Delivering continuity of midwifery care to Queensland women

• In situations where the service is working with the nearest tertiary hospital for birth
care or other services, the tertiary service must be fully engaged as a stakeholder in the
development of communication processes and pathways.
• Midwifery Unit Managers providing the day-to-day services will either manage the project
or be closely involved with the project officer. Unit size and context of practice will
determine which unit managers are involved (this may include areas external to maternity
such as the accident and emergency department in rural areas).
Medical: obstetric and neonatal (larger units)
Meaningful engagement of medical staff is essential. New models that have developed
successfully have found that one or more consultants attached to a group of continuity
midwives provide for improved interdisciplinary relationships and assist with continuity
of care. Please see Section 11 which discusses initial engagement, communication and
collaboration with medical staff.
In larger units neonatal or paediatric staff should be involved from initial planning and
development through implementation, ongoing collaboration and evaluation. Opportunities
for meaningful contribution from other medical staff may need to be actively pursued.
Engagement and collaboration with GPs is covered in Section 11. The timing and involvement
of GPs depends on the local context and the role of GPs within the model. In rural areas, where
the model is dependent on GP engagement, Section 11 should be studied in detail.
Midwives: core and potential caseload
Midwives working in a service where a new model is to be introduced will be affected
whether they are employed in the model or not. Ensure that midwives across the service
are aware how the model inter-relates with existing services, or how any services will be
realigned. Communication strategies have been outlined throughout this document.
Steering committees must include representation of midwives planning to work in the
continuity model as well as core midwifery staff. All staff must have an opportunity to be a
vital member of the team and be equally valued in relation to their input.
Union
The Queensland Nurses Union plays an advocacy and expert role in advising on the
industrial processes and legal working arrangements for staff in the midwifery continuity of
care model and also remaining maternity and nursing staff.
Some stages in this process:
Early engagement with the Union is essential.
• The QNU will have steering committee representation. QNU representation should be
sourced via a written request to QNU State Secretary so that appropriate representation
can be provided and supported.
• Facilitated meetings are required between managers within the service, the QNU and MGP
midwives to discuss model proposal, workforce, population demographics, to ensure safe
working arrangements and for annualised salary.
The QNU has a key role in supporting midwives and midwifery models. They particularly
support models that increase workforce satisfaction and facilitate differentiated career paths.
Partnerships
A range of partnerships are integral to midwifery continuity of care. These include the
relationship between the midwife and the woman, midwives’ practice partners and
partnerships with interconnected services. Some partnerships are consolidated through
service agreements or collaborative arrangements to secure continuity of care beyond the
facility. Other partnerships complement the local model, such as emergency transport
services, community services or higher level maternity support services. Please see Section
2 and Section 10 for discussion about the midwifery partnership with women and Section 11
for partnership with interconnected services.
A guide to implementation
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