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"Lack of continuity and support during antenatal care"

About: Exmouth Health Service

(as the patient),

I am currently receiving antenatal care at Exmouth hospital and have been disappointed with the lack of continuity of care in this service. Fortunately I have been through a pregnancy before so I have some understanding of the process and tests required, but for a first time mother this may be an extremely daunting experience.

Our midwife is currently on leave for an extended period (~4 months) and has not been replaced so all antenatal appointments are via the GPs. The GPs do a fantastic job, especially as they have to staff the clinic and emergency department, but the clinic is very busy and the wait time for an up appointment is currently 4 weeks. Adding all antenatal care to their load seems unfair and I am wondering why no replacement midwife has been brought in for this period. Additionally, I was not initially told that antenatal appointments should be be back-to-back (I. e. 30 mins) so I was further clogging up an already busy system.

Finally, I have been disappointed to find that the National Pregnancy Handheld Record has still apparently not been introduced to Exmouth Community Health Service. This Handheld Record was introduced for the purpose of improving continuity of antenatal care and would be especially valuable in Exmouth as all pregnant women must transfer to a different health service to deliver their babies. The midwives who were responsible for my care at my 'birth' hospital during my last pregnancy were surprised (to say the least) when I turned up at 36 weeks gestation without a Handheld Record.

These issues will unfortunately probably not be resolved during my pregnancy but I hope that the system can be improved so that future antenatal care will provide greater continuity.

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Response from Liz Kelly, A/Coordinator Executive Services, WA Country Health Service Midwest 7 years ago
Liz Kelly
A/Coordinator Executive Services,
WA Country Health Service Midwest
Submitted on 2/06/2016 at 2:51 PM
Published on Care Opinion at 4:31 PM

picture of Liz Kelly

Dear Expecting In Exmouth

I am sorry to hear that you have had difficulties accessing antenatal care at Exmouth Hospital. The Midwife needed to take leave urgently and short term cover is unfortunately difficult to provide given the State-wide shortage of Midwives. The General Practitioners (GP’s) have agreed to provide antenatal care during this time. Our aim is to provide safe high quality care as close to home as possible. Your concerns will be further considered to ensure all options for providing service continuity are explored and to ensure that antenatal patients receive timely information about service availability and how best to access service during periods when a Midwife is not available.

We are concerned that you were not provided with a Pregnancy Hand Held Record during your last pregnancy as this has been introduced at Exmouth Hospital and provides a valuable communication tool. We would be grateful if you could contact us directly to discuss the issues you have raised about continuity of care and the hand held record, so that we can make sure that the action we take addresses your concerns. Your call would be welcome and your concerns still addressed anonymously if you wish. If you would like to do this please phone Jan Cook, Acting Operations Manager Gascoyne on 9941 0300.

Feedback from patients and carers is valued at WA Country Health Service Midwest as it allows us to reflect on our services and improve them in a manner that meets the needs of the community. Thank you for taking the time and effort to share your story with us. I hope your pregnancy continues to progress well and that we can work with you to improve services.

Yours sincerely


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Update posted by Expecting in Exmouth (the patient)

Hi Liz. Thanks for your response to my feedback. I am more than happy to provide additional comments regarding antenatal care in Exmouth, especially if it results in better outcomes for women in the community. However, I am pretty disappointed to find that the number you provided for the Acting Operations Manager seems never to be answered. I have attempted calling every day this week at a variety of times - only to have the number ring out again and again. I understand that the person may be on leave or not often at their desk, but there is no voicemail or re-direct to a reception or other team member for me to even leave a message.

Since posting my story I have spoken with some other pregnant women in the community and when asked about the Pregnancy Handbook their responses to me varied from (1) don't have one, (2) haven't seen one being filled out during my recent appointments and (3) it wasn't properly filled out. Based on this information, I really think this is an issue that needs to be addressed and look forward to experiencing some positive changes in relation to antenatal care in Exmouth.

Response from WACHS-Midwest 7 years ago
We have made a change
Submitted on 13/06/2016 at 6:02 PM
Published on Care Opinion on 14/06/2016 at 1:04 PM

Dear Expecting in Exmouth

Thank you for getting back to us via Patient Opinion and letting us know that you were unable to contact me. I am disappointed you were unable to reach me - there have been ongoing issues with the phone line and it is currently being resolved. From your feedback we have made an improvement which will be to include two contact numbers with all of our Patient Opinion responses so in the event there are issues with the phone or the phone is unanswered there will be a backup.

I will be travelling to Exmouth next week and would be available to meet with you if you wish. I’m available on the 24th (before lunch), 29th and 30th June. We could talk through the issues you have raised and the improvement plan to address these matters. I would be grateful if you could contact me (or Michele Young at the number below) to arrange a convenient time to meet.

Alternatively should you wish to remain anonymous and discuss your concerns by phone, could you contact Michele Young on 9956 8695 (during office hours) or via email to provide your contact phone number so that I can contact you.

Again I'm sorry that you were unable to contact me last week and I hope to hear from you soon.

Kind regards

Jan Cook

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Response from Michele Young, REOC Lead, Executive Services, WACHS-Midwest 7 years ago
We have made a change
Michele Young
REOC Lead, Executive Services,
Submitted on 27/06/2016 at 11:46 AM
Published on Care Opinion at 12:10 PM

picture of Michele Young

Dear Expecting in Exmouth

Jan has advised that she has spoken with you and I was pleased to note that as a result of your feedback the following improvements will be made:

Pregnancy hand held records will be given to the patient and the hospital will have a copy on file;

A documented guideline will be developed for antenatal care, for all staff to follow;

Strategies have been put in place to take phone calls should the key contact person not be available at the time of the initial call.

Jan also advised that she is looking at the potential for a Midwife from Carnarvon to visit Exmouth on a regular basis.

So thank you again for taking the time to get in touch and also, allowing us the opportunity to continually improve our services into the future.

Kind regards

Michele Young

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