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Drawing of Mother and Father and Baby Maternity Care in Victoria

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Archived 1 July 2004

Maternity Services Program
Funding, Conditions of Funding and Information for 2003 - 2004

Contents:

Maternity Services Program Allocations for each Health Service
Requirements regarding performance data for 2003/04 (full details to be on this site in August 2003)
Update procedures on changes to models of care for website: Having a baby in Victoria
Rural Maternity Initiative
Other Statewide projects and initiatives 2003/04

Maternity Services Program Allocations for each Health Service

The $14.3 M Maternity Service Program funds are recurrent and will be continuing.  Whilst there has been work undertaken to find a mechanism for mainstreaming these recurrent funds, this has not proceeded for this year.  Allocations continue to be made on a per birth basis.  On a per birth basis, there is a 5% increase in funding for 2003-2004.   Maternity Services Program Allocations for 2003 - 2004 are based on 2001 - 2002 birth separations.  

Hospitals are expected to continue to improve antenatal and postnatal care provision and maternity services for women with special needs; promote care during pregnancy and childbirth that reflects best available evidence on effectiveness; promote continuity of midwife care and improve the provision and quality of information about care options. 

Specifically, hospitals are required to provide:

(a) an offer of at least one postnatal domiciliary visit to every woman giving birth and further visits for women according to their needs (needs are further defined below);
(b) care during pregnancy and childbirth that reflects best available evidence on effectiveness;
(c) increased continuity of care, with respect to hospital care and integration with the community provision of antenatal and postnatal care and support;
(d) improved responsiveness to women with special needs;
(e) improved arrangements for monitoring, review and improvement in the quality of care; and
(f) greater opportunities for consumers to make informed choices, participate in decision making and provide feedback for service improvement.

Hospitals are required to ensure adequate postnatal care for women and their families according to clinical and psycho-social needs.  This is defined as offering as a minimum:

(a) at least two postnatal home visits or more if required for women with special needs, e.g. newly arrived migrants, single young mothers, women with disabilities, some first time mothers; and
(b) at least two or more postnatal home visits for women after a caesarean section, or with complications arising from the birth or immediate postnatal period.
METROPOLITAN HEALTH SERVICE CAMPUS    HOSPITAL
$ 358.42 per birth
Women's & Children's Health 1230 Royal Women's Hospital [Carlton]
1,578,840
Total    
1,578,840
Southern Health 1170 Monash Medical Centre [Clayton]
818,631
1220 Monash Medical Centre [Moorabbin]
372,040
2111 Dandenong Hospital
786,732
Total    
1,977,403
Eastern Health 1050 Box Hill Hospital
636,912
1590 Angliss Health Services [Upper Ferntree Gully]
788,524
3330 Yarra Ranges Health Service [Healesville]
35,484
Total    
1,460,920
Northern Health 1280 Northern Hospital  The
592,468
Total    
592,468
Peninsula Health 1250 Rosebud Hospital
145,877
2220 Frankston Hospital
472,756
Total    
618,633
Western Health 1390 Sunshine Hospital
806,445
1460 Williamstown Hospital
144,085
Total    
950,530
Bayside Health 1360 Sandringham & District Memorial Hospital
237,991
Total    
237,991
Mercy Hospital Inc. 1160 Mercy Public Hospital Inc.(East Melbourne)
1,193,897
1320 Mercy Public Hospital Inc.(Werribee)
479,208
Total    
1,673,105
Metropolitan Sub Total    
9,089,890

