Information on the work the Ministry is undertaking in the maternity sector.
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Telephone/Video Interpretation Service Access for LMCs
We understand that there have been some issues with accessing this interpreting service and we have worked with the provider to remove the request for a cost centre or purchase order number. Once you have inputted your pin number simply follow the system prompts.
Information for lead maternity carers (LMCs) reinstating their authorisation to claim after the COVID-19 vaccine mandate ends
This update applies to lead maternity carers (LMCs) whose authorisation to claim under the Primary Maternity Services Notice 2021 (the Notice) was suspended with the implementation of the COVID-19 vaccine mandates.
The Government has announced that all remaining Government vaccine mandates will end on 11:59pm, 26 September 2022. From 27 September 2022 LMCs with a suspended authorisation to claim under the Notice, who wish to re-commence claiming, are able to have their authorisation reinstated.
We are yet to confirm a national Access Agreement policy, in the meantime contact your local maternity facility to clarify their position.
There are three possible scenarios that will apply to impacted LMCs who wish to have their authorisation to claim reinstated. You will need to identify which situation applies to you in order to determine if any action is required – see below:
- If you have a current APC and a valid safety check*, then your ability to claim will be automatically reinstated effective from 27 September 2022. You are not required to do anything.
- If you do not have a current APC (since 1 April 2022) but do have a valid safety check* your authorisation to claim will be reinstated from the day your APC is granted. Please note it may take up to two weeks to reinstate your authorisation to claim. Back pay will be made for any work done from the day you get your APC.
- If you have a current APC but you do not have a valid safety check*, you should complete your application with CV Check as soon as possible. Your authorisation to claim will be reinstated once we receive confirmation of a valid safety check*. However, you will be granted a 6-week grace period in which you can work (from the date you provide proof of application for your safety check). Claims for payment of services provided during this period will only be paid in retrospect when we have received confirmation of your valid safety check*.
* Safety check is a product of the legislative requirement in New Zealand under the Children’s Act 2014 for all children’s workers to have passed an appropriate check of their suitability to work with children.
Advisory to lead maternity care (LMC) midwives of continued funding for care of COVID-19 positive women/people
As New Zealand continues to see cases of COVID-19 in our community, specific clinical guidance has continued to be developed to support the provision of safe and integrated maternity care.
Funding for LMC midwives to claim $100 per person if the LMC provides in-person care to someone who is COVID-19 positive, or a household contact of a positive case has been extended until the end of December 2022. This is in recognition of the additional work in supporting pregnant women / people, including donning and doffing PPE and providing home visits.
The payment is made per case, not per visit, and is applicable for antenatal, labour and birth, or postnatal care (or a combination of all three).
To claim this fee, LMC midwives must complete the form below once per quarter. Claims for the previous quarter must be submitted before the end of the next quarter, as an example claims for 1 April to 30 June must be made before 30 September.
Transfer of agreements from the Ministry of Health to HNZ or MHA
You will no doubt be well aware of the upcoming changes to our health and disability system.
On 1 July 2022, subject to the enactment of the Pae Ora (Healthy Futures) Bill, Health New Zealand (HNZ) and the Māori Health Authority (MHA) will be established as the new entities to lead and operate our future health system. Some functions currently housed in the Ministry will transfer to HNZ or the MHA.
Agreements commissioned by these functions will accordingly transfer to corresponding entities using the Health Sector (Transfers) Act. Transferring agreements this way means you do not have to do anything to effect the transfer.
Responsibility for the Primary Maternity Services Notice (the Notice) will be transferred to Health New Zealand (HNZ) on 1 July 2022. Subsequently, if you hold an agreement to provide primary maternity services and claim for these under the Notice, your agreement will be transferred to HNZ. Your rights and obligations will remain the same. The only change is that your contract will be with HNZ, rather than the Ministry.
Please note that on Friday 1 July 2022, as this change is enacted, there will be a one-day interruption to payment of claims. If you would like to ensure your claims are paid on 30 June 2022, please submit all relevant claim information by 29 June 2022. Claim processing will continue and usual claim payment processes will resume on Monday 4 July 2022.
Maternity Consumer Survey 2022
The Maternity Consumer Survey aims to assess women and whānau experiences of the maternity services they received. The Maternity Consumer Survey 2022 is the sixth national survey of women/people who had live babies, and the 2022 Survey of whānau who have lost a pēpē/baby is the third national survey of those who have lost a baby between 20 weeks’ pregnancy and four weeks after birth.
Consumer feedback is important to the quality of maternity services. The objective of the survey is to measure satisfaction among women/people who have recently used maternity services and compare the levels of satisfaction (or percentage of those satisfied) to those recorded in previous surveys.
The Maternity Consumer Survey 2022 is a quantitative satisfaction survey of a sample of women/people who have had live births.
A series of focus groups and in-depth conversations with priority populations (Māori, Pacific Island, women/pregnant people with a disability and pregnant parents in the rainbow community) will follow, to gain insights on how to improve services.
The 2022 Survey of Bereaved Parents will include a qualitative survey of a sample of people who have had a stillbirth, termination of pregnancy, or neonatal death after 20 weeks of pregnancy and up to the 28th day following birth. This will also include a focus group component.
