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Speaker 1: Now, if you were listening to the show earlier in

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Speaker 1: the week, we spoke to two mums concerned about changes

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Speaker 1: when it comes to maternity services which are being delivered

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Speaker 1: here in the Northern Territory. Now we've seen a letter

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Speaker 1: advising that Midwiffree Group Practice on call services have been

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Speaker 1: stopped while a review is carried out to ensure the

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Speaker 1: model is sustainable. Now the letter states that anti natal

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Speaker 1: and post natal appointments are going to be conducted by

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Speaker 1: Maternity group services, by Maternity Group Practice, i should say,

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Speaker 1: their team during business hours, and that labor and birth

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Speaker 1: care will be provided by midwives and doctors then in

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Speaker 1: the delivery suite. Now we also caught up with the nurses'

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Speaker 1: union yesterday who said that staff weren't informed about those

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Speaker 1: changes until the letter was sent to patients and claimed

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Speaker 1: the stoppage was due to staff shortages. Now I'm pleased

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Speaker 1: to say that joining me on the line is Nursing

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Speaker 1: and Midwiffree, director of Operations at Royalty are in hospital.

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Speaker 1: Sarah and Hahn. Good morning to you, Sarah and.

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Speaker 2: Good one and Key. Thanks for having me on today.

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Speaker 1: Yeah, thank you so much for your time this morning. Now,

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Speaker 1: first off, Why are the midwifree group practices? Why is

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Speaker 1: that under review at the moment?

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Speaker 2: So it's a usual business process to review services across

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Speaker 2: all disciplines and that includes MGP. And it's also on

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Speaker 2: the back of the midle Free Futures Report which was

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Speaker 2: released in October last year, which recognizes that we do

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Speaker 2: have significant issues with workforce and starting shortages in MIDWI

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Speaker 2: three nationally and globally, and so part of that is

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Speaker 2: making sure service is a review to make sure they're

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Speaker 2: contemporary and that's contemporary and evidence based from a clinical

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Speaker 2: point of view for consumers, but also to ensure that

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Speaker 2: we've got workforce sustainability and satisfaction for staff, including being

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Speaker 2: able to grow our own next generation of future mid

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Speaker 2: midwives and MGP newwives as well.

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Speaker 1: So, Sarah, how long do you anticipate that the review

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Speaker 1: going to take?

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Speaker 2: So we're hoping to meet quickly on this review and

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Speaker 2: get things sorted and really would hope to have final

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Speaker 2: products and resolutions definitely before the end of this year.

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Speaker 1: So before the end of this year. Now, how many

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Speaker 1: staff short are we at the moment when it comes

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Speaker 1: to mid we're for a group practice.

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Speaker 2: So we don't have about four shortages, but we also

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Speaker 2: have obviously people need to take leave and unexpectedly it

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Speaker 2: happens at times as well, so that can obviously sometimes

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Speaker 2: exacerbate your staffing shortages at times.

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Speaker 1: Obviously four doesn't sound like a huge number, but how

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Speaker 1: big is that team?

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Speaker 2: So it's not a huge number, but again the team

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Speaker 2: is relatively small, so it does have fifteen staff members

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Speaker 2: to fulfill all of the teams.

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Speaker 1: So fifteen staff and then four short and then others

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Speaker 1: on leave at different times. I mean, that's almost like

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Speaker 1: a third of your workforce.

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Speaker 2: Yeah, so it is challenging at the moment, as I said,

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Speaker 2: reflecting those notional trends, and that's not just in we

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Speaker 2: re Free bat also other jurisdictions with mgps are facing

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Speaker 2: similar challenges. So yeah, it definitely is challenging for the

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Speaker 2: staff involved at this time.

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Speaker 1: I mean, is any of the challenge I guess as

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Speaker 1: well with staff, is any of that related to those

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Speaker 1: positions not being permanent some of those positions.

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Speaker 2: No, So it's important that when we advertisee of positions

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Speaker 2: that we make sure the structure is right and we

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Speaker 2: know what they look like. And that's again so we

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Speaker 2: can make sure that going forwards as it is a

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Speaker 2: sustainable model for future people coming into those and we've

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Speaker 2: utilized many recruitment strategies to be able to still keep

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Speaker 2: the service fulfilled, whether that be in temporary contracts or not.

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Speaker 2: And you always will have some staff in temporary contracts

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Speaker 2: because obviously we have to cover maternity leave and things

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Speaker 2: like that as well, so they will always be temporary

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Speaker 2: while people are on leave for those important times for

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Speaker 2: themselves as having a baby as well.

