National Services, as part of the DHB Performance, Support and Infrastructure directorate, is tasked with leading and delivering the design and implementation of National Services or Service Improvement Programmes. The directorate is responsible for ensuring a strong working relationship between the Ministry and DHBs in the planning, funding and performance of services, including national services.

The following improvement Action Plan is subject to consultation before being finalised.

Maternal Fetal Medicine: Action Plan

The Ministry has worked with an improvement advisory group to describe a service model for Maternal Fetal Medicine (MFM) services, and have identified actions required to implement the recommended model. Once finalised the Ministry will work with DHBs and a MFM leadership group to oversee implementation of the MFM Action Plan.

The MFM Action Plan has an overarching goal that mothers and babies achieve the best possible outcomes, through high quality MFM assessment and treatment, provided by expert practitioners.

Service objectives are:

1. Women with complex pregnancies, and their whānau, receive the right care in the right place at the right time
2. Improved services for women and babies, provided through sustainable MFM hubs that achieve high quality care and equitable outcomes
3. Women and their whānau receive integrated and coordinated care across maternity providers
4. MFM providers consistently collect and report their activity and outcome data to inform service improvement and workforce sustainability.

We are now seeking feedback on the MFM Action plan, prior to finalizing it.

Response may be provided by on-line survey at:

https://consult.health.govt.nz/electives/mfm-action-plan

Alternatively, you can provide feedback on the Consultation Feedback Form

Feedback forms may be emailed to:  [email protected]

If you would like to submit by post, please send your comments to:

Electives & National Services
DHB Planning, Performance and Infrastructure
Ministry of Health
PO Box 5013
Wellington 6145

The closing date for submissions is 5pm, Friday 13 December 2019.

Closed Consultation

Consultation on the following service models has closed. These are now being finalised and will be released shortly.

1. Perinatal Pathology Services.
2. Vascular Services.
3. Extra Corporeal Membrane Oxygenation (ECMO).
4. Stroke Clot Retrieval

Service Model for National Perinatal Pathology Services

The Ministry has undertaken a review of the service delivery model for Perinatal Pathology Services, with a view to implementation of a sustainable national service. The below consultation document outlines the main recommendations of the Perinatal Pathology Working Group for establishment of a Service Model for National Perinatal Pathology Services.  The Ministry sought feedback on the recommendations and the proposed Service Model from a range of stakeholders. Feedback from stakeholders is important because it helps shape the final service model, ensuring it is appropriate and achievable.

• Service Model for National Perinatal Pathology Services - final draft (pdf, 1.49 MB)
• Consultation on Service Model for National Perinatal Pathology Services (pdf, 876 KB)

Model of Care for Vascular Services

In 2015 a Project Advisory Group was convened by the Ministry of Health, with the support of DHB General Managers Planning & Funding and Chief Operating Officers .  The intent was to develop a nationwide tier two Vascular Services Service Specification that describes minimum requirements for a DHB intending to deliver vascular services, to ensure an integrated and safe service for patients.  As part of the development of the specification, it was necessary to describe a model of care for vascular services.  The model of care will guide the types and locations of services, ensuring patients access the right level of care in a seamless and timely manner. 

• Model of Care for Vascular Services - final draft (pdf, 2.65 KB)
• Tier Two Vascular Services Service Specification (docx, 79 KB)
• Consultation on Model of Care for Vascular Services (pdf, 837 KB)

Service Model for Extra Corporeal Membrane Oxygenation

ECMO refers to the use of a portable modified heart-lung bypass machine to support patients whose hearts and/or lungs are failing. ECMO is a highly specialised and resource intensive input into the care of patients with complex medical conditions.

The Ministry of Health and a sector based Technical Advisory Group have developed service model for ECMO  to improve the quality of patient care and outcomes, as well as ensuring resources are used wisely. There are six key objectives for the service model.

1. To have a clearly defined patient pathway to ensure patients who are clinically eligible for venovenous ECMO have, as far as clinically possible, equity of access to the service.
2. To provide referrers and patients requiring ECMO within the cardiovascular intensive care unit at Auckland DHB with:

a. expert advice on the diagnosis and management of potentially reversible severe respiratory and/or cardiac failure, including collaboration with other tertiary providers where appropriate
b. a retrieval service for those patients that meet the criteria and are accepted for ECMO, including safe mobile ECMO.

3. To support safe repatriation of patients to an appropriate hospital close to their home following ECMO.
4. To improve patient outcomes through timely and appropriate referral to the ECMO service, as reported within the local clinical outcomes database and through submission of data to Extracorporeal Life Support Organisation (ELSO) and communicated nationally.
5. Safe and high quality clinical care for all patients referred for ECMO.
6. To provide cultural, as well as family and whānau support.

Stakeholders were asked to provide feedback on the consultation draft service model, available below.

• ECMO Service Model for Consultation, (pdf, 871 KB)

Action Plan for Stroke Clot Retrieval (SCR) 

The Ministry of Health has worked with the SCR Advisory Group and Clinical Director, SCR to design an Action Plan to support the existing New Zealand Strategy for Endovascular Clot Retrieval. Once finalised the Action Plan will be submitted as a National Services Improvement Programme.

SCR is an effective, but time sensitive, treatment for acute ischaemic stroke (AIS) patients. The SCR Action Plan has been developed to improve access to high quality care and outcomes for people who experience AIS and who are clinically suitable for SCR. The following objectives have been identified as being important for SCR services:

improve access to SCR
reduce inequity of access to SCR
provide patient centred, culturally appropriate care
achieve improved health outcomes
improve equity in outcomes for people experiencing AIS.

To achieve these objectives SCR services will need to be nationally consistent, sustainable, available 24 hours, be supported by an appropriately skilled workforce and make optimal use of technology to support referral pathways and decision making. The Action Plan puts forward five improvement priority areas and outcome measures to track achievement of the five objectives.    

Action Plan (1.11MB).

 https://consult.health.govt.nz/electives/stroke-clot-retrieval-services

 Consultation Feedback Form – Action Plan for Stroke Clot Retrieval (434.67 KB)