The surveys have been approved for the Sponsored Data initiative that will allow whānau to access the online survey via mobile phone without incurring data use charges. This removes barriers to accessing the survey so that a more diverse range of participants can complete the surveys. Read about the Sponsored Data initiative.
The surveys will be carried out by Research NZ. The last maternity experience survey in 2014 had just under 4000 participants, with 114 participants in the bereaved women/whānau survey. We are keen to increase this in 2022.
About the survey
The survey is an online or paper questionnaire asking you to comment on your experiences of the Aotearoa New Zealand Maternity system. Focus group participants can be chosen through expressing an interest when completing the paper/online survey.
The results of this survey will be used by the Ministry to make sure the maternity care services provided to women/people in Aotearoa/New Zealand are of the highest possible standard. The results will help identify any areas that need to be improved, to better support whānau/families in the future.
Invitation to the survey questionnaires is by invitation only.
If you are invited to take part, you will be sent an invitation letter and information sheet.
- No preparation will be required
- It will only take 15 minutes to complete
- You will have the choice of completing it on paper, online or via a scheduled telephone appointment with an interviewer.
- You are welcome to have a support person with you while you complete the survey.
- You will not have to answer any questions if you don’t want to.
- You will be able to stop at any time, restart or decide not to continue.
At no stage will you be asked to provide any personal information.
Completing the survey is voluntary, you can change your mind and any time and not continue with the survey.
A prize draw is offered to those completing the maternity experience survey.
Keeping your information safe
Taking part in the survey is completely voluntary and confidential. If you choose to take part, you will not be personally identified in any way when the results are reported.
A very small team of researchers at Research New Zealand are the only people who will be able to see your individual survey responses. Any information relating to you personally (e.g. your name) will be removed from the survey data and deleted from their records when the survey period ends. This means the final dataset that contains everyone’s survey answers will be completely anonymous.
Who to talk to if you have a complaint
If you have any questions or concerns, please contact Katrina Magill, Research Director, Research New Zealand ([email protected]) or 0800 500 168.
If you would like to talk to someone who isn’t directly involved in the survey, you can contact an independent health and disability advocate:
- Phone: 0800 555 050
- Fax: 0800 2 SUPPORT (0800 2787 7678)
- Email: [email protected]
- Website: https://www.advocacy.org.nz
You can also contact the Health and Disability Ethics Committee (HDEC) that approved this survey (Ref number: 2021 EXP 11335) on:
- Phone: 0800 ETHIC
- Email: [email protected]
How to find more support
If you have lost a pēpē/baby, you can find a regionally based Sands NZ volunteer to talk to at www.sands.co.nz, including their phone contact details.
If you would like to talk to someone who isn’t directly involved in the survey, you can contact an independent health and disability advocate:
- Phone: 0800 555 050
- Fax: 0800 2 SUPPORT (0800 2787 7678)
- Email: [email protected]
- Website: https://www.advocacy.org.nz
Temporary medical exemptions
As of 16 May 2022, a new temporary medical exemption (TME) process has been implemented for workers who have COVID-19 vaccination mandated under the Public Health Response (Vaccinations) Order 2021 and who test positive for COVID-19. These workers are exempt from being vaccinated, or receiving their booster dose, for a period of 100 days from the date they receive evidence of their positive test.
The new process allows for employers to grant these TME upon provision of evidence of confirmed COVID-19 infection. As lead maternity carers (LMCs) do not have an employer, they will apply to the Ministry of Health, via a medical professional or nurse practitioner to get a TME. This is a funded visit and can be done virtually with no cost to the LMC.
If the LMC also works in an employed capacity, they can apply for a TME through their employer. Evidence of the TME should be forwarded via email to [email protected] to ensure the authorisation to claim off the Primary Maternity Services Notice is not interrupted.
Advisory to lead maternity care (LMC) midwives about funding for care of COVID-19 positive women/people
As New Zealand sees more cases of COVID-19 in our community, specific clinical guidance has continued to be developed to support the provision of safe and integrated maternity care.
The ‘Care Framework for pregnant women and people isolating in the community for COVID-19’ recognises that, depending on individual circumstances, isolating in the community may be a good option for some people. This shift in approach will see more LMC midwives becoming involved in the care of COVID-19 positive pregnant women / people. View more: COVID-19: Maternity
LMC midwives can now claim $100 per person if the LMC provides in-person care to someone who is COVID-19 positive or a household contact of a positive case. This is in recognition of the additional work in supporting pregnant women / people, including donning and doffing PPE and providing home visits. The payment is made per case, not per visit, and is applicable for antenatal, labour and birth, or postnatal care (or a combination of all three).
In acknowledgment that many LMC midwives have already been providing care in the community to COVID-19 positive women / people, the Ministry will backdate these payments to the date that New Zealand moved into the Red Setting of the traffic light system, 23 January 2022.
To claim this fee, LMC midwives must complete the form below once per quarter. The first claim can be made from 1 April 2022 for the first quarter of 2022. Claims for the previous quarter must be submitted before the end of the next quarter.
Update on COVID-19 Public Health Response (Vaccinations) Order communications
The COVID-19 Public Health Response (Vaccinations) Order 2021 (the Order) has been amended to require affected workers to have a booster vaccination. For health and disability workers this came into effect on 25 February 2022 (11.59pm, 24 Feb 2022).