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Speaker 1: All Right, So, Sarah, the situation that we're in at

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Speaker 1: the moment, obviously that review into maternity group service practice,

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Speaker 1: it's hope that it's going to be complete by the

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Speaker 1: end of the year. Right now, at least four staff

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Speaker 1: down in that fifteen person team, but obviously that can

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Speaker 1: fluctuate as well based on based on people being on leave.

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Speaker 1: What does that mean for women listening this morning who

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Speaker 1: are either pregnant, are set to give birth, or you know,

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Speaker 1: are considering going down that path and having babies. What

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Speaker 1: kind of impact is this going to have for them?

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Speaker 2: Yes, so hopefully the impact is minimal and for a

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Speaker 2: short period, which is what we've advised to consumers about.

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Speaker 2: But it is actually to make sure that they do

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Speaker 2: have safe care and that the care coordination, particularly which

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Speaker 2: is what's important in the MGP setting, especially the intenagal period,

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Speaker 2: that's what is important to sustain as well. And by

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Speaker 2: pausing this on care for this period means we can

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Speaker 2: ensure that that continuity and coordination of care will continue

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Speaker 2: to happen for consumers in our service, and particularly for

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Speaker 2: remote women, they will still receive all of the same

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Speaker 2: supports and services, which is multidisciplinary and involves community services

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Speaker 2: as well. That is all still available for women coming

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Speaker 2: in for remote communities too.

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Speaker 1: Okay, so right now, if a lady is pregnant and

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Speaker 1: she calls through to the midway free group practice, you're

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Speaker 1: not going to be able to get that twenty four

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Speaker 1: hour support from them at this point in time. You're

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Speaker 1: going to have to if it's after ours, you're going

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Speaker 1: to have to call the ward.

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Speaker 2: Yes, that's actually our normal business practice anyway, when MGP

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Speaker 2: is on call that outside of ours, women are in

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Speaker 2: MGP services call through the delivery suite and then we're

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Speaker 2: able to advise them appropriately, treat them and if we

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Speaker 2: need to, we can then call their MGP midwife in

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Speaker 2: which is the usual practice so that's actually unchanged for

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Speaker 2: women in regards to who they would call out of

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Speaker 2: ours for advice. But at this time for the four weeks,

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Speaker 2: obviously we wouldn't be able to call the midwife from

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Speaker 2: MGP in outside of ours, but we would brief them

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Speaker 2: in the morning and they would be available to touch

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Speaker 2: base with the women when they come in in the morning.

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Speaker 1: I mean, is that going to make it more difficult

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Speaker 1: for the staff on the war that are already busy.

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Speaker 2: Well, no, because as I said, this is our normal

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Speaker 2: business practice that we would take the triaging and often

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Speaker 2: free women for antenatal concerns out of ours in delivery

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Speaker 2: suite already, and that's the long standing business practice and

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Speaker 2: a lot of services do that for mgps to be

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Speaker 2: able to provide them with manageable and sustainable workload and

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Speaker 2: then increase their availability for women when they really need them.

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Speaker 2: So I recognize that in this pause for four weeks

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Speaker 2: that that isn't there for the intrapartent care out of ours,

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Speaker 2: but it is certainly still there in regards to continuity

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Speaker 2: from their midwives and MGP who are still available in

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Speaker 2: business hours seven days a week.

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Speaker 1: All right, Sarah, We've had quite a large number of

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Speaker 1: mums get in contact with us throughout this week with

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Speaker 1: differing concerns we did here. We have been told that

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Speaker 1: inductions are being delayed due to staffing issues.

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Speaker 2: Is that the case, No, so inductions are challenging because

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Speaker 2: both thing is unpredictable. But obviously inductions in any jurisdiction

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Speaker 2: in Australia has to be medically triarched and balanced according

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Speaker 2: to need. And sometimes things can arise for another consumer

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Speaker 2: that are quite urgent and their induction might need to

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Speaker 2: be brought forward. And so it's about medically triarging and

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Speaker 2: prioritizing care and that's a very normal business practice.

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Speaker 1: Okay, we are also being told, and we've spoken to

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Speaker 1: one of these mums on air who said that she

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Speaker 1: was in labor in the hall or in a public area.

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Speaker 1: They're sort of on the maternity ward. Is that happening regularly.

