Maternity Services Funding - Conditions of Funding and Policy and Program Information 2008 - 2009

As growth in demand for maternity services continues the Department’s policy direction is for each maternity service to meet demand from its local area. This is to ensure tertiary hospital services are available for high risk or complex pregnancies. For the financial year 2008-09, approximately $20.8M in total has been distributed to individual health services as a Variable Maternity Services Grant (VMSG). This includes:

• $429 per public birth episode separation which is approximately 5.1% increase from the previous year, plus
• $120 per public birthing episode separation where LOS is less than 24 hours. This is a supplementary payment towards additional postnatal support for women with a short length of stay for the birthing episode, and for related breastfeeding, mother or newborn health issues

The allocation is based on 2007 calendar year VAED data.

The once-off supplementary payment, which reflects the increase in early discharges, is intended to recognise the additional workload associated with the nature of postnatal support provided when women leave hospital shortly after birth.  Page 39 of the 2008-09 Policy and Funding Guidelines outlines further work to be undertaken in the course of the year to assess funding approaches for postnatal domiciliary care. http://www.health.vic.gov.au/pfg/pfg0809/pfg0809.pdf

Health services are expected to provide appropriate postnatal care for women and newborns, including breastfeeding support, across the in-patient and domiciliary episode of care on the basis of clinical and psycho-social needs. This is defined as offering as a minimum:

• An offer of at least one postnatal domiciliary visit to every woman giving birth and further visits for women according to their needs;

• 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
• 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.
• Care during pregnancy and childbirth that reflects best available evidence on effectiveness;
• Increased continuity of care, with respect to hospital care and integration with the community provision of antenatal and postnatal care and support;
• Improved responsiveness to women with special needs;
• Improved arrangements for monitoring, review and improvement in the quality of care; and
• Greater opportunities for consumers to make informed choices, participate in decision making and provide feedback for service improvement.

Information regarding funding and health service responsibilities under the Variable Maternity Services Grant (VMSG) (PDF File 64KB) - September 2008

Health services are expected to:

• Manage local maternity demand with appropriate referral between services to ensure women have access to the required levels of care. Given variability and uneven distribution of future birthing demand, it will be important for individual services to plan to meet various possible demand scenarios.
• Report levels of maternity activity when required.
• Review progress against Future Directions for Victoria’s Maternity Services policy framework with the Department.
• Consider service development and new models of care for the provision of safe primary maternity services and consumer oriented care, to better meet demand and contribute to collaborative efforts (eg Maternity & Newborn Clinical Network, Regional Meetings, Maternity Managers meetings, 3Centres Collaboration).
• Ensure that any additional funding allocated for maternity services is used exclusively on the provision of maternity services.
• Provide data for entry into the annual Maternity Services Performance Indicator report and regularly review results and trends.
• Effectively address mortality and morbidity issues at each service, in partnership with the Maternity & Newborn Clinical Network.
• Ensure that maternity performance data is included in the health service quality systems and reports.
• Review requirements for additional training and education and ensure clinicians attend appropriate activities.
• The Maternity Services Education: A program for Victorian clinicians will be utilised by health services over the next several years along with other education programs.
• Implement the Victorian Maternity Record (VMR), if not already done, and provide the Department with feedback regarding its implementation. Health services will need to meet capacity and capability criteria to participate. All health services are expected to use the VMR or eVMR (or hybrid record) by December 2009.
• Implement infant hearing screening as per the staged implementation plan, managed by the Royal Children’s Hospital. (Statewide infant hearing screening implementation will be completed by 2010-11).
• Contribute to statewide or regional initiatives eg strategies to strengthen the maternity workforce and the Maternity & Newborn Clinical Network.
• Ensure appropriate co-ordination and liaison with local Koori Maternity Service to provide integrated care meeting individual clinical needs and maximising wellbeing.

For further information please refer to the Victorian – Public Hospitals and Mental Health Services Policy and Funding Guidelines 2008-09

Variable Maternity Services Grant 2008-09