RURAL REGION CAMPUS    HOSPITAL
$ 358.42 per birth
Barwon-South Western 1071 Western District Health Service
53,405
  1130 Colac Community Health Services [Colac]
66,666
  2050 Barwon Health
546,949
  2090 Casterton Memorial Hospital
358
  2160 South West Healthcare [Warrnambool]
154,479
  2360 Timboon & District Healthcare Service
25,806
  2460 Portland & District Hospital
59,498
  3080 South West Healthcare [Camperdown]
18,996
  3350 Terang & Mortlake Health Service [Terang]
10,394
Total    
936,551
Gippsland 1040 Bairnsdale Regional Health Service
91,756
  1580 West Gippsland Healthcare Group [Warragul]
190,321
  1670 Wonthaggi and District Hospital
46,953
  1770 Yarram & District Health Service
2,509
  2060 Central Gippsland Health Service [Sale]
135,483
  2252 Gippsland Southern Health Service
79,928
  2440 New Latrobe Regional Hospital [Traralgon]
307,166
  4240 South Gippsland Hospital [Foster]
23,656
  5050 Far East Gippsland Health & Support Service [Orbost]
16,129
Total    
893,899
Grampians 1101 East Grampians Health Service [Ararat]
32,258
  1571 Rural Northwest Health [Warracknabeal]
4,659
  1572 Rural Northwest Health [Hopetoun]
0
  2010 Ballarat Health Services
292,829
  2170 Wimmera Health Care Group
89,247
  2260 Stawell District Hospital
36,559
  2371 West Wimmera HS - Nhill
8,244
  2480 East Wimmera Health Service [St Arnaud]
5,735
  3190 East Wimmera Health Service [Donald]
0
  4120 East Wimmera Health Service [Birchip]
4,659
  4130 East Wimmera Health Service [Charlton]
1,434
  3020 Djerriwarrh Health Service - Bacchus Marsh & Melton Memorial Hospital
143,726
  3240 Edenhope & District Hospital
2,151
  3120 Beaufort & Skipton Health Service [Beaufort]
0
  4161 Hepburn Health Service - Daylesford District Hospital
9,677
Total    
631,178
Hume 1121 Goulburn Valley Health [Shepparton]
207,167
  1150 Wangaratta District Base Hospital
127,956
  1660 Wodonga Regional Health Service
382,434
  1780 Yarrawonga District Health Service
23,297
  1881 Alpine Health [Myrtleford]
6,810
  1882 Alpine Health [Bright]
3,584
  1883 Alpine Health [Mount Beauty]
2,509
  2150 Upper Murray Health & Community Services [Corryong]
1,075
  2190 Seymour District Memorial Hospital
53,405
  2670 Mansfield District Hospital
23,297
  3010 Alexandra District Hospital
4,301
  3030 Numurkah & District Health Service
18,279
  3460 Kilmore & District Hospital  The
56,272
  4010 Nathalia District Hospital
0
  4050 Benalla & District Memorial Hospital
41,577
  4460 Beechworth Hospital The
358
  5120 Cobram District Hospital
5,376
Total    
957,698
Loddon Mallee 1020 Bendigo Health Care Group
330,463
  1260 Kyabram & District Memorial Community Hospital
51,612
  1270 Kyneton District Health Service
46,953
  1351 Maryborough District Health Service [Maryborogh]
41,935
  1340 McIvor Health & Community Services [Heathcote]
0
  1491 Swan Hill District Hospital
87,454
  2130 Cohuna District Hospital
19,355
  2180 Echuca Regional Health
85,662
  3130 Robinvale District Health Services
0
  2240 Kerang & District Hospital
29,032
  3060 Boort District Hospital
2,151
  5010 Mount Alexander Hospital [Castlemaine]
23,297
  2320 Mildura Hospital
200,357
Total    
918,272
Rural Sub Total    
4,337,599

Metropolitan Sub Total
9,089,890
Rural Sub Total
4,337,599
Grand Total
13,427,488

Performance Reporting Requirements for 2003/04 (full details to be on this site in August 2003)

Hospitals will be required to provide data in line with performance reporting requirements as outlined at: http://www.health.vic.gov.au/maternitycare (August 2003)

The Maternity Services Performance Indicators will remain broadly consistent with those implemented in 2002 - 2003.  There will be no new reporting requirements but there may be some minor modifications to the indicators or to the reporting timetable.  An email will be sent to advise rural regional offices and nominated metropolitan maternity services contacts when these are posted on the website.

The maternity service performance indicators address both process and outcome measures across antenatal, intrapartum and postnatal care.  They are evidence based, and were developed in consultatation with managers, clinicians and consumers.  They assist with monitoring maternity services across the state and are also designed to provide a useful tool for hospitals to monitor their own performance. 

Hospitals are required to provide patient level data monthly, on postnatal domiciliary care through both the VAED and AIMS: Domiciliary Postnatal Services: Form 111/D1. 

Update procedures on changes to models of care for website: Having a baby in Victoria

The Having a baby in Victoria website located at (http://maternity.health.vic.gov.au), will have further enhancements during the year, detailed in the section on Statewide Projects and Initiatives on this website.

The Department requests all health services to review the entry related to your maternity service provision.  Please complete the electronic form at

(http://maternity.health.vic.gov.au/contact/contact.htm)

to either change your model(s) of care or if you need to update the information about models of care provided at your health service.

Rural Maternity Initiative

The Victorian Government is committed to providing safe, effective and consumer-focused maternity services in rural Victoria.  The Programs Branch of Metropolitan Health and Aged Care Division is currently in the process of developing a "Rural Maternity Initiative."  This is being undertaken in collaboration with Rural and Regional Health and Aged Care Division. The Government has provided $4M ($500,000 in 2003/04) for improved maternity services in rural Victoria over the next four years.

The aim of the initiative is to support a model of midwifery-led care which takes account of current challenges in obstetrics and maternity care such as:

  • shortages of highly skilled midwives, GP obstetricians and obstetricians, particularly in rural Victoria;
  • continuing concerns about maintaining safe birthing environments;
  • managing clinical risk, supporting health services and clinicians to maintain high standards and avoid adverse events and litigation;
  • ensuring consistent and appropriate ongoing professional development is available to support midwives and doctors to maintain and extend their skills. 

