options for consideration– What happens next?
Discussion in groups after the presentation (30 minutes)
Feedback and next steps (20 minutes)
Summary of review findings
As they are currently configured, primary maternity services in these facilities are:
– Underutilised – The building is no longer fit for purpose e.g., risks
associated with room size and access– Maternity is not connected to other local maternal and
child health services– Poor use of the maternity workforce– Not sustainable over the long-term– Costly
Summary of review recommendations
1. That Waikato DHB consolidates current service provision (birthing) from Rhoda Read and Matariki into the two urban primary units in Hamilton.
THIS DOES NOT MEAN ALL MATERNITY SERVICES SHOULD MOVE TO HAMILTON.
Whilst the recommendation is to cease provision of local maternity hospital services for childbearing women, this does not mean that all maternity services should be removed from these localities.
Engage the two affected communities in consultation to explore what community-based maternity priorities / initiatives are needed.
Feasibility study – Rhoda Read birth numbers
Rhoda Read has 24/7 staffing on-site with 24/7 on-call LMC cover.Births in the facility are declining and that trend is expected to continue.
In the 6 months to July 2013, each month on average:
– 4.2 women admitted – 2.5 women were transferred to Waikato Hospital intrapartally– 5.3 babies were born– 6.3 mothers and babies transferred into the facility postnatally
Women are bypassing local facilities to have their babies in Hamilton
Morrinsville/Te Aroha area Facility used
Birth year Pohlen Rhoda Read Thames Waihi
Waikato Hospital
Hamilton Birthing
Grand Total
2011/12 1 65 1 209 29 305 2012/13 4 58 1 1 234 33 331 Grand Total 5 123 2 1 443 62 636
- The above figures are updated from the feasibility study (pages 21 and 25)- Only women from the local area have been included in these slides- There were 12 out-of-area mothers who gave birth at Rhoda Read in 2012/13
Why are women choosing not to have their babies in their local facility?
EN = enrolled nurse LMC = lead maternity carer
Theme Morrinsville Te Awamutu Factors Impacting on Utilisation
The environment is small Facility is old Local midwifery rooms are a
distance from the unit No visibility of the unit The food is unsuitable for
maternity patients EN being the 2nd at births
prevents usage by some LMCs Distance perceived to be unsafe
by some providers
The model of care prohibits LMC utilisation
The environment is small Facility is old Population unaware of
the unit Lack of community
involvement No local antenatal
classes Distance perceived to be
unsafe
Other issues raised
Theme Morrinsville Te Awamutu Issues related to physical environment
Small size of postnatal rooms
No room for partners sleeping over
Last refurbishment many years ago
Poor maintenance No ensuites Not soundproof Needs better
birthing pool
Small size of postnatal rooms
Last refurbishment many years ago
Poor maintenance Partners sleeping
‘under the sink’ on a mattress if they stay
No ensuites Not soundproof Needs better
birthing pool
Financial viability
• At present, it costs Waikato DHB a total of $1,281,459 to operate these facilities ($665,802 for Rhoda Read, and $615,657 for Matariki).
• This is $856,468 more than the DHB pays for the same number of births in Hamilton.
• Improving community-based maternity services is likely to be a better use of taxpayers’ money than keeping underused, out-of-date maternity facilities open
Where there are no risk factors, women are best served by using primary birthing facilities:
•Hamilton has two primary birthing units; River Ridge East and Waterford•Thames, Te Kuiti, Taumarunui, Tokoroa and Pohlen hospitals have primary birthing units•There are also primary birthing facilities in Huntly and Waihi
Waikato Hospital is best kept for women who have complications.
Where would women birth if Matariki and Rhoda Read closed?
Has the decision to close these facilities already been made?
No.Waikato DHB is consulting with the communities affected. We want your ideas on:
• The advisability of retaining or closing the local birthing facilities• What primary maternity services would be needed in your area if all women
were to have their babies in Hamilton. These could include:
• Improvements to existing community-based services• Grouping some providers into a family / resource centre• Other ideas from the community
This is outlined in more detail in the consultation document andin the submission form.
At the Morrinsville meeting in December, we were told . . .
• Women do not want to have their babies at Waikato Hospital• The DHB should give Rhoda Read a ‘facelift’ and then
women would go there• It’s too hard for families to travel to Hamilton to visit the
mother (cost, distance)• Would the DHB consider a proposal from a private provider?• The DHB team needs to hold a meeting in Te Aroha• Meetings should be held at 7.15pm so they’re after children
are in bed
We looked at what is currently available in MorrinsvilleCurrently in Morrinsville Would no
longer be available in Morrinsville
Will remain in Morrinsville
Could be enhanced locally
Lead Maternity Carers (LMCs) Midwife group practice with shared rooms √ √
10 LMCs live in the area √ √26 LMCs service the area (but not all will use Rhoda Read)
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Total of 96 LMCs with access agreements to Rhoda Read (but not all will use the facility)
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Maternity Services at Rhoda Read Waikato DHB midwife Antenatal clinics Birth/postnatal stays CTG Lactation service
√ √
√ √
√ √√
Other related services Postnatal checks in the woman’s home √
Pregnancy and parenting classes √
√
Well child providers (GPs, Plunket) √
Maternal Mental Health Service
Currently provided as needed
A family / resource centre: an option?
• A centrally located site could offer screening and immunisation
• Room for classes such as pregnancy and parenting classes
(particularly for women with high needs
• Midwives to work together to maximise cover / relief for each other and ensure back-up for home births
• Resource centres currently exist in Levin, Otaki, Pahiatua and Palmerston North: http://mamaternity.org.nz/maternity-resource-centres/
Family / Resource Centre possibilities:
• Resources:
Information / advice, monitoring, smoking cessation, pepi pods• Lactation services:
Outreach service for women with higher needs• Nutrition advice:
Nutrition support / advice for those mothers with BMI over 35. Can lead to complications in pregnancy and birth
• Promoting connections:
Space for coffee mornings, toy library, playgroups
Summary
• The birthing facilities are under-utilised and not sustainable in the long-term
• There has been a recommendation to close these facilities• We need to know if keeping them open is the best use of the
funding, which could be used to provide other services for our communities
• Waikato DHB wants your views on this and if facilities are closed, what maternity services your community needs and how they should be provided
• Submissions close 21 February• A decision is planned for late March 2014
What happens next?
The final decision on the proposed closure is planned in lateMarch 2014.
This decision will take account of the reviewers’ recommendations and the reasons behind them and the consultation feedback.
Submissions can be made in various ways: email, post, 0800 number. Details are in your submission document and at the end of this presentation.
There will be a further meeting in Morrinsville on 11 February from 6.30-8pm in the Events Centre, Ron Ladd Place
Submissions close on 21 Feb 2014.
Submission options
Post to: Planning & Funding, Waikato DHB, PO Box 934, Hamilton 3240
Email your submission to: [email protected]
Attend meetings in December, January and February
Complete your survey online at: www.waikatodhb.health.nz/birthing
Ring 0800 100 178 and leave your name and phone number. A member of staff will call you back within two working days and will guide you through the submission form.
The rest of this meeting time
• Discussion in groups – 30 minutes
• Questions:– Views on closure of Rhoda Read and how the issues
could be addressed?– What is most needed in the Morrinsville/Te Aroha area if
Rhoda Read maternity facility closed and all women have their babies in Hamilton?
– What other ideas do you have for enhancements of community maternity services?
• Feedback and next steps – 20 minutes