On 25 February, a number of individuals who hold agreements to provide maternity services and claim from the Primary Maternity Services Notice 2007/2021, received communications from the Ministry of Health that their agreements had been suspended.
It has been determined that some people received this email in error due to a data issue. We are working to fix the problem as soon as possible and put systems in place to prevent this from happening again.
We have contacted those affected by this data issue to apologise for any stress this may have caused, and to thank them for their patience while we work to resolve this issue.
Advisory on the COVID-19 Public Health Response (Vaccinations) Order amendment to Primary Maternity Services Notice agreement holders
The COVID-19 Public Health Response (Vaccinations) Order 2021 (the Order) has been amended to require affected workers to have a booster vaccination. For health and disability workers this comes into effect on 25 February 2022 (11.59pm, 24 Feb 2022).
The Order mandates that a booster dose is required by six months (183 days) from the end of the primary vaccination course. People aged 18 and over can get a booster three months (93 days) after their second dose.
The Ministry of Health (the Ministry) will be reviewing booster status for all midwives. If, on review of the COVID-19 Immunisation Register, it appears practitioners have not received their booster COVID-19 vaccination within the timeframe required by the Order, the Ministry may suspend their authorisation to claim under the Primary Maternity Services Notice.
LMC’s will be notified if their authorisation to claim is suspended.
Their authorisation to claim will be reinstated as soon as possible, after evidence is submitted to [email protected] which proves they have either received the booster vaccination, or are deemed exempt ie have a current temporary medical exemption.
Thank you for your continued support of the COVID-19 response.
Update on Primary Maternity Services Notice payments
Further to the information published on the Ministry of Health website and distributed to maternity providers via the College of Midwives earlier this month, we would like to update you on our work to improve the timeliness of the Primary Maternity Services Notice 2021 (the 2021 Notice) payments system.
The Ministry is sorry the stress and inconvenience caused to providers who were affected by a significant technical error that interrupted the processing of some maternity claims which were submitted between 24 December 2021 and 10 January 2022.
The Ministry values the vital role that the maternity sector plays in our communities. It is important to us that our providers are appropriately remunerated and receive the funding for their services as intended and as quickly as possible.
Prior to the discovery of the recent technical issue, claims were processed on a weekly basis. However, from 31 January 2022 a new regular payment cycle will allow for eligible maternity provider claims to be processed within 72 hours (three working days) after receipt by the Sector Operations team.
The modular funding mechanism of the 2021 Notice, which was implemented on 29 November 2021 is complex and the Ministry has identified that some claims do not have the necessary information for payment to be approved. We are working with vendors to ensure the correct data is supplied so that payment is made for eligible claims as quickly as possible.
The 2021 Notice was intended to better support maternity service providers who care for women/pregnant people and whānau with additional care requirements, and for those living rurally. We would also remind Lead Maternity Carers that the Rural Practice and Travel Supplement (RPaTS) classifications are currently being reviewed. This is because the Ministry is aware that the access to health services in some areas has not been effectively captured by the current automated solution for these claims. Changes are currently being made to the Ministry’s classification system for some regions.
In the short term, if an LMC believes a Rural Practice and Travel Supplement payment they have received is incorrect, they can email the Ministry on [email protected] with brief details of the claim, so the payment can be reviewed.
We appreciate the patience the sector has shown over these issues and look forward to them being resolved.
Update on Primary Maternity Services Notice payment issues
The Ministry of Health would like to thank and acknowledge midwives for their continued care and support of whānau and babies.
We would also like to sincerely apologise for any stress and inconvenience caused by a significant technical error that interrupted the processing of some maternity claims that were submitted between 24 December 2021 and 10 January 2022.
This technical error was corrected as soon as it became evident and the Ministry’s payments team is working with the Maternity IT Vendors (MMPO, Expect and Solutions Plus) to process all effected claims within one working day of resubmission. Midwives do not have to provide further information in order for claims affected by the technical error to be re-processed.
The Ministry has also identified that some claims do not have the necessary information for payment to be made. We are working with vendors to ensure the correct data is supplied so that payment is made as quickly as possible. The Ministry is currently processing maternity claims as soon as they are received and providing feedback on data errors so claims can be adjusted and resubmitted by vendors in a timely way.
As you are aware, the Primary Maternity Services Notice 2021 (the 2021 Notice) was implemented on 29 November 2021. The intention of the updated Notice was to better support maternity service providers who care for women/pregnant people and whānau with additional care requirements, and for those living rurally.
It is important to us that our providers are appropriately remunerated and receive the funding as intended. The modular funding mechanism of the Notice is complex, and the Ministry continues to work with the sector to identify and rectify claims that have been rejected for other reasons.
We would also like to take this opportunity to remind Lead Maternity Carers that the Rural Practice and Travel Supplement (RPaTS) classifications are currently being reviewed. This is because the Ministry is aware that the access to health services in some areas has not been effectively captured by the automated solution for these claims that was initially implemented. Changes are currently being made to the Ministry’s classification system for some regions. In the short term, if an LMC believes a Rural Practice and Travel Supplement payment they have received is incorrect, they can email the Ministry on [email protected] with brief details of the claim, so the payment can be reviewed.
Advisory to lead maternity carers (LMCs) of changes to funding for care of COVID-19 positive pregnant women/people
As New Zealand prepares to see more cases of COVID-19 in our communities’ specific clinical guidance has been developed to support the provision of safe and integrated maternity care.
