women-centred (including the ability for women to self-refer to mental health services for triaged assessment and the provision of opportunities to visit maternity facilities and meet staff pre-birth should a woman be concerned about birth or be experiencing mental health or addiction issues) coordinated and engages with a wide of service providers involved in maternal mental health care (including primary care, well child services, and representatives of all DHB departments involved in maternity services or caring for mothers and babies – including mental health services) DHB-wide: all-department meetings are held to discuss maternal mental health issues consistently applying a standardised screening tool (in this case, the Edinburgh Postnatal Depression Scale), which has included health practitioner training, and providing ongoing leadership: the establishment of a pathway and appointment of dedicated FTE is only the first step. The changes we expect to see next We expect all “established” DHBs to be planning how and preparing for movement into the “excelling” tier. This pathway should be described in the MQSP Annual Report. We encourage the Ministry of Health to support promotion of Taranaki DHB’s implementation of its maternal mental health pathway as it demonstrates a good approach on how to embed the mental health as a core maternity service. We expect all DHBs to continue to monitor the implementation of maternal mental health pathways. We expect that all DHB MQSP coordinators continue to be supported with dedicated time to complete their coordination role rather than fitting this important work around other clinical or administrative roles. Review key sector publications including the Report on Maternity Our for 2015/16 was to review key maternity sector publications and accompanying data tables to provide advice on the findings and possible priorities for future action. Reviewing key sector publications and providing advice on the findings of reports is one of the key functions of the NMMG and one of the ways in which we contribute to continuous systems improvement. We have previously reviewed each Report on Maternity and provided advice on possible improvements: we expect to continue to do this. What we have done this year and our findings We reviewed the Ministry of Health’s Report on Maternity 2014.
We were encouraged to hear that the Ministry of Health is implementing the eighth edition of the ICD-10. Implementation includes an upgrade to in-house training for DHB coding staff. We were also pleased to note that several DHBs have identified clinical coding as a quality improvement area and are implementing new programmes of work to address identified quality issues. The NMMG continues to support strong communication between MQSP coordinators and maternity care professionals regarding coding decisions. The changes we expect to see next We encourage the Ministry of Health to release the 2015 Maternity Clinical Indicators dataset as soon as possible in 2016. When this is released, the NMMG will consider the dataset and correspond with DHBs intended actions to take as a result of the new data. We expect DHBs to continue to review the Maternity Clinical Indicators data and use this to guide quality improvement initiatives, including reporting on this work and its impact in their MQSP Annual Reports. The NMMG will meet with the Expert Working annually to discuss trends, consider the impact of the Maternity Quality Initiative on maternity outcomes and assess proposed or required changes to the Clinical Indicators, including addition or removal of individual Indicators. We encourage DHBs to review births that have been initiated earlier than 39 weeks to determine if organisational factors are a contributory factor to that timing and to then consider initiatives to optimise the timing of birth for these babies.