National Women's Annual Clinical Report 2010

2.5.3 University Links
There are close research links with the School of Medicine. Senior medical staff,
University medical staff and the neonatal fellows are involved in clinical research and
audit. Newborn Services are fortunate that recent fellows have been able to obtain
external research funding for their postgraduate degrees and, whilst not employed by the
service, have remained valued members of the Department and have contributed to both
research and clinical care. There are also links with the Liggins Institute with clinical
applications of their research being developed for specific research studies of newborn
babies. The Newborn Service is active in both local and international studies, being
involved in multi-centre international randomised trials of neonatal interventions.
There continues to be a joint appointment between the Newborn Service and Massey
University for the Neonatal Nursing Programme. This includes the co-ordination of the
Neonatal Nurse Specialist – Advanced Practice programme at Masters level and the
Neonatal Nursing course, also positioned at Masters level. Both courses attract students
locally and nationally.
In 2010 the Neonatal Science and Clinical Care of the Neonate 2 paper was transitioned
from passive to active learning modules with students synthesizing cases with guidance
from web-supported content application and study forums with clinical experts. This hybrid
paper supports clinical questioning, critical review of the literature & application of
evidence-based practice for advanced neonatal nursing content. Further review of the
Neonatal Science 1 paper and the Neonatal Practicum paper will occur in 2011.
2.6 Lead Maternity Carer services
The provision of health in New Zealand is funded by the Ministry of Health, which sets
policy, through 21 District Health Boards (DHBs). In 1996 significant changes to the way
that maternity care was funded, and therefore provided, were outlined in Section 88 of the
Public Health and Disability Act. The Section 88 notice requires all women to have a Lead
Maternity Carer (LMC), who is chosen by the woman and has responsibility for ensuring
provision of maternity services throughout her pregnancy and postpartum period.
Maternity services, apart from the services provided by a private obstetrician, are free.
LMCs are required to obtain access agreements with any maternity facility where they
intend to provide care. To ensure the woman receives continuity of care all LMCs are
required to have back up arrangements with another self employed practitioner who the
woman has met. There is a range of LMC models of care available in New Zealand. At
National Women’s the following models are available:
1 Independent Midwifery. These midwives are self employed and generally provide
continuity of care in the antenatal, intrapartum and postnatal period. Antenatal visits are
usually provided through a midwifery clinic in the community and postnatal visits are
provided in the woman’s home. If the woman’s pregnancy and or labour become
complicated then the midwife and woman can choose a private obstetrician or NW
secondary services to provide care.
2 General Practitioner (GP). Antenatal care is based in the GP’s rooms. Midwifery
care intrapartum and in the postnatal period for women who choose a GP is provided by
either a hospital midwife or an independent midwife. If the woman’s pregnancy and or
labour become complicated then the GP and woman can choose a private obstetrician or
NW secondary services to provide care.
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