The ‘Care Framework for pregnant women and people isolating in the community for COVID-19’ recognises that, depending on individual circumstances, isolation in the community may be a good option for some people COVID-19: Maternity. This shift in approach will see more LMCs becoming involved in the care of COVID-19 positive pregnant women/people.
From 28 February 2022, LMCs will only be able to claim under the Primary Maternity Services Notice for care of women/pregnant people and infants with actual or suspected COVID-19 infection when they have continued to provide the care themselves.
If a woman requires a clinical transfer of care to obstetric services due to risk stratification or severity of disease, a three-way consultation will take place to determine the involvement of the LMC, in accordance with the Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines). If the LMC does not remain involved in care provision they will not be able to claim off the Primary Maternity Services Notice, for care provided after their involvement.
The coordinated national health response will ensure all people continue to have access to safe and timely care regardless of their COVID-19 status.
Update on progress of Maternity Consumer Survey and the Survey of Bereaved Parents
Research NZ are in the process of reaching out to maternity consumers to participate in the Triennial Maternity Consumer Survey and the Survey for whānau/families who have lost a pēpē/baby.
The 2022 survey of whānau/families’ experience of the maternity system is a form-based satisfaction survey of a sample of women/pregnant people who have had live births. A series of focus groups with priority populations (Māori, Pacific Island, women/pregnant people with a disability and pregnant parents in the rainbow community) will provide insights into how to improve services.
The objective of the survey is to measure satisfaction among women/pregnant people who have recently used maternity services and compare the levels of satisfaction (or percentage of those satisfied) to those recorded in previous surveys.
The 2022 Survey for whānau/families who have lost a pēpē/baby will include a form-based survey completed either by phone or online from a sample of people who have experienced pregnancy loss from 20 weeks of pregnancy to the 28th day following birth. This will also include a focus group component.
The results of this survey will assist in the development of a bereavement pathway for parents.
Advisory to LMC and Community midwives to get P2/N95 Particulate Respirator mask fit tested
The health and safety of the maternity workforce and of those in their care is of paramount importance and ensuring appropriate infection prevention protocols are followed at all times is essential.
Once 90% of eligible New Zealanders are fully vaccinated and protected, the Government will introduce the COVID-19 Protection Framework which introduces a new flexible 3-level approach to managing COVID-19 in the community and does not rely on lockdowns as the main measure to stop the virus from spreading.
As we move towards the implementation of this framework, and a future where there could be more cases of COVID-19 in the community, the Ministry is advising all LMC and Community midwives to ensure they have been P2/N95 Particulate Respirator mask fit tested.
These masks provide the best level of protection for you and those you care for. They are recommended when providing in-person care to anyone who is confirmed or suspected of having COVID-19.
Many midwives have already taken the opportunity to be fit-tested for p2/N95 masks. If you have not yet made an appointment to be fit tested please contact your local DHB to book an appointment today.
The Ministry acknowledges the expertise and dedication of our health professionals, as they continue to work together to ensure people continue to have access to safe and timely care, regardless of their COVID-19 status.
Updated Advisory on the COVID-19 Public Health Response (Vaccinations) Order 2021 to Primary Maternity Services Notice agreement holders
On 23 October 2021 the Government gazetted the COVID-19 Public Health Response (Vaccinations) Order 2021 (the Order) which has been updated to require those working in the health and disability sector to be fully vaccinated against COVID-19.
To comply with the Order, those who hold agreements with the Ministry of Health to provide maternity services and claim from the Primary Maternity Services Notice 2007/2021 (the Notice), were required to have received their first vaccination by 11.59pm on 15 November 2021, and are required to have their second vaccination by 11.59pm on 1 January 2022.
Maternity providers who have not received their first vaccination within the timeframe or hold a certified exemption have had their Ministry Health claiming agreement suspended and should not be working in a clinical capacity.
A maternity provider’s authorisation to claim will be reinstated when the required evidence is submitted to verify first vaccination or that they have a certified exemption.
Advisory on the COVID-19 Public Health Response (Vaccinations) Order 2021 to Primary Maternity Services Notice agreement holders
The health and wellbeing of pregnant people and their babies is of paramount importance, and evidence shows that these people are at greater risk of poor outcomes if infected with COVID-19.
The overwhelming majority of midwives understand the importance of getting vaccinated so they can protect themselves, and keep those they support, their whānau and colleagues safe from COVID-19.
On 23 October 2021 the Government gazetted the COVID-19 Public Health Response (Vaccinations) Order 2021 (the Order) which has been updated to require those working in the health and disability sector to be fully vaccinated against COVID-19.
To comply with the Order, those who hold agreements with the Ministry of Health to provide maternity services and claim from the Primary Maternity Services Notice 2007/2021 (the Notice), are required to have received their first vaccination by 11.59pm on 15 November 2021 and to be fully vaccinated by 11.59pm on 1 January 2022.
Maternity providers who do not comply with the Order and who have not received their first vaccination by 15 November 2021, will not be able to work in a clinical capacity from 16 November 2021 (inclusive) until they have received their first vaccination. Those who have not received their second vaccination by 1 January 2022, will not be able to work in a clinical capacity from 2 January 2022 (inclusive).
