YOUR MIDWIFERY BUSINESS

SHANTI DAELLENBACH LOCUM SUPPORT CO-ORDINATOR

community midwife locum support

The past year has continued to see ongoing challenges for the midwifery workforce in Aotearoa which have been amplified even more by the effect of Covid-19 and the changing government response and related requirements.

The MMPO has continued to respond to these challenges through ongoing advocacy work, and negotiation with the Ministry to have community midwife locums acknowledged for the vital work that they continue to do. Furthermore, we have asked for fair and reasonable funding increases to support both the existing types of locum support services we provide, and for payments to recognise the extra work being carried out to support the midwifery workforce across the motu with locuming as we negotiate our way together, through this unprecedented pandemic.

COVID-19 LOCUM SUPPORT In early 2020, the MMPO (together with the College) secured funding from the Ministry to support Covid-19 emergency locum cover for all LMC midwives. Throughout 2020 and 2021 this funding was only used during Covid Alert Levels 3 and 4 and the funding was limited by criteria and for a set period.

In advance of the outbreak of Omicron and based on the expectation of greater locum cover demand for Covid-19 emergencies, the MMPO and College were able to negotiate the continuation of this funding, at the same time widening the criteria required for community midwives to access this support and payment.

Importantly, the Covid-19 contract negotiation also allowed us the opportunity to negotiate more funding and payments for locums, recognising the extra work they are required to perform when planning and handing over cover. The negotiations also recognised the significant impact labour and birth care has on a midwife providing locum cover.

Since the start of March 2022 and with the impact of Covid-19 Omicron, there has been an unprecedented increase in locum support, with the MMPO workforce team managing and administering cover for over 620 community midwives who accessed more than 2,670 days of Covid emergency cover in that period alone. We expect that the need for this type of locum cover will continue to remain high throughout the winter.

The MMPO would like to reassure midwives that Covid emergency locum funding has been agreed upon and extended with the Ministry until at least June 2023.

NEW PAYMENTS FOR COMMUNITY MIDWIFE LOCUMS FOR ALL EMERGENCY COMMUNITY MIDWIFERY LOCUM COVERS

(INCLUDING COVID-19 URBAN AND RURAL NON-COVID EMERGENCY SITUATIONS)

Over the past six months, the MMPO (together with the College) successfully advocated for and negotiated new payments that better recognise and remunerate locum midwives for the work they do, including:

• A Birth Acknowledgement Payment of $550 (exc GST), paid to locums where they undertake birth care during an emergency locum cover. This fee is in addition to the daily rate and can be claimed up to two times per locum cover. • An additional Planning and Handover

Payment, based on the daily rate and pro-rated to the cover duration. This payment recognises the work done by the locum prior to and following the locum cover, such as receiving a handover from the midwife, planning the cover, and handing back to the midwife at the end.

• Support to any locum community midwife who relocates for at least eight weeks to another region (that is affected by shortages of fully vaccinated LMCs in line with the Covid-19 Vaccination Order) with a payment of relocation costs up to $3,000 (exc GST) per midwife to cover travel, accommodation, and other start-up costs.

LOOKING FORWARD The stabilisation and future sustainability of the community midwifery workforce continues to face strong headwinds.

The passing of the Vaccination Order for Health Workers into law in November 2021, saw the entire community midwifery workforce abruptly contract. This government requirement, whilst affecting all, has had a significant impact on rural communities who are supported by only a small number of community midwives, where even the loss of one midwife is significant. Furthermore, some remote rural communities lost all access to primary maternity care from a midwife at this time, leaving them reliant on DHB hospital services hours away from where they lived.

To help with the current situation the MMPO locum service has expanded its role

Since the start of March 2022 and with the impact of Covid-19 Omicron, there has been an unprecedented increase in locum support, with the MMPO workforce team managing and administering cover for over 620 community midwives who accessed more than 2,670 days of Covid emergency cover in that period alone.

and scope to support some of the most affected communities across the motu. The MMPO did this primarily by working together with DHBs in the worst affected areas to find interim workforce solutions and facilitate DHB funded support packages, to support the sustainability of community midwives in those areas of crisis.

The start of July 2022 will see the establishment of Health NZ and the Māori Health Authority; national entities that will replace the DHB system across Aotearoa. For the MMPO locum service this means a shift of our workforce contracts (as they currently stand) from the Ministry to these new entities until at least 30 June 2023.

At time of writing, our negotiations with the Ministry continue, for both improvements to existing services and additional funding for new workforce and locum initiatives. Some critical requests have been ongoing for a long time, such as increases to the current daily rate (which have not been changed for over a decade) and are still outstanding. Some are new workforce and locum initiatives and requests, including:

• Introducing professional development leave locum cover for all community midwives • Introducing cultural leave locum cover (for kaupapa Māori professional development including te reo Māori) • Increasing emergency locum leave cover (including sick leave) to be more equitable considering the recent changes to employed sick leave entitlements • Increasing non-emergency leave and locum support for all community midwives • Expanding the new locum payments detailed above to include non-emergency locum covers.

At time of writing we wait patiently, but intently, for the announcement of Budget 2022. square

MMPO, the Midwifery and Maternity Providers Organisation provides self employed community midwives with a supportive practice management system.

www.mmpo.org.nz mmpo@mmpo.org.nz 03 377 2485