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Speaker 2: No, it doesn't happen regularly, And I'm obviously unable to

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Speaker 2: comment on individual situations for individual consumers, but it isn't

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Speaker 2: something that happens regularly, and it's obviously not the ideal

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Speaker 2: situation to have someone laboring in a waiting room or

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Speaker 2: in the hallway. But as I said, birthing is a

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Speaker 2: bit unpredictable, and so there are times that on occasion

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Speaker 2: where somebody might present and being labor or early labor

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Speaker 2: and need a room, and we do have to shuffle

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Speaker 2: and move patients to accommodate who needs the rooms the

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Speaker 2: most at the time. And that's just a birthing thing

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Speaker 2: that sometimes our services are in demand on some days

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Speaker 2: more than others. But we have capacity management plans in

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Speaker 2: place to be able to flex up and down as

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Speaker 2: we need to, because we know that birthing is quite

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Speaker 2: unpredictable in that nature, so obviously we try and prevent

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Speaker 2: that from happening at all times. But yes, it does

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Speaker 2: at times happen where people have to wait, all right.

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Speaker 1: Last week we also spoke to a mum who had

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Speaker 1: given birth at home after being sent home by staff.

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Speaker 1: She said, without an internal examination conducted, she then gave

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Speaker 1: birth at home within a couple of hours, her mum

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Speaker 1: catching that baby. Are women being turned away.

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Speaker 2: Not? And again I can't comment on an individual case

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Speaker 2: due to confidentiality, but we do not turn women away. Obviously,

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Speaker 2: we are there twenty four to seven and always available

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Speaker 2: for women to call us to present a delivery suite

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Speaker 2: and we will carry out the usual processes and assessments

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Speaker 2: that are required, which obviously varies on individual cases. And

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Speaker 2: you know, I am aware of the feedback and obviously

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Speaker 2: we always we do appreciate consumer feedback and it's one

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Speaker 2: of the great mechanisms we have to continue to review

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Speaker 2: and grow and improve our services. So we always welcome

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Speaker 2: consumers to submit that feedback to us through the appropriate

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Speaker 2: processes and we would absolutely make contact with them and

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Speaker 2: discuss their individual case with them.

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Speaker 1: So can I ask, obviously, you know the maternity ward

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Speaker 1: is you know, is still operational and used very busy

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Speaker 1: at the moment by the sounds of things. What about

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Speaker 1: the birthing suite that used to be like downstairs on

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Speaker 1: the ground level at Royal Dalen Hospital, Is it's still operational?

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Speaker 2: Yeah, So the MVP actually operates services out of the

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Speaker 2: birth center on the ground floor and it's a space

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Speaker 2: that is very busy with activity in business hours, particularly

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Speaker 2: as they're running those antenatal and post natal services. We

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Speaker 2: obviously also have the birthing suites there as well, which

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Speaker 2: are still available for women to use based on their

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Speaker 2: risk profile and the staffing situation on a day to

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Speaker 2: day basis, but we are also, as I've mentioned before,

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Speaker 2: looking at different models of staffing and how we can

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Speaker 2: hopefully try and utilize the access to that berth into more.

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Speaker 1: Now. I want to say a lot of the feedback

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Speaker 1: as well that we're getting from mums there is no

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Speaker 1: criticism of the staff. They actually think the staff are

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Speaker 1: doing a brilliant job. But they're worry is that there's

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Speaker 1: just not enough resources and that there's just not enough space.

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Speaker 1: You know. That's what we're sort of hearing from quite

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Speaker 1: a few mums also in terms of you know, the

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Speaker 1: Darwin Private Hospital's closure of the maternity ward. I mean,

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Speaker 1: we had been told that that would not have an

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Speaker 1: impact on the public maternity ward.

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Speaker 2: But is it no So that infrastructure challenges and resourcing

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Speaker 2: their issues that were already at play before the private closed,

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Speaker 2: and that continues to be a concern. As I said,

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Speaker 2: we do have infrastructure challenges, we do have an older

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Speaker 2: building and that's part of the reason why there has

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Speaker 2: been as the Minister has notified the public of many

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Speaker 2: months ago of the request to the federal government for

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Speaker 2: thirty five million dollars to try and get some funding

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Speaker 2: to improve the infrastructure. Starting again, the resourcing, it is

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Speaker 2: an ongoing challenge. As I've said, it is a national

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Speaker 2: and a global issue. So absolutely that isn't a challenge

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Speaker 2: that we continue to face. And we have a number

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Speaker 2: of recruitment strategies that we utilize regularly, and we've explored

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Speaker 2: extra recruitment options as well to try and resolve that

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Speaker 2: issue around staffing. But it is a problem that is

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Speaker 2: national and global, and so yeah, it does continue to

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Speaker 2: be a challenge to us, but that is erstive of

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Speaker 2: the private sittle clothing.

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Speaker 1: Sarah and somebody else has contacted us and said, you know, Katie,

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Speaker 1: the reason why people are waiting as well to be

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Speaker 1: able to labor in a room in some cases is

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Speaker 1: because of the time it takes them to clean that room.

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Speaker 1: I mean, what do you say to that person.

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Speaker 2: Well, we obviously have robust cleaning processes and that's part

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Speaker 2: of infection control and patient safety. So there is a

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Speaker 2: certain amount of time that that takes to do that.

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Speaker 2: But we do have services available twenty four seven at

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Speaker 2: ARDIHH which we can utilized to make that happen. So

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Speaker 2: I don't usually foresee that as a problem, but it

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Speaker 2: obviously does take a sad amount of time, and that's

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Speaker 2: to make sure that that space is absolutely right from

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Speaker 2: the safety and infection point of view for the next consumer, Sarah.

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Speaker 1: And we also we have obviously had confirmation I'm sure

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Speaker 1: that you guys probably already know this that doctor Jenny

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Speaker 1: Mitchell has obviously said that she is finishing her last

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Speaker 1: few deliveries later this month, not continuing deliveries at Royal

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Speaker 1: dah And Hospital after August. We also know that doctor

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Speaker 1: Alia Vmuri has confirmed that her last babies are going

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Speaker 1: to be born in January twenty twenty six. What impact

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Speaker 1: is this going to have on Royal Darwin Hospital.

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Speaker 2: Well, obviously the patients are already birthing their babies with

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Speaker 2: us at Royal Dalen Hospital since the transition. It is

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Speaker 2: unfortunate obviously that that is a choice that women won't

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Speaker 2: have going forwards for a private obstetrition if those things

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Speaker 2: do eventuate. But that's probably a matter that.

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Speaker 1: Yeah, I guess I'm more so mean in terms of

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Speaker 1: the additional additional needs and associated with women rather than

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Speaker 1: going to see their private ob for those appointments obviously

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Speaker 1: having to come through Royal Dahin Hospital and the extra

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Speaker 1: patients for you guys.

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Speaker 2: Yeah, so were already providing obviously the midwif free care

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Speaker 2: in labor and birth those women now, and we've forecasted

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Speaker 2: that increase in activity and have our capacity management plans

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Speaker 2: around that. And we also have already early on predicted

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Speaker 2: and forecasters for that increase in antenatal activity. And we

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Speaker 2: do also already see a lot of the patients for

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Speaker 2: some antenatal activity because they come to us from monitoring, etc.

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Speaker 2: So we obviously build that into our business continuity plans

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Speaker 2: when we look at our service growth and projections each

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Speaker 2: year and then try and match out resources to accommodate that.

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Speaker 2: So we're definitely very aware of that and that is

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Speaker 2: part of our future planning and also included in the

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Speaker 2: planning of our maternity services and MGP review to make

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Speaker 2: sure obviously, as I said, that we can have sustainable

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Speaker 2: services and workforce going forward.

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Speaker 1: All right, Well, you are indeed listening to MIX one

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Speaker 1: O four nine. We are speaking with nursing Aman Befree,

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Speaker 1: Director of Operations at Royal Dale and Hospital, Sarah and Hahn. Sarah,

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Speaker 1: and I do want to ask I know that you

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Speaker 1: know some women are saying that they're going into State

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Speaker 1: to birth their babies because they are feeling concerned about

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Speaker 1: potentially laboring in a hallway, or you know, being sent

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Speaker 1: home in the early stages of labor, or whatever their

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Speaker 1: other concerns may be. What do you say to any

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Speaker 1: mum listening this morning who has those concerns.

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Speaker 2: Because Edie's unfortunate to hear that, and we do take

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Speaker 2: pride in the fact that, you know, we're able to

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Speaker 2: support Territory mums and welcome new little Territorians into the world,

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Speaker 2: So it is sad to hear people a choosing to

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Speaker 2: go into state. We have an amazing team of midwives

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Speaker 2: and doctors here that are very passionate and very committed

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Speaker 2: to serving the NT women and families, and they continue

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Speaker 2: to come to work every day and do that and

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Speaker 2: as a service, you know, we support them and strive

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Speaker 2: to provide excellent care to all our MTA mums and bubs.

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Speaker 2: So we hope to continue to do that, and we

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Speaker 2: strive to do that every day, And you know, I

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Speaker 2: would hope those mums would stay, but if they don't,

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Speaker 2: that's obviously their choice. But if they do have concerns,

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Speaker 2: I would encourage them also to reach out to us

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Speaker 2: and we can always support them and talk through some

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Speaker 2: of those concerns with them well.

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Speaker 1: Nursing and mid we're free Director of Operations at Royal

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Speaker 1: Darwin Hospital. Sarah and Hahn really appreciate your time this morning.

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Speaker 1: Thank you very much for joining us on the show.

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Speaker 2: Thanks very much, Katie, you have a great day, you two.

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Speaker 1: Thank you