The Ministry holds vaccination records in the COVID Immunisation Register (CIR). The CIR is used to help control COVID-19 by providing information about immunisation coverage across the population, and to keep a record of the immunisations you have received.
To ensure the Ministry and operators of maternity facilities where Ministry-funded providers work can comply with the Order, the Ministry is checking the CIR to ascertain the vaccination status of all its maternity service agreement holders and providing maternity facilities with information about any providers who may not meet the vaccination requirements to deliver health services from 16 November. The sharing of this information is being done under principle 11(f) of the Privacy Act 2020, to prevent or lessen a serious threat to public health or safety, or the life or health of the individual concerned or another individual. Only the information required to meet the purposes of complying with the Order will be shared.
The Ministry will be contacting maternity service agreement holders who have not received their first vaccination by 15 November 2021, to advise them of the next steps.
Advisory to Primary Maternity Services Notice agreement holders
On 23 October 2021 the Government gazetted the COVID-19 Public Health Response (Vaccinations) Order 2021 which has been updated to require those working in the health and disability sector to be fully vaccinated against COVID-19. In order to comply with the Government’s direction, those who hold agreements with the Ministry of Health to provide maternity services and claim from the Primary Maternity Services Notice 2007/2021 (the Notice), are required to have received their first vaccination by 15 November 2021 and to be fully vaccinated by 1 January 2022.
Further information will be issued soon for those providers who hold an agreement, are authorised to claim under the Notice and choose to remain unvaccinated.
Launch of the Clinical Coach initiative. This programme funds experienced midwives working in New Zealand’s DHBs to provide clinical support to other midwives. Funding of $5 million ($3.8 million from this Government and an additional $2.2 million from DHBs) has been committed to support this initiative over the next three years. At least one clinical coach will be available at each DHB. DHBs with multiple hospitals, higher birth rates and/or tertiary levels of care may receive additional coaching support.
Launch of the Return to Practice initiative which aims to make it easier and more attractive for former midwives to refresh their practising certificates and return to this rewarding career. Funding of $1600 per midwife is being made available for up to 40 midwives in the first year, and 60 midwives in further years.
The Primary Maternity Services Notice 2021 was gazetted on 30 June 2021 and can be found here: https://gazette.govt.nz/notice/id/2021-go2473?stageDraft
The 2021 Notice will be implemented on 29 November 2021. Until then, the 2007 Notice remains in place.
The Ministry held the first in a series of information sessions on changes to the Primary Maternity Services Notice 2021, and on the Health Information Standards Organisation (HISO) Maternity Care Summary Standard and the New Zealand Perinatal Spine. Read about stakeholder information sessions.
Children’s workers advised to allow more time for Police vetting process to be completed
The Ministry of Health is aware that some Police Vetting Service requests are taking longer than 20 working days and children’s workers are advised to allow at least 6 weeks for their safety check requests to be processed.
New Zealand Police recently updated their website with police vetting timeframes. As at 10 May 2021, the Police Vetting Service is processing 51.9% of vetting requests within 20 working days, and 99.2% of all requests within 29 working days.
Having a current and up to date safety check is the responsibility of independently employed contracted providers and the Ministry encourages them to take this timeframe into consideration when applying for a Children’s Act 2014 safety check whether this is a new safety check or a safety check renewal.
The National Breastfeeding Strategy: Rautaki Whakamana Whāngote was officially released.
The strategy sets a clear direction for DHBs and providers such as GPs and midwives to improve access to technical, financial, emotional, cultural and public support for whānau.
The Ministry of Health recommends that babies are exclusively breastfed for the first six month.
The launch of Te ara ō Hine, a new initiative to support and increase Māori and Pasifika midwifery students.
The programme will provide pastoral care, academic support, and financial aid to Māori and Pasifika midwifery students across the five midwifery schools in New Zealand: Auckland University of Technology (AUT), Victoria University of Wellington Te Herenga Waka, Otago Polytechnic, Ara Institute of Canterbury (Ara) and Waikato Institute of Technology (Wintec).
The programme is the result of collaboration between the Ministry of Health, midwives, Māori and Pasifika faculty, current students and recent graduates from each of the five schools. Read more about Te ara ō Hine.
National Guidance is released for the Assessment, Diagnosis and Surgical Treatment of Tongue-tie in Breastfeeding Babies.
Ministry of Health issues advice to maternity provider ‘authorisation to claim’ data in January 2021
The Ministry of Health is reviewing its database to ensure it has current information for providers’ authorisations to claim under the Primary Maternity Services Notice 2007.
Starting from 15 January 2021, the Ministry will lapse authorisations to claim under the Notice that haven’t been claimed against for 18 months.
This only relates to authorisations granted before 1 July 2019, which have not been claimed against since 1 July 2019.
Once your agreement is lapsed, you can no longer claim against it. However, the Ministry welcomes providers to reapply for an authorisation at any time with evidence of a safety check and APC should they wish to restart claiming for primary maternity services.
If you have not claimed in the last 18 months and you plan to provide maternity services again in the near future, or if you need to reapply for authorisation, you can contact the Ministry of Health team on 0800 855 066 or email [email protected].
In the future, the Ministry will routinely review and lapse authorisations where no claim has been made in the preceding 18 months, to ensure their records remain up-to-date.
The Maternity Quality Safety Programme is a national programme to improve and build on the quality and safety of maternity services in Aotearoa.
