Academic journal article Australian Health Review

Mapping of Allied Health Service Capacity for Maternity and Neonatal Services in the Southern Queensland Health Service District

Academic journal article Australian Health Review

Mapping of Allied Health Service Capacity for Maternity and Neonatal Services in the Southern Queensland Health Service District

Article excerpt

Introduction

Involvement of allied health professionals (AHPs) in maternity and neonatal services is essential for quality care and outcomes for mothers and their babies.1-3 However, a clear representation ofstaffing levels and description of models of care for AHP across the Southern Queensland Health Service District (SQHSD) is not known. This has become more apparent during the development and release of various Queensland Health state-wide maternity and neonatal clinical guidelines,4 and Queensland Health's Clin- ical Services CapabilityFramework (CSCF) v3,5,6 which outlines minimum requirements for the provision of health services in Queensland public facilities, including minimum service and workforce structure.

Queensland Health's background CSCF document outlines that clinical services are categorised into six service levels, with Level 1 managing the least complex patients and Level 6 man- aging the highest level of patient complexity.7 Service levels generally build on the previous service level's capability; for example, 'service Level 6 should have all the capabilities of service Level 5 plus additional capabilities resourcing the most highly complex service'.7 It is reported that the minimum require- ments must be met at each level to provide safe and quality clinical services. A service level may exceed the minimum requirements and cannot claim subsequent service level status until the minimum requirements for the subsequent level are met. The allied health (AH) requirements for maternity and neonatology services are outlined in Table 1.

The variations in staffing levels (and general low levels of staffing), as well as a lack of systematic delivery of services to patients of tertiary nutrition and dietetic maternity services across Australia, was demonstrated in a scoping project per- formed by one profession within the health service district in 2008.8 Although representing only one AHP profession (nutrition and dietetics), that study does illustrate the seriousness of the problem. It may be assumed that smaller centres, with fewer resources, face potentially greater struggles in delivering ade- quate care to their maternity and neonatal patient population.

A similar staf fi ng and service structure knowledge gap was recognised by the Central Queensland Maternity and Neonatal Clinical Network (CQHSD) in 2009, resulting in an AHP scoping project for this district. The project examined staffing, funding, support, guidelines and practical issues in maternity and neona- tology services in this district, which has over 15 500 births per year, and produced a report entitled 'Scoping of allied health involvement in maternal and neonatal services within (former) central area health service'.9 The project surveyed the 13 centres with over 50 births per year and was limited to scoping three AHPs (nutrition and dietetics (DN), physiotherapy (PT) and social work (SW)) because these were considered the AHPs predominantly involved in maternity and neonatology services. Key findings were a 'sizeable shortfall' in current services, with only 7.3 full-time equivalent (FTE) SW, 6.7 FTE PT and 1.5 FTE DN. It was noted in the CQHSD report that although many best practice guidelines had been identified by clinicians, inadequate time prevented their application,which createdjob dissatisfaction andperception of the delivery of a poorer service. Many identified 'underdeveloped' areas within their service. Although some key learnings can be drawn from that report,9 unique issues exist in the SQHSD requiring an individual scoping project within this health service district.

Current and comprehensive data across all AHPs for the SQHSD would provide a clear picture of AHP staffing levels and service gaps, models of care in use and models of care or resources that may be shared within the network. Furthermore, comparison of AHP staffing in the SQHSD with the maternity and neonatology CSCF v3 and comparison with CQHSD AHP scoping project would be of interest and enable some bench- marking. …

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