Media Kit. August 2016

Transcription

1 Media Kit August 2016 Please contact External Communications and Media Advisor, Ali Jones on / ali@alijonespr.co.nz Or Maria Scott, The College Communications Advisor on / maria.s@nzcom.org.nz for any additional information. 1 P a g e

2 The New Zealand College of Midwives The New Zealand College of Midwives (the College) is the professional organisation for midwives and student midwives in New Zealand. ( The College represents more than 3100 members and works in partnership with maternity consumer groups such as Plunket, Parents Centre New Zealand, the Home Birth Association and La Leche League to ensure high quality maternity services in New Zealand. The College sets and actively promotes high standards for midwifery practice and assists midwives to meet these standards through involvement in midwifery education and the Midwifery Standards Review process. The College membership has developed the Philosophy, Code of Ethics, Standards of Practice and Consensus Statements that guide the professional activities of midwifery practitioners. The College also provides Resolution Committees for consumers who have a concern in relation to their midwifery care experience. At an international level, the College represents New Zealand on the International Confederation of Midwives (ICM) Board as the midwife association member for the Asia Pacific Region. New Zealand also has the College s Chief Executive as the Co-Chair of the ICM Scientific Planning and Programing Committee. The New Zealand College of Midwives is the only professional membership body specifically for NZ registered midwives. The College promotes midwifery standards of practice and ongoing education courses for midwives once they are registered. It represents and advocates for midwifery and women s health interests to government, health organisations, consumer groups and the general public. The regulatory body is the Midwifery Council and is responsible for the protection of the health and safety of women and babies during the childbirth process by providing mechanisms to ensure that midwives are competent and fit to practise midwifery. The HPCAA (The Health Practitioners Competence Assurance Act) provides this regulatory framework. The College in the regions: 2 P a g e

3 The College has 10 geographic regions and 5 sub-regions in the smaller provincial centres. The regions function autonomously and have their own constitutions which align to the national NZCOM constitution. Each region has its own elected office bearers, i.e. Chairperson, Secretary, Treasurer, Standards Review Panels, Standards Review Co-ordinators, Resolution Committee members, Education Committee representatives and so on. Each of the regional chairpersons is part of the National Committee (the governance body of the College) which meets three times a year. The chairpersons therefore have a key role in raising regional midwifery related issues at a national level and ensuring that issues of national interest to midwifery are brought to the regions for comment and feedback. The map below outlines the geographic area of the College regions. 3 P a g e

4 Maternity in New Zealand a snapshot New Zealand s maternity service is the envy of many countries and the College is regularly invited to present its model of care to other health ministries and governments. New Zealand women have access to a free maternity service that provides them with consistent care from one main practitioner their Lead Maternity Carer - LMC. Lead Maternity Carers can be midwives, general practitioners or obstetricians. Most women have a midwife LMC. Maternity care in New Zealand is a community based primary health service delivered by community midwives who ensure all women have access to free obstetric care from hospital services if they need it. It integrates primary care with the additional secondary hospital services and women can have easy and free access to obstetricians and other specialists if problems arise. It is also integrated with the acute specialist tertiary service for women and/or babies with severe complications. There are five tertiary level hospitals in New Zealand. This integrated service enables women to make informed decisions about their care, provides them with visits in their own homes and covers the whole childbirth experience from early pregnancy through to six weeks after the birth of the baby. Section 88 is that aspect of the NZ Public Health and Disability Act 2000 that deals with payment for the primary maternity service. It provides a set of minimum specifications for the maternity service provided by LMCs. It also sets the prices for those services. It provides a set fee for each of four modules of care (second trimester of pregnancy, third trimester of pregnancy, labour and birth and the postnatal period of four - six weeks). It also provides set fees for single services such as registration with the LMC, visits to GPs in pregnancy and postnatally if necessary, ultrasound etc. 4 P a g e