Maternity Quality and Safety Coordinators play an important role within maternity services, working closely with maternity groups and advisors that represent pregnant people and their whānau, building vital relationships to help ensure their feedback and experiences can help drive change, and shape current and future maternity services.
From October, additional funding from of $2.2 million from Budget 2020 will enable at least one MQSP Coordinator to work in every DHB to ensure maternal quality and safety is prioritised, and work towards improving maternal and neonatal outcomes can continue.
The Ministry of Health monitors DHB delivery of Maternity Quality and Safety programmes through regular reports required by each DHB’s Crown Funding Agreement.
From 4 September to 13 November 2020, the Ministry of Health undertook a public consultation on proposed changes to the Primary Maternity Services Notice 2007. Find out more about the Primary Maternity Services Notice 2021 Consultation.
Following Budget 2020 announcements, the Ministry of Health is increasing fees paid to Lead Maternity Carers for 12 modules of care that relate to complexity of care and to rural services. The draft fee schedule and a list of the modules affected is now available at Primary Maternity Services Notice 2007.
This recognises the additional time some LMCs spend travelling to provide services to women in rural locations, and the care LMCs provide for complex cases in the third trimester.
It follows the increase of 2.18% for all modules introduced on 1 July 2020.
The Ministry is currently consulting on further changes to primary maternity service to increase the flexibility of community maternity services to better meet the needs of women and their whānau.
- Primary maternity fee increases for rural and complex modules of care: Questions and answers (Word, 247 KB)
- Primary maternity fee increases for rural and complex modules of care: Questions and answers (PDF, 109 KB)
LMCs who have questions can also contact the Ministry at [email protected].
More information about the review of Section 88 at Primary Maternity Services Notice Review 2021.
On 16 July 2020, the Government announced a further $180 million Budget 2020 package for the maternity sector. This brings the total new investment in maternity services in Budget 2020 to $242 million over 4 years.
Community maternity providers will receive an $85 million boost over the next four years to acknowledge the increased workload of providing care to rural women ($24 million) and women with complex needs ($61 million). This funding is additional to the previously announced $57 million over four years to cover cost and volume pressures under Primary Maternity Services Notice.
This new funding for rural and additional care will be disbursed by adding new modules to the Primary Maternity Services Notice, which will be undergoing a full review and public consultation this year, to be implemented in 2021.
The Ministry will work with the community maternity sector to determine options to disburse funding for rural and additional community maternity care outside of the Notice prior to the new Notice coming into force.
The Ministry has also received $35 million over four years to support the maternity sector through expansion of the Ministry of Health’s Maternity Action Plan (MAP). The MAP includes initiatives to strengthen national and local maternity quality and safety programmes, support workforce sustainability and support women and whānau.
A further $60 million over four years is allocated to support community maternity initiatives arising from any accepted recommendations of the Health and Disability System Review.
On 14 June 2020, the Minister of Health announced COVID-19 contingency funding to community Lead Maternity Carer (LMC) midwives.
The eligibility criteria are based on LMC module claims submitted from 1 July 2019 to 9 June 2020 (transition to Level 1). LMC midwives who have claimed at least one full or partial LMC module from 1 July 2019 to 9 June 2020 are eligible.
This funding acknowledges the changes in operation during the COVID-19 lockdown period.
The COVID contingency funding was implemented on 22 June 2020.
If you have any queries about the funding and the implementation process, please email [email protected].
Child wellbeing remains a high priority for the Ministry of Health (the Ministry), and universal health services, including maternity services, play a critical role in supporting and improving outcomes for women, babies and children.
Collectively as a sector we are focused on ensuring that New Zealand women, babies and whānau receive high quality maternity care from midwives, doctors, district health boards (DHBs) and other health and social service providers.
Currently the Ministry is actively collaborating with many people involved in maternity services including women, pēpi, whānau, communities, and with the New Zealand College of Midwives in a number of areas.
Delivering on Budget 2018 and Budget 2019
For the first time, the 2019 Budget contains a Wellbeing Outlook, in addition to an Economic and Fiscal Outlook.
Over the past year, the Ministry has worked with the New Zealand College of Midwives on a number of initiatives that have benefitted midwives, including the uplift Section 88 fees, recognising the work of second midwives, and the Business Contribution Payment. The initiatives in Budget 2019 will continue to build on this work. These include:
- $7.425 million per year to allow a fee uplift to Lead Maternity Carers and Non-Lead Maternity Carers for the services they provide to women and infants. This is a fee uplift of 4.93 percent, which compliments the 8.9 percent uplift for LMCs in the 2018/19 year. An amendment to the Primary Maternity Services Notice 2007 (the Notice) has been notified which will implement this increase for claims with service date on or after 1 July 2019.
- $4.563 million of new funding for overall rural and regional workforce training. In the 2019/20 year and ongoing, $500,000 per annum will be added to the existing locum support provided for rural midwives.
- $4.335 million over four years for a wraparound support programme for Pacific students who would like to gain a nursing or midwifery undergraduate degree. This will reduce financial and other barriers faced by Pacific students.
The Budget 19 initiatives outlined above will assist working towards a more sustainable workforce by strengthening the pipeline into midwifery and then the support of the midwifery workforce. In addition, the Maternity Improvement Programme has a significant workforce component.