The new model of care is expected to build on strengths of existing models, rather than encourage further proliferation of differing models in each location.  To this end a group of health services will be invited to work together on structuring a model, developing standards, structures, protocols and associated documentation.  This will be co-ordinated and supported by DHS and is aimed to further encourage transferability of the model to other locations over time as appropriate.

In most existing models of midwifery-led care, when complications arise women are referred to a high-risk model of care and lose their previous continuity of care and the ongoing relationship with their midwife or team of midwives.  This can be at a time when reassurance and continuity may provide its greatest clinical benefit.  In this case, the model being developed will aim to enhance collaborative practice between obstetricians, general practitioners and midwives, and also maximise continuity of care for women during pregnancy, childbirth and the postnatal period, including when complications arise, and help to ensure that women are referred when necessary in an appropriate and timely manner.

A concurrent evaluation will be planned to examine whether the anticipated processes have been put in place, whether they are working and to examine key outcome measures.

Additional funding will be provided to those health services taking part in this development.  Further information regarding the "Rural Maternity Initiative" will be available in a few months. 

Rural and Regional Health Services Branch are preparing a paper which aims to stimulate discussion that will contribute to the development of an agreed framework to describe optimal services and health outcomes for women, babies and families.  The framework is intended to assist rural health agencies to make their own decisions about the appropriateness of their birthing services.  The "Rural Maternity Initiative" will be closely linked to work being undertaken to develop the agreed framework.

Other Statewide Initiatives for 2003-2004 and beyond

The focus on promoting evidence based care (including continuity of care), multidisciplinary collaboration and a consumer focus will continue through the following:

Koori Maternity Services

Two new Koori Maternity Services will be developed in Dandenong and Echuca in 2003 - 2004.

In partnership with the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), recurrent funding is provided to support and evaluate a program to enhance existing community based Koori health services in providing additional and culturally appropriate support to Koori women during pregnancy, birth and the postnatal period. 

To date, the program has been successful in improving access to antenatal care, and this is acknowledged as a key strategy for improving Koori birth outcomes.  Health services are expected to ensure that maternity care for Koori women is provided in collaboration with their community based carers in a manner which is sensitive and appropriate.

The Victorian Maternity Record

Consultation and development work will continue on a hand-held statewide maternity record incorporating the best features of existing records and linked to the Three Centres Consensus Antenatal Guidelines.  The record will facilitate better integration of primary and acute services, rural, regional and tertiary health services, and assist consumers in decisions regarding their own care.

3Centres Consensus Antenatal Guidelines

Further funding has been provided to commence researching and writing of guidelines for matters related to antenatal care not currently covered and to commence the review of existing guidelines.

3Centres Collaboration will continue

The three tertiary hospitals have agreed to continue meeting together and will discuss matters of mutual concern and interest.  One project under their management will examine issues arising when Level 2 or Level 1 hospitals have perinatal emergencies.  The primary aim of this project is to improve the processes by which maternity care providers (doctors and hospitals) in Victoria access: expert clinical advice from tertiary obstetric consultants; key obstetric and neonatal information, and arrangements for in-utero transfer to an appropriate facility.

Intrapartum Fetal Surveillance Education and Credentialing Program

VMIA and DHS have jointly funded a project to improve the safety and quality of fetal surveillance by establishing a State education and credentialing program to ensure all health professionals (midwives, General Practitioners, specialist obstetricians and trainees) involved in intrapartum care have and maintain an acceptable level of knowledge, skills and competence in the appropriate application and interpretation of fetal surveillance.

Having A Baby in Victoria Website

Consumer information will continue to be a focus. The Having A Baby in Victoria Website (http://maternity.health.vic.gov.au), has now been translated into eight languages.  Later in 2003, new consumer information will be loaded on to the website.  This information will provide evidence-based information on the stages and issues of pregnancy Your Pregnancy and A Guide to tests and investigations for uncomplicated pregnancies.

Maternity Services Advisory Committee

The Maternity Services Advisory Committee continues to meet on a quarterly basis to advise on the implementation of the government's policy for maternity services, and the ongoing work of the Department in monitoring and improving the quality of maternity services.  The Advisory Committee provides a mechanism for the provision of multi-disciplinary advice to the Department.

Maternity Services Information Systems - comparative report available

Performance monitoring is important both for the Government but also for health service management and clinical monitoring.  A sub-committee of the Maternity Services Advisory Committee (MSAC) will be examining the extent to which both commercial and publicly owned obstetric information systems/software support internal performance monitoring and streamlined external reporting.  The report designed to assist health services in selecting appropriate and useful information systems is now available at: http://www.health.vic.gov.au/maternitycare/pubs.htm

Maternity Care in Victoria - this website

Is designed predominantly as a communication vehicle for maternity providers in Victoria. The website is regularly updated.

http://www.health.vic.gov.au/maternitycare/

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