Common sense trumps red tape at the WCH 

16 September 2021

Members at the Women’s and Children’s Hospital appear to have had a victory for common sense with the expected removal of red tape which had badly bogged down the process for clinical investigations.

Midwives were unable to initiate orders for clinical investigations as per the Nursing and Midwifery Initiation and Management of Clinical Investigations Procedure due to medical staff removing consent to order investigations under their name and/or provider number.

This has impacted in a number of ways on flow and activity and women’s journey in the Women’s Outpatients Department as it requires a medical review before tests are ordered. Ordering specified pathology and imaging is within a midwife’s scope of practice and the process is governed by LHN Procedures.

Usually, at a 12-week outpatient appointment, the midwife would order the morphology scan and give this to the patient to have done at around 18/19 weeks.

Under the changed processes, the woman was forced to come back at 16/17 weeks solely to have an appointment with a consultant to receive the path form for testing. They then attended another appointment with the midwife to undertake the full checks and tests.

This was a clear doubling up of processes when resources were already stretched within the hospital. It just didn’t make sense to the midwives and was disruptive to clients.

Members raised the issue with ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM during one of her walkarounds at the hospital, a 12-month long issue which appeared to be without a clear, or near, resolution.

As a result of member pressure and ANMF (SA Branch) investigations, the Women’s and Children’s Health Network has created a provider number for midwives in OPD and are just needing an agreement over escalation before the midwives can resume their practice and clients won’t have make multiple visits to the hospital, in the process chewing up resources just to get a piece of paper (the morphology request).

It is expected that at the end of this month, common sense will prevail and things will return to “normal”.