The recent Midwifery Accord, agreed between the Midwifery Employee Representation and Advisory Service, the New Zealand Nurses Organisation (NZNO) and DHBs, and the Director–General of Health, has the focus on ensuring safe staffing levels of midwives employed by DHBs.
Primary Maternity Services Review
There is commitment to the continuity of care approach and are using co-design principles to design future maternity services and systems. This approach will continue to inform future direction and decisions. The Ministry is focused on designing a service commissioning model that will provide a sustainable alternative to the Notice.
In June and July 2019, the Ministry will actively engage with both consumers and midwives. This consultation will include looking at funding options and the development of a national midwifery provider organisation, as well as determining a fair and reasonable service price for Lead Maternity Care midwifery services. Feedback on the presented options will be welcomed.
In preparation for this work, we have collaborated with Māori leaders for their input and insights to ensure that going forward maternity services will be able to better deliver for Māori women and their pēpi. The Ministry acknowledges that this is the start of a longer conversation with Māori and that there is much more work to be done in the area of Māori health improvement.
Following a request from the Health & Disability Commissioner in late 2018, the Ministry held a meeting in April 2019 to discuss New Zealand’s current and future approach to the assessment, diagnosis and surgical treatment of tongue-tie in breastfeeding babies. The meeting was attended by 35 clinicians representing a variety of professions including midwifery, paediatrics, surgery, general practice, dentistry and lactation consultancy.
Meeting attendees reached consensus that multi-disciplinary guidance is required for the sector. Several issues were identified including a lack of consistent information for consumers about the risks and benefits of surgical treatment for tongue-tie; inconsistent and inequitable access to treatment when indicated; and a lack of nationally consistent breastfeeding support in the community. The Ministry is leading development of this multi-disciplinary guidance for completion in 2019.
National Strategic Plan of Action for Breastfeeding 2008–2012
The project of refreshing the National Strategic Plan of Action for Breastfeeding 2008–2012 is well underway. The refreshed plan will re-focus on strategies to improve breastfeeding rates in New Zealand. An external advisory group is assisting in the development of this work. A framework for the refreshed plan has been agreed, which incorporates a kaupapa Māori approach. The timeframe for delivering a beta version of what will be an online plan is December 2019.
Maternity Quality and Safety Programme
DHB Maternity Quality and Safety Programme coordinators have recently shared their thoughts on how the Ministry can better support quality and safety initiatives at local, regional and national levels. This will inform our work going forward.
Health Information Standards
In the preparation for release of the draft Health Information Standards Organisation Maternity Care Summary Standard for public consultation, there has been collaboration with many groups across the sector.
Maternity Research Programme
The Ministry has recently been in discussion with the Health Research Council regarding the potential to establish a maternity research programme. At the April Health Research Council – Ministry Partnership Governance Group meeting, the group identified opportunities to fund maternity research. The NMMG has been helping the Ministry identify and recommend areas for research. Two immediate research priorities are preterm birth prevention and maternal mental health. The Ministry aims to progress preterm birth prevention research initially. There is need for wider discussion scoping the topic of maternal mental health in light of the recent Mental Health funding announcements and the response to the Mental Health Inquiry.
In May 2017 the Ministry of Health (Ministry) and the New Zealand College of Midwives (the College) reached an agreement to settle the College’s application for judicial review alleging discrimination against midwives based on gender.
As part of the agreement reached in May 2017, the Ministry and the College agreed to a process for the co-design of a new model for the funding and contracting of community Lead Maternity Carer midwives. The Ministry also agreed to prepare a bid for the 2018 Budget that reflected the findings of the Co-design report and job evaluation process.
While the Co-design process proceeded as agreed, the Ministry did not prepare a Budget bid that reflected the findings of the Co-design process. Accordingly, the Ministry acknowledges that it breached the May 2017 agreement that it had reached with the College.
Representatives of the Ministry and the College met in mediation on 14 December 2018. As a result of that mediation, the Ministry and the College have reached further agreement. Some, but not all, of the matters agreed are recorded in this statement.
The Ministry apologises to the College and its members for breaching the May 2017 Settlement Agreement. Having expressly and formally agreed to do so, the Ministry did not prepare a Budget bid reflecting Co-design. The Ministry acknowledges that its breach was through no fault of the College.
The Ministry has reaffirmed its commitment to the Co-design principles, including a Blended Payment Model for LMC midwives. The Ministry has also reiterated its support for the continuity of midwifery model of care as central to maternity services in New Zealand.
The Ministry has agreed to a process to ensure a ‘fair and reasonable’ service price for LMC midwives. The College and the Ministry will work on this together throughout 2019.
The Ministry and the College have agreed to work together in early 2019 on structural changes to the way LMC midwives are funded and contracted.
The Director-General of Health, Dr Ashley Bloomfield, reiterates that strengthening and stabilising maternity services is a priority for the Ministry. The Ministry and the College have renewed their commitment to work together in good faith.
The Ministry and the College of Midwives met in September and agreed to a number of recommendations from the co-design process. The co-design documents are available to view on this page.
This work includes agreeing the following principles when developing any new Maternity system which is a fundamental part of the Government's priority for child wellbeing.
- Primary maternity care will continue to be free to all eligible women.
- The midwifery led model of continuity of care will be maintained.
- The right for community midwives to choose self-employment will remain under any new contract arrangements.
