Delivering continuity of midwifery care to Queensland women

implementing a new or different service would equate to more, similar or less workload. Staff
need to be consulted on how the model will affect communication and referral pathways
within and outside the organisation.
The impact on staff should become clear through good communication and understanding
of the model of care document. Mapping should be done to ensure the appropriate service
and staffing levels will be achieved through the business planning framework. There must be
plans for ongoing communication and staff meetings.
Once complete, local agreements are signed off by the CEO and the QNU.
A sample local agreement template is provided in Appendix 8.02.
Local agreements—content
Local agreements should specify:
• a description of the model of care
• the numbers of women to be cared for (e.g. up to 40 women per one FTE per year)
• reasons to vary caseloads per FTE/year
• who provides and has responsibility for administration functions including data collection
and entry into a database
• how the graduate role will be used in the model
• transport using hospital and/or personal vehicles
• orientation and professional development
• relief for leave and professional development
• home visiting (antenatal, early labour, postnatal visits)
• ongoing review of the local agreement (required in current enterprise bargaining
arrangement)
• care provider after primary midwife reaches time limit on duty
• geographical area to be covered
• time spent in non-clinical care, such as administrative duties, work-team meetings
• on-site hospital car parking with safe ease of access to attend births
• pagers, mobile telephones, or both depending on service coverage
• process of transfer to child and family health nurses.
Other issues to be considered for inclusion in local agreements:
• care of unbooked women presenting in labour
• provision of non-maternity women’s health care
• meal relief arrangements
• expectations of caseload midwives to provide care to women above her case load
• any population or cultural considerations (young women, indigenous, transient,
homeless, refugees)
• included services offered—lactation consultant, pap smear, vaccination, pathology
collection
• wearing of uniforms (not usual in caseload models due to the social model of care and
high community component)
• remote access for logging administration details and checking women’s care
(e.g. pathology results)
• access or supply of computers and administrative resources
• responsibility for ongoing care where women require transfer to another facility.
Work arrangements must consider how this work will be practically undertaken, the
resources that will be provided and the level of remuneration that can be expected.
A guide to implementation
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