 ““Iwouldliketo respectfullyacknowledgeIwouldliketo respectfullyacknowledge
theTraditionaltheTraditional
Custodians of th...
Collaborative ArrangementsCollaborative Arrangements
between an Eligible Midwife andbetween an Eligible Midwife and
medica...
Improving Maternity Services in Australia -Improving Maternity Services in Australia -
The report of the Maternity Service...
National maternity services reformNational maternity services reform
 Commonwealth legislation has beenCommonwealth legis...
The following points summarise the changes to legislationThe following points summarise the changes to legislation
that ha...
 National Registration and accreditation for
Chiropractic, Dental, medicine, Nursing and
Midwifery, Optometry, Osteopathy...
Amended/ enabled Acts to enable access:Amended/ enabled Acts to enable access:

The Health Legislation AmendmentThe Healt...
INDEMNITY INSURANCE:INDEMNITY INSURANCE:
 Under the National Registration and AccreditationUnder the National Registratio...
Continuing professional development
(CPD)
Recency of practice
Professional Indemnity Insurance
(PII)
Criminal history
Engl...
ELIGIBILITY:ELIGIBILITY:
 The only requirement for midwivesThe only requirement for midwives
applying for a Medicare prov...
In summary, the midwife must demonstrate theIn summary, the midwife must demonstrate the
following to achieve eligibility ...
COLLABORATIVECOLLABORATIVE
ARRANGEMENTS:ARRANGEMENTS:
 A key issue with access to MBS/PBS is theA key issue with access t...
What is a collaborativeWhat is a collaborative
arrangement?arrangement?
 A collaborative arrangement is an arrangement be...
Collaborative arrangement can beCollaborative arrangement can be
demonstrated by:demonstrated by:
 being employed or enga...
 Written collaborative arrangements areWritten collaborative arrangements are
required by MIGA not Mediprotect. If thisre...
For the definition of authorised midwife inFor the definition of authorised midwife in
subsection 84 (1) of the Act, the f...
Misconceptions
Supervisory role
Legally responsible for the
actions of the midwife
Support homebirth
Extra work
Extra on c...
 Queensland Health is committed to enabling theQueensland Health is committed to enabling the
Commonwealth reform.Commonw...
Why bother?Why bother?
Women!!!!Women!!!!
Women are aware of the nationalWomen are aware of the national
maternity reform ...
 The statewide working group wasThe statewide working group was
developed through the Nursing anddeveloped through the Nu...
 The first stage was to pilot collaborativeThe first stage was to pilot collaborative
arrangements at Toowoomba Hospital....
 The successful pilot of collaborativeThe successful pilot of collaborative
arrangements and roll out of three morearrang...
Project outcomes to date haveProject outcomes to date have
includedincluded

Mapping the Patient JourneyMapping the Patie...
Statewide CollaborativeStatewide Collaborative
Arrangements Steering CommitteeArrangements Steering Committee
 to oversee...
Roll out of further sitesRoll out of further sites
 IpswichIpswich
 Gold CoastGold Coast
 BundabergBundaberg
Employment as a midwife
 Public
 Private
 Self employed
 Hybrids of all of the above
Eligibility Medicare 19(2)
exemption – revenue for public
employed midwives to attract
Medicare rebates
 
Into the futureInto the future
 For Queensland to find pathways:For Queensland to find pathways:
 to ensure national ref...
 To identify, develop and implement collaborativeTo identify, develop and implement collaborative
arrangements by identif...
Strategic national framework to guide policy
and programme development across
Australia over the next five years
Focus i...
Woman centered
Evidence based
Continuity of care
Culturally competent
“Closing the gap”
 ThankyouThankyou
National maternity reformcollaarrnag march 2013
National maternity reformcollaarrnag march 2013
National maternity reformcollaarrnag march 2013
National maternity reformcollaarrnag march 2013
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National maternity reformcollaarrnag march 2013

Published on: Mar 3, 2016
Source: www.slideshare.net


Transcripts - National maternity reformcollaarrnag march 2013

  • 1.  ““Iwouldliketo respectfullyacknowledgeIwouldliketo respectfullyacknowledge theTraditionaltheTraditional Custodians of thelandonwhichwemeetCustodians of thelandonwhichwemeet todayandElders bothpast andtodayandElders bothpast and present.”present.”
  • 2. Collaborative ArrangementsCollaborative Arrangements between an Eligible Midwife andbetween an Eligible Midwife and medical doctor [s] in a QHmedical doctor [s] in a QH maternity facility:maternity facility: for the implementation of national maternity reformfor the implementation of national maternity reform measures – Increasing women's access tomeasures – Increasing women's access to Medicare and PBS rebates for private midwiferyMedicare and PBS rebates for private midwifery carecare
  • 3. Improving Maternity Services in Australia -Improving Maternity Services in Australia - The report of the Maternity ServicesThe report of the Maternity Services Review, 2009. Australian Government:Review, 2009. Australian Government: Department of Health and AgingDepartment of Health and Aging
  • 4. National maternity services reformNational maternity services reform  Commonwealth legislation has beenCommonwealth legislation has been enacted to enable nurse practitioners andenacted to enable nurse practitioners and eligible midwives to access the nationaleligible midwives to access the national health care scheme.health care scheme.
  • 5. The following points summarise the changes to legislationThe following points summarise the changes to legislation that has occurred, that impact on Queensland Health andthat has occurred, that impact on Queensland Health and its employees.its employees.  National Registration Authority Scheme - NRAS  Australian Health Practitioners Registration Authority - AHPRA  Nurses and Midwives Board Australia - NMBA  Australian Nursing and Midwifery Accreditation Council - ANMAC
  • 6.  National Registration and accreditation for Chiropractic, Dental, medicine, Nursing and Midwifery, Optometry, Osteopathy, Pharmacy, Physiotherapy, Podiatry, Psychology and from 2012;  Aboriginal and Torres Strait Islander Health Practice, Chinese medicine and Medical radiation Practice.  Mandatory reporting of registrants  Demonstration of continuing practice development and recency of practice  National boards with the power to delegate all board decisions  Criminal history and identity checks  Simplified complaints arrangements for the public  Student registration  Handling of complaints
  • 7. Amended/ enabled Acts to enable access:Amended/ enabled Acts to enable access:  The Health Legislation AmendmentThe Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009(Midwives and Nurse Practitioners) Bill 2009  Health Insurance Act 1973 for MBS accessHealth Insurance Act 1973 for MBS access  National Health Act 1953 for PBS accessNational Health Act 1953 for PBS access  National Health (Pharmaceutical Benefits)National Health (Pharmaceutical Benefits) Regulations 1960Regulations 1960  Health Insurance (midwife and nurseHealth Insurance (midwife and nurse practitioner) Determination 2010practitioner) Determination 2010  Queensland Legislation - Health (Drugs andQueensland Legislation - Health (Drugs and Poisons) Regulation 1996.Poisons) Regulation 1996.  Collaborative arrangements for MBS/PBS:Collaborative arrangements for MBS/PBS:  National Health (Collaborative arrangementsNational Health (Collaborative arrangements for nurse practitioners) Determination 2010.for nurse practitioners) Determination 2010.  National Health (Collaborative arrangementsNational Health (Collaborative arrangements for eligible midwives) Determination 2010.for eligible midwives) Determination 2010.
  • 8. INDEMNITY INSURANCE:INDEMNITY INSURANCE:  Under the National Registration and AccreditationUnder the National Registration and Accreditation Scheme (NRAS) for health professionals that came intoScheme (NRAS) for health professionals that came into effect from 1 July 2010, midwives will be required toeffect from 1 July 2010, midwives will be required to carry professional indemnity insurancecarry professional indemnity insurance  Midwives employed will be covered by their employers’Midwives employed will be covered by their employers’ insurance arrangements.insurance arrangements.  Private practice or self employed midwives had noPrivate practice or self employed midwives had no access to Indemnity Insuranceaccess to Indemnity Insurance  MIGA insurance won the tender and developed aMIGA insurance won the tender and developed a package with Commonwealth supported run off cover.package with Commonwealth supported run off cover.  Professional indemnity cover does not cover to claimsProfessional indemnity cover does not cover to claims relating to homebirths.relating to homebirths.
  • 9. Continuing professional development (CPD) Recency of practice Professional Indemnity Insurance (PII) Criminal history English language skills
  • 10. ELIGIBILITY:ELIGIBILITY:  The only requirement for midwivesThe only requirement for midwives applying for a Medicare provider numberapplying for a Medicare provider number is to be an “eligible midwife”. This isis to be an “eligible midwife”. This is achieved by a notation on a midwife’sachieved by a notation on a midwife’s registration by the Australian Healthregistration by the Australian Health Practitioners Registration AuthorityPractitioners Registration Authority (AHPRA).(AHPRA).
  • 11. In summary, the midwife must demonstrate theIn summary, the midwife must demonstrate the following to achieve eligibility status:following to achieve eligibility status:  Current general registration as a midwife in AustraliaCurrent general registration as a midwife in Australia with no restrictions on practice;with no restrictions on practice;  Midwifery experience - equivalent of 3 years full timeMidwifery experience - equivalent of 3 years full time post initial registration as a midwife;post initial registration as a midwife;  Current competence;Current competence;  Successful completion of an approved professionSuccessful completion of an approved profession practice review programpractice review program  20 addition hours per year of continuing professional20 addition hours per year of continuing professional developmentdevelopment  Formal undertaking …’an accredited and approvedFormal undertaking …’an accredited and approved program of study determined by the Board to developprogram of study determined by the Board to develop midwives’ knowledge and skills in prescribing’midwives’ knowledge and skills in prescribing’
  • 12. COLLABORATIVECOLLABORATIVE ARRANGEMENTS:ARRANGEMENTS:  A key issue with access to MBS/PBS is theA key issue with access to MBS/PBS is the legislated requirement forlegislated requirement for written collaborativewritten collaborative arrangements with a medical doctorarrangements with a medical doctor  Midwives do not need a “collaborativeMidwives do not need a “collaborative arrangement” to become eligible. This is aarrangement” to become eligible. This is a requirement of the MBS/PBS items.requirement of the MBS/PBS items.  Medical doctors do not have to have aMedical doctors do not have to have a collaborative agreement or enter into one withcollaborative agreement or enter into one with an Eligible midwifean Eligible midwife
  • 13. What is a collaborativeWhat is a collaborative arrangement?arrangement?  A collaborative arrangement is an arrangement betweenA collaborative arrangement is an arrangement between an eligible midwife/eligible nurse practitioner with aan eligible midwife/eligible nurse practitioner with a medical practitioner that must provide for:medical practitioner that must provide for:  consultation with a specified medical practitioner;consultation with a specified medical practitioner;  referral of a patient to a specified medical practitioner;referral of a patient to a specified medical practitioner; andand  transfer of the patient’s care to a specified medicaltransfer of the patient’s care to a specified medical practitioner,practitioner,  as clinically relevant, to ensure safe, high quality healthas clinically relevant, to ensure safe, high quality health care.care.
  • 14. Collaborative arrangement can beCollaborative arrangement can be demonstrated by:demonstrated by:  being employed or engaged by a medicalbeing employed or engaged by a medical practitioner or an entity that providespractitioner or an entity that provides medical services;medical services; OROR  receiving patients on written referral fromreceiving patients on written referral from a medical practitioner;a medical practitioner; OROR  a signed written agreement with aa signed written agreement with a specified medical practitioner/s;specified medical practitioner/s; OROR  an arrangement in the midwife’s or nursean arrangement in the midwife’s or nurse practitioner’s written records.practitioner’s written records.
  • 15.  Written collaborative arrangements areWritten collaborative arrangements are required by MIGA not Mediprotect. If thisrequired by MIGA not Mediprotect. If this is unattainable, a submission of a careis unattainable, a submission of a care plan to a public hospital, andplan to a public hospital, and acknowledgement by public hospital, willacknowledgement by public hospital, will meet MIGA requirements.meet MIGA requirements.
  • 16. For the definition of authorised midwife inFor the definition of authorised midwife in subsection 84 (1) of the Act, the followingsubsection 84 (1) of the Act, the following kinds of medical practitioners are specified:kinds of medical practitioners are specified:  an obstetrician:an obstetrician:  a medical practitioner who providesa medical practitioner who provides obstetric services;obstetric services;  a medical practitioner employed ora medical practitioner employed or engaged by a hospital authority andengaged by a hospital authority and authorised by the hospital authority toauthorised by the hospital authority to participate in a collaborative arrangement.participate in a collaborative arrangement.
  • 17. Misconceptions Supervisory role Legally responsible for the actions of the midwife Support homebirth Extra work Extra on call Reality Professionalism Collegiality Healthy women and babies Timely and appropriate access to medical care Effective and timely use of resources
  • 18.  Queensland Health is committed to enabling theQueensland Health is committed to enabling the Commonwealth reform.Commonwealth reform.  There are over 85 eligible midwives inThere are over 85 eligible midwives in Queensland.Queensland.  Queensland Health hospitals have not hadQueensland Health hospitals have not had formal arrangements with self-employedformal arrangements with self-employed midwives. However, there have been informalmidwives. However, there have been informal arrangements in some facilities whereby thearrangements in some facilities whereby the public maternity hospitals have informationpublic maternity hospitals have information relating to the care of a women choosing privaterelating to the care of a women choosing private midwife care.midwife care.
  • 19. Why bother?Why bother? Women!!!!Women!!!! Women are aware of the nationalWomen are aware of the national maternity reform and therematernity reform and there has been an increase ofhas been an increase of women seeking privatewomen seeking private practice midwifery care withpractice midwifery care with a preference to birth in aa preference to birth in a hospital.hospital. Safe and equitable access to careSafe and equitable access to care EPPM role in Queensland is aEPPM role in Queensland is a service innovation andservice innovation and integral to the healthintegral to the health workforce reform agenda inworkforce reform agenda in Australia.Australia.
  • 20.  The statewide working group wasThe statewide working group was developed through the Nursing anddeveloped through the Nursing and Midwifery Office Queensland.Midwifery Office Queensland.
  • 21.  The first stage was to pilot collaborativeThe first stage was to pilot collaborative arrangements at Toowoomba Hospital.arrangements at Toowoomba Hospital.  Toowoomba hospital was chosen asToowoomba hospital was chosen as they had executive and medical supportthey had executive and medical support for collaborative arrangements.for collaborative arrangements.  A private practice midwifery group, inA private practice midwifery group, in Toowoomba were willing to be involvedToowoomba were willing to be involved in pilot project.in pilot project.
  • 22.  The successful pilot of collaborativeThe successful pilot of collaborative arrangements and roll out of three morearrangements and roll out of three more makes Queensland the first state inmakes Queensland the first state in Australia to successfully implement theAustralia to successfully implement the National Maternity reforms working forNational Maternity reforms working for the benefit of women.the benefit of women.
  • 23. Project outcomes to date haveProject outcomes to date have includedincluded  Mapping the Patient JourneyMapping the Patient Journey  Establishing a credentialing and scope of clinicalEstablishing a credentialing and scope of clinical practice process at the local levelpractice process at the local level  Formalization of a collaborative agreement betweenFormalization of a collaborative agreement between the obstetricians of Toowoomba Hospital and Fivethe obstetricians of Toowoomba Hospital and Five (5) Private Practice Midwives(5) Private Practice Midwives  Development of a License agreement to betweenDevelopment of a License agreement to between the District Chief Executive officer and Eligiblethe District Chief Executive officer and Eligible Midwives with a signed collaborative agreement, atMidwives with a signed collaborative agreement, at Toowoomba Hospital.Toowoomba Hospital.
  • 24. Statewide CollaborativeStatewide Collaborative Arrangements Steering CommitteeArrangements Steering Committee  to oversee the Statewide roll outto oversee the Statewide roll out  to advise on, and determine Statewideto advise on, and determine Statewide processes and templatesprocesses and templates  to provide high level key stakeholderto provide high level key stakeholder engagement with Districts regarding theengagement with Districts regarding the Statewide development of processes andStatewide development of processes and templates for the roll out of collaborativetemplates for the roll out of collaborative arrangementsarrangements
  • 25. Roll out of further sitesRoll out of further sites  IpswichIpswich  Gold CoastGold Coast  BundabergBundaberg
  • 26. Employment as a midwife  Public  Private  Self employed  Hybrids of all of the above
  • 27. Eligibility Medicare 19(2) exemption – revenue for public employed midwives to attract Medicare rebates
  • 28. Into the futureInto the future  For Queensland to find pathways:For Queensland to find pathways:  to ensure national reform measures areto ensure national reform measures are implemented successfully;implemented successfully;  for women to have equitable and safefor women to have equitable and safe access to midwifery care and;access to midwifery care and;  for women to have timely and safe accessfor women to have timely and safe access to medical services.to medical services.
  • 29.  To identify, develop and implement collaborativeTo identify, develop and implement collaborative arrangements by identifying and articulating:arrangements by identifying and articulating:  Agreed pathways for consultation, referral andAgreed pathways for consultation, referral and transfer of a woman and/or babytransfer of a woman and/or baby  Credentialing processCredentialing process  model to enable admitting rights for PPMmodel to enable admitting rights for PPM  Public employee relationship pathways to bePublic employee relationship pathways to be exploredexplored  Clinical Handover as per the Australian CollegeClinical Handover as per the Australian College of Midwives consultation and referral guidelines.of Midwives consultation and referral guidelines.  To facilitate collaborative partnership and enableTo facilitate collaborative partnership and enable ongoing sustainability EPPM Model of care.ongoing sustainability EPPM Model of care.
  • 30. Strategic national framework to guide policy and programme development across Australia over the next five years Focus is Primary Services not specialist services
  • 31. Woman centered Evidence based Continuity of care Culturally competent “Closing the gap”
  • 32.  ThankyouThankyou

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