- A National Community Midwifery Organisation will be developed.
- A national primary midwifery contract will be developed as an alternative to Section 88.
- The new contract will protect, strengthen and integrate the existing model of care, and will include a regular review clause, thus affording community midwives the right to regular renegotiation of the terms and conditions of the contract.
- The on call and 'self-employed' nature of community midwifery will be accounted for in the new funding framework to enable flexible service delivery based on individual need.
- Work is underway to develop a revised national strategy for breastfeeding as a cornerstone for child wellbeing.
- The Ministry is undertaking this work in partnership with the New Zealand Breastfeeding Alliance (NZBA), who will govern its progression with an aim to deliver a new strategy in 2019.
- The NZBA is also revising the baby friendly hospital initiative (BFHI) to better align with community based provision of breastfeeding education and support.
- Work is underway on the first recommendation of the Maternity Ultrasound Advisory Group (MUAG), which is the development of national quality standards and guidance for primary maternity ultrasound.
- The first phase is development of universal guidelines to support radiology and sonography professionals to deliver nationally consistent and high quality maternity ultrasound screening services.
- A clinical expert working group is developing the guidelines and are making good progress.
- The guidelines will be circulated for consultation before year end.
- It is anticipated the guidelines will be completed beginning of 2019.
- The guidelines will form the basis of work regarding commissioning of primary maternity ultrasounds.
The next update at the end of October will provide further information on how a new sector maternity oversight group will be established, and how it will work with an 'all of systems' approach.
The Ministry and NZCOM Co-design Project: 21 August 2018
The Ministry of Health thanks the NZCOM staff, Ministry staff, community midwives and women involved in a project to co-design a new community primary midwifery funding model. Recommendations were delivered to the Ministry in December 2017.
The outputs of the project are not government policy but are informing future service models for wider maternity care.
Maternity and midwifery workforce is a priority for the Ministry. A whole of sector approach is in place to deliver more equitable, high quality and sustainable maternity care through a broad maternity work programme.
- Community Primary Midwifery Payment Model Report (Word, 32 KB)
- Community Primary Midwifery Funding Model Report (Word, 25 KB)
- Community Primary Midwifery Pricing Model Report (Word, 481 KB)
- Covering Memo and Recommendations to Steering Group (PDF, 2.5 MB)
- Presentation to Steering Group (Powerpoint, 3.4 MB)
- FAQs to support the presentation to the Steering Group (Word, 26 KB)
Agreement on second midwife funding: 3 August 2018
The Ministry of Health has reached agreement with the New Zealand College of Midwives on terms and conditions for which funding for second midwives can be claimed, where required, to support community midwifery practice.
A definition of the scope of second midwife services during labour and birth and how payment for these can be claimed will be communicated directly to the sector by 31 August, and will also be available on this website.
Claims for payment for second midwife services within the scope of this definition will be able to be submitted for payment from 17 September 2018, for services delivered from 1 July 2018.
Maternity services: update April 2018
The Ministry of Health and the New Zealand College of Midwives are working together with urgency on a maternity programme designed to address current pressure on the midwifery-led service.
Acting Director-General Stephen McKernan acknowledges collaboration over the last month between the College and Ministry officials has resulted in a positive way forward.
“Addressing workforce shortages and collaborating on a maternity programme that delivers a sustainable midwifery model of care has guided discussions.
“The Ministry has taken on board advice from the College to include elements of the co-design process.
“As a result the Ministry has agreed to develop a Memorandum of Understanding with the College to improve ongoing collaboration on the maternity work programme,” says Mr McKernan.
New Zealand College of Midwives, Chief Executive Karen Guilliland says women, their babies and families need improved access to safe, integrated, high quality services.
“The College and the Ministry agree a midwifery continuity of care model must be resourced effectively to provide support during pregnancy, labour and birth and through the postnatal period until the baby is six week old.
“I am also pleased that the issues raised by the current workforce shortage will be prioritised for resolution; for example, continuing to provide rural primary maternity service provision in all areas,” says Ms Guilliland.
Maternity services: update March 2018
Joint statement: New Zealand College of Midwives and Ministry of Health
Tuesday 14 March 2018
The Acting Director-General of Health, Stephen McKernan, met the Chief Executive of the New Zealand College of Midwives, Karen Guilliland and Deputy Chief Executive, Alison Eddy this morning (14 March) to discuss the co-design process and the Ministry’s response.
Both parties acknowledge the importance of women’s access to and experience of care, and the health and wellbeing of the midwifery workforce.
Chief Executive of the New Zealand College of Midwives, Karen Guilliland says the Ministry of Health is taking the issue seriously and values the relationship with the College.
“We have been working together on the co-design project since May 2017. The process exposed the current vulnerability of community midwifery services and highlighted that many midwives are finding the workload unsustainable.
“I expressed the urgency needed to support the workforce and I am looking forward to exploring how we do this with the Ministry over the next month,” says Ms Guilliland.
The Acting Director-General of Health agrees the co-design process highlights the urgent need for a sustainable way of working for the community-based midwives.
“The Ministry values the role self-employed midwives bring to maternity care. We will continue to discuss with the College the range of measures required. This will ensure improved access to safe, integrated, high quality services that meet the needs of mother and baby and work better for our midwives in addressing hours of work, workload, income and support,” says Mr McKernan.