Background information on the Regional Women's Health Service development plan

Last month the Whanganui (22 June) and MidCentral District Health Boards (26 June) resolved to support the development of the Regional Women’s Health Service (RWHS) with specialist services provided at Wanganui and Palmerston North Hospitals.
After adding to the Whanganui DHB’s resolution around major points discussed on 22 June, the MidCentral DHB resolved as follows:
1.            that the board acknowledges and supports Whanganui DHB’s decision to support Option 2, being a Regional Women’s Health Service with secondary maternity and gynaecology services provided from both Wanganui and Palmerston North Hospitals supported by a consultant O&G 24/7 rosters provided by DHB employed doctors;
2.            that the board supports the creation of a development plan and specifications for the Regional Women’s Health Service to be submitted to the board in accordance with the Whanganui DHB’s resolution of 22 June 2012, including
  • responsibilities and accountabilities that reflect the centralAlliance partnership expectations through all levels of the service,
  • that it also include an agreed process for engagement with all health professionals involved in this service,
  • that it includes a set of principles and engagement process for consumer participation in the ongoing service development, and
  • that input from board members will be through the committee and board process;
and further to incorporate but not be limited to the specifications set out in management’s report dated 14 June 2012, namely:
  • appointment of the regional leadership group
  • appointment of implementation project support
  • development, by clinicians, of the clinical model of care (including all referral processes)
  • integration of the maternity quality and safety programme and clinical information systems sub projects
  • development of clinical supports systems and interfaces to other specialties
  • finalisation of financial models and control
  • reporting framework
  • post implementation review process
  • service emergency plan should either Wanganui or Palmerston North Hospitals be unable to provide their normal range of services
  • review of feedback from the staff consultation process and review of relevant FTE levels
  • HR processes (including staff appointments) to establish a regional service
  • supporting contracts.
3.            that in order to mitigate against future risks to sustainability, the Regional Women’s Health Service develop a capacity risk management plan to incorporate but not be limited to the specifications set out in management’s report dated June 2012, section 6, ‘capacity risk mitigation plan’ namely:
  • an active management plan for on-referral of women/babies to Hawkes Bay, Taranaki and Wellington Hospitals. In this scenario the regional service would manage the referral of both MidCentral and Whanganui women, on an equal basis, with a preference (should either Wanganui or Palmerston North Hospitals have insufficient capacity to cope) for referral to the other regional service facility and if that is not possible referral to whichever other DHB’s hospital is most consistent with best outcomes for the mother and baby and most convenient to the women and their family
  • how immediate clinic, delivery and ward space could be made available through reconfiguring existing capacity across a range of departments
  • how staffing could be rapidly increased to the levels required to cope; including using staff flexibly across both DHB facilities.
4.            that the board accepts the MidCentral senior clinicians and management’s recommendation as per the June 2012 report that no urgent women’s health facility changes to be undertaken, but rather that Women’s Health Service development at Palmerston North Hospital is included within the current investment and campus evaluation work, which would include:
  • sufficient standing clinic, birthing and ante/postnatal space to cope with Whanganui DHB women requiring acute maternity/gynaecology services; should that be required
  • evaluation (including on-campus/off-campus variants) of the option of developing a primary birthing unit in Palmerston North
  • ensuring improved access to acute obstetric theatre facilities – including review of the use of outsourced surgery in other specialties to make more theatre time available.
5. that the board acknowledge the work and commitment of staff throughout the process.