NOTICE PURSUANT TO SECTION 88 OF THE
NEW ZEALAND PUBLIC HEALTH
AND DISABILITY ACT 2000
THIS NOTICE IS ISSUED BY THE CROWN AND IS EFFECTIVE FROM 1 JULY 2007
Primary Maternity Services Notice 2007
Pursuant to section 88 of the New Zealand Public Health and Disability Act 2000, the Crown issues the following notice.
1 Title
(1) This notice is the Primary Maternity Services Notice 2007.
(2) In this notice the Maternity Services Notice is called the "principal notice".
2 Commencement
(1) This notice comes into force on 1 July 2007.
(2) This notice revokes and replaces in its entirety the Maternity Services notice that came into effect on 1 July 2002 (published as a Supplement to the
New Zealand Gazette, 24 April 2002, No. 40, page 1101) and the amendment to the notice that came into force on 16 December 2005 (published in the New Zealand Gazette, 3 November 2005, No. 183, page 4597).
____________________
Contents
PART A
INFORMATION ABOUT THIS NOTICE
A1 Title 1033
A2 Commencement 1033
Purpose and objectives
A3 Purpose of this notice 1033
A4 Objectives of primary maternity services 1033
Overview of this notice
A5 Revocation and transitional provisions 1034
A6 Definitions and interpretation 1034
A7 General requirements for all primary maternity services 1035
A8 Specific requirements for each primary maternity service (including service specifications and payment rules) 1035
A9 Fees 1035
rocess for amending or revoking notice
A10 Process for amending or revoking notice (excluding amendments that consist
of only fee increases) 1035
A11 Streamlined process for amendments consisting of only fee increases 1037
A12 Default transitional provisions for amendments consisting of only fee increases 1037
PART B
DEFINITIONS AND INTERPRETATION
B1 Definition of primary maternity services 1039
B2 Definition of persons who are eligible for primary maternity services 1040
B3 Definition of maternity provider 1040
B4 Definition of practitioner 1040
B5 Other definitions 1040
B6 Meanings of terms and expressions defined in Act 1046
B7 Parts of speech and grammatical forms 1046
B8 Numbers 1046
B9 Time 1046
B10 Interpretational aids: list of defined terms 1047
PART C
GENERAL REQUIREMENTS FOR ALL PRIMARY MATERNITY SERVICES
Subpart CA-Authorisations
CA1 Granting authorisation 1048
CA2 Duration of authorisation 1048
CA3 Withdrawal from providing primary maternity services 1048
CA4 Exemptions 1048
CA5 Termination or variation of authorisation by Ministry of Health 1049
CA6 Process for terminating or varying authorisation by Ministry of Health 1049
CA7 Lapse of authorisation 1049
CA8 Consequences of termination or lapse of authorisation 1050
Subpart CB-General requirements for providing primary maternity services
CB1 Compliance with statutory, regulatory, legal, and professional requirements 1050
CB2 Audit 1051
CB3 Manner of providing primary maternity services 1051
CB4 Achieving Maori health outcomes and reducing Maori health inequalities 1052
CB5 Practitioner to have access agreement 1052
CB6 Relationship to be based on informed consent 1052
CB7 Information about primary maternity services 1052
CB8 Maternity provider to advise woman on alternative maternity providers if not providing the primary maternity services 1053
CB9 Maternity provider to co-operate with others in order to promote safe and
effective primary maternity services 1053
CB10 Ongoing improvement of quality of primary maternity services 1053
CB11 Practitioners to participate in professional review process 1053
CB12 Maternity provider and their practitioners to co-operate with Perinatal and
Maternal Mortality Review Committee 1053
CB13 Practitioners to include the required information on all prescriptions and
referrals 1054
Subpart CC-Claims
CC1 Basis for claiming under this notice 1054
CC2 No claim if claim is covered by another arrangement 1055
CC3 Claim to be properly completed 1055
CC4 Timing of claims 1055
CC5 Manual claims 1056
CC6 On-line maternity claiming 1056
CC7 Electronic claiming 1056
CC8 Payment of claims 1057
CC9 Set-off 1057
CC10 Reconsideration of claim 1057
PART D
SPECIFIC REQUIREMENTS FOR EACH PRIMARY MATERNITY SERVICE (INCLUDING SERVICE SPECIFICATIONS AND PAYMENT RULES)
Subpart DA-Lead maternity care
General information about lead maternity care
DA1 Aim of lead maternity care 1058
DA2 Registration 1058
DA3 Charging for lead maternity care 1059
DA4 Where lead maternity care may be provided 1059
LMCs
DA5 Lead maternity carer (LMC) 1059
DA6 General responsibilities of LMCs 1059
DA7 Continuity of care 1060
DA8 Transfer of care to secondary maternity services, tertiary maternity services,
and specialist neonatal services 1060
Service linkages
DA9 Service linkages: transfer to well child services 1061
DA10 Service linkages: transfer to primary health services 1061
DA11 Linkages with other services 1061
Exclusions
DA12 Exclusions 1062
Claims
DA13 General requirements for making claims for lead maternity care 1062
Reporting requirements
DA14 Purchase units 1063
DA15 Registration information 1063
DA16 Service delivery information 1063
DA17 Health status information 1063
DA18 NIR information 1064
Module: First trimester and second trimester
DA19 Service specifications for first and second trimester 1064
DA20 Payment rules: First and second trimester 1065
Module: Third trimester
DA21 Service specification: third trimester 1066
DA22 Payment rules: third trimester 1066
Module: Labour and birth
DA23 Service specification: labour and birth 1067
DA24 Payment rules: labour and birth 1068
DA25 Service specification: labour and birth (exceptional circumstances) 1068
DA26 Payment rules: labour and birth (exceptional circumstances) 1069
DA27 Service specification: labour and birth (rural support) 1069
DA28 Payment rules: labour and birth (rural support) 1069
Module: Services following birth
DA29 Service specification: services following birth 1069
DA30 Payment rules: services following birth 1071
DA31 Payment rules: services following birth: rural travel 1072
Subpart DB-Maternity non-LMC services
General information about maternity non-LMC services
DB1 Aim of maternity non-LMC services 1073
DB2 Charging for maternity non-LMC services 1073
DB3 Where maternity non-LMC services may be provided 1073
DB4 Practitioners who may not provide maternity non-LMC services 1073
DB5 Service linkages 1074
DB6 Exclusions 1074
DB7 General requirements for making claims for maternity non-LMC services 1074
DB8 Reporting requirements: purchase units 1074
DB9 Reporting requirements: service delivery information 1075
Module: Non LMC first trimester
DB10 Service specification: first trimester 1075
DB11 Payment rules: first trimester 1076
Module: Urgent pregnancy care (non-LMC maternity care)
DB12 Service specification: urgent normal hours pregnancy care 1076
DB13 Service specification: urgent out of hours pregnancy care 1077
DB14 Payment rules: urgent pregnancy care 1077
Module: Non-LMC labour and birth (rural support)
DB15 Service specification: Non-LMC labour and birth (rural support) 1077
DB16 Payment rules: labour and birth (rural support) 1078
Module: Urgent postnatal care
DB17 Service specification: urgent postnatal care 1078
DB18 Payment rules: urgent postnatal care 1078
Subpart DC-Specialist medical maternity services
General information about specialist medical maternity services
DC1 Aim of specialist medical maternity services 1079
DC2 Charging for specialist medical maternity services 1079
DC3 Where specialist medical maternity services may be provided 1079
DC4 Referral criteria 1079
DC5 Quality of service requirements 1080
DC6 Service linkages 1080
DC7 Exclusions 1080
DC8 Reporting requirements: purchase units 1081
DC9 Reporting requirements: service delivery information 1081
Module: Ultrasound scans
DC10 Service specification: ultrasound scan 1081
DC11 Payment rules: ultrasound scan 1082
Module: Obstetrician services
DC12 Service specification: obstetrician services 1083
DC13 Payment rules: obstetrician services 1083
Module: Paediatrician services
DC14 Service specification: paediatrician services 1084
DC15 Payment rules: paediatrician services 1084
SCHEDULE 1
FEES
1 Maternity LMC Antenatal Services (WM1007) 1085
2 Maternity LMC Labour and Birth Services (WM1008) 1085
3 Maternity LMC Postnatal Services (WM1009) (Services Following Birth) 1086
4 Maternity Non-LMC Services (WM1000) 1087
5 Maternity radiology specialist consult (WM1005) 1087
6 Maternity obstetrician specialist consult (WM1002) 1087
7 Maternity paediatrician specialist consult (WM1004) 1087
SCHEDULE 2
RURAL TRAVEL
1 General information 1088
2 Rural Area Unit Classifications 1088
SCHEDULE 3
ACCESS AGREEMENT
Terms and conditions of access to a maternity facility or birthing unit
Purpose of this agreement
1 Purpose 1106
Obligations of both parties
2 Clinical safety 1107
3 Cultural safety 1107
4 Maori health outcomes 1107
5 Referral guidelines 1107
6 Policies and procedures 1107
7 Relationship between the maternity facility or birthing unit and the practitioner 1107
8 Complaints management 1108
9 Dispute management 1108
10 Suspension 1108
Obligations of the practitioner
11 Compliance with Statutes and Regulations 1108
12 Qualifications 1108
13 Professional responsibilities 1109
14 Clinical competencies 1109
15 Participation in protected quality assurance activities 1109
16 Indemnity Protection 1109
17 Students 1110
18 Availability 1110
19 Administrative Requirements 1110
20 Contact Details 1110
Obligations of the facility
21 Health and Safety 1110
22 Orientation 1110
23 Education forums 1110
24 Administrative requirements 1111
25 Availability of facilities 1111
Other terms and conditions
26 Entire agreement 1111
27 Term 1111
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Part A
Information about this notice
A1 Title
This notice is the Primary Maternity Services Notice 2007.
A2 Commencement
This notice comes into force on 1 July 2007.
Purpose and objectives
A3 Purpose of this notice
The purpose of this notice is to set out the terms and conditions on which the Crown will make a payment to a maternity provider for providing primary maternity services.
Defined in this notice: maternity provider, primary maternity services
A4 Objectives of primary maternity services
The objectives of primary maternity services are to-
(a) give each woman, her partner, and her whanau or family, every opportunity to have a fulfilling outcome to the woman's pregnancy and childbirth by facilitating the provision of primary maternity services that are safe, informed by evidence and that are based on partnership, information, and choice; and
(b) recognise that pregnancy and childbirth are a normal life-stage for most women; and
(c) provide the woman with continuity of care through her LMC who is responsible for assessment of her needs, planning of her care with her and the care of her baby; and
(d) facilitate the provision of appropriate additional care for those women and babies who need it.
Defined in this notice: LMC, primary maternity services
Overview of this notice
A5 Revocation and transitional provisions
(1) This notice revokes and replaces the previous notice.
(2