5 Who is the New Zealand midwife? Is highly experienced; the average time in the midwifery workforce is 15 years Is aged 47.8 years on average May be working in the community, as part of a midwifery practice or be working in a maternity hospital or birthing unit Has a Bachelor of Midwifery degree requiring 4,800 hours of study, the equivalent of four academic years, or the equivalent in other recognised qualifications and experience. This is followed by an intern year with a mentor. Cares for women throughout pregnancy, labour and birth and until their babies are 6 weeks old Is paid by the Government so that care to women is free Is educated to know when a pregnancy is not progressing normally and will refer the woman to an appropriate medical specialist Works closely with doctors, other health professionals and community support agencies as part of the maternity team Holds an Annual Practising Certificate from the Midwifery Council, the regulator operating within the framework that governs 13 other health professions under Health Practitioners Competence Assurance Act Stays up-to-date with current practice through regular attendance at educational workshops Has her work formally reviewed every two years through the Midwifery Standards Review process administered by the New Zealand College of Midwives Reference: Workforce statistics from the Midwifery Council 2015 Midwifery Workforce Survey 5 P a g e

6 What Does This Mean? LMC Lead Maternity Carer This is the midwife or other maternity health professional responsible for your care during pregnancy and up to 6 weeks after a baby is born. Primary care / Primary unit Sometimes called a birthing unit, these facilities do not have the staff or medical equipment to undertake surgery or apply anaesthesia related to a birth for example, caesarean sections, epidurals. These units are where well-women who have experienced a pregnancy without complications have their babies. Secondary care / Secondary unit A hospital providing secondary care has the facilities to undertake caesarean sections and other pregnancy related surgery or anaesthesia such as epidurals. Continuity of care This describes the consistency of the close relationship between an LMC midwife and a pregnant woman, where the same LMC (and her back up) midwife sees a woman throughout her pregnancy and postnatally (for 4 to 6 weeks). This is an important part of the NZ maternity system and one that many women who experience both the NZ maternity system and an overseas maternity system hold up as being key to the positive outcomes and experiences delivered by the NZ system. Employed LMC midwife A midwife in a midwife team employed by the DHB (District Health Board) who works with a caseload of women who usually have more complicated pregnancies. Self-employed LMC midwife An LMC midwife based in the community and paid by the Ministry of Health. This LMC midwife usually works in partnership with another midwife or a small team of midwives and manages her own caseload of women. Core midwife A midwife who works rostered shifts in a maternity facility and works alongside LMC midwives and obstetricians to assist them in providing care for women. Postpartum / Post natal The timeframe beginning immediately after the birth of a child and extending for about six weeks. Antenatal The period during a woman s pregnancy, up to the birth of her baby. 6 P a g e

7 References: Ministry of Health. (2007). Report on Maternity: Maternal and Newborn Information Wellington: Ministry of Health. Ministry of Health. (2008). Statistical Information on Hospital-based Maternity Events 2005 N. Z. I. Service (Ed.) Retrieved from Ministry of Health. (2010). Hosptial-based Maternity Events Wellington: Ministry of Health. Ministry of Health. (2012). Report on Maternity 2010 Wellington: Ministry of Health. Ministry of Health. (2015). Report on Maternity, Wellington: Ministry of Health. Perinatal and Maternal Mortality Review Committee. (2015). Ninth Annual Report of the Perinatal and Maternal Mortality Review Committee: Reporting mortality Wellingotn: Health quality & Safety Commission. Research New Zealand. (2015). Maternity Consumer Survey Wellington: Ministry of Health. Statistics New Zealand. (2013). Births and Deaths: Year ended Retrieved 27th March 2014, from 7 P a g e

8 Number of births and a significant increase in women registering with an LMC Midwife The number of women giving birth annually has always fluctuated and over the last sixteen years it has been as high as 64, 343 in 2008 to a low 54,021 in 2002 (figure 2). We are currently seeing an upturn again with 61,038 births recorded in During this time the number of women registering with a midwife for Lead Maternity Care (LMC) has more than doubled (23,200 to 50,878). The number of women registering with a general practitioner has dropped from 6902 in 1999 to 261 in The proportion of women registering with a midwife LMC has increased from 70% in 2007 to 92% in 2014 this means LMCs face increasing numbers of women over an increasing time frame for the maternity service. The LMC midwife Workforce As approximately 160 new graduates join the workforce annually the proportion of the midwifery workforce working as LMC s has remained stable (Fig 2) but the proportion of midwives staying and the proportion of employed midwives providing LMC case load care has reduced since This has resulted in the proportion of the total number of LMC midwives available to provide continuity of care reducing from 41.2% to 37.8%% in This reduction in overall numbers of midwives providing LMC services is accompanied by rising birth rates and a 22% increase in women registering with midwife LMCs. Figure 2: Total LMC Midwife workforce (Self-employed and DHB employed) (Source: Midwifery Council of New Zealand Midwifery Workforce surveys 2009 to 2015) 8 P a g e

9 While the volumes/numbers of midwives being recruited are currently stable, at an individual level most midwives now work part-time and retention is decreasing overall (see Fig 4). There are more births in total, less DHB LMCs, maternity hospital services have the lowest FTE allocation of core staff of all health services and therefore inadequate core midwifery services to assist and back up LMC midwives to manage the increasing complexity that comes with moving secondary/tertiary care into the community. Because of this DHB withdrawal from DHB caseload care provision the LMC workforce has been forced to take up the increased workloads that result. Coupled with the significantly low FTE staffing in maternity hospitals (0.69 V 0.81 on average for all workforces) and the increase in case complexity LMCs have had to respond by lowering their caseloads with more midwives reporting a caseload of less than 30 and fewer midwives reporting a caseload of more than 61. Income About 40-50% of an LMC s gross income from Section 88 goes in paying for others to provide her with back up, sick and on call relief and other expenses which include clinical equipment, indemnity insurance, vehicle and travel, professional education and accountability fees, electronic equipment, documentation and other business costs. In 2015 the average taxable income of a midwife working as a Lead Maternity Carer (LMC) providing care for 41 women was $58,239 after expenses. Comparisons to other working groups are provided in Figure 6. Figure 5: Income for different occupations senior positions (Source: Careers NZ) * LMC midwife income after expenses for providing care to 41 women) 9 P a g e

10 Employed midwives Whilst there would appear to be an increase in the number of midwives working within secondary and tertiary facilities the DHB Employed workforce report for 2016 demonstrates that there has been no increase in full time equivalent (FTE) with the majority of core midwives working part-time (DHB Workforce Information, 2016). The midwifery DHB workforce has the lowest mean FTE (0.69) compared to other professional groups (Table 2) despite being responsible for double the caseload of other services -the woman and her baby. Mean FTE of health professional groups (Source DHB Workforce information Occupation group 2016 Mean FTE Midwifery 0.69 Nursing 0.81 Corporate/other 0.87 Allied & Scientific 0.84 Care and support 0.82 Senior Medical 0.83 Junior Medical P a g e

11 Additional information re: Midwives and Midwifery in NZ Midwives are highly educated health professionals with strong and effective accountability frameworks supporting practice. The College provides all new graduates with a mentored intern year called Midwifery First Year of Practice (MFYP) Programme The College and the Midwifery and Maternity Provider Organisation (MMPO) work in partnership to provide a locum and mentoring service for all rural midwives that ensures a sustainable rural maternity services and retains midwives in these areas The NZ College of Midwives works in partnership with associated professional groups such as the College of Obstetricians and Gynaecologists, the NZ Society of Anesthetists, the College of GPs, and the Paediatric Society, the DHB s and all other agencies with an interest in maternity services. These partnerships help implement Government strategies which will further improve maternity and midwifery services for New Zealand women and their babies. With the support, information and knowledge Midwives share with women, a new born baby has the best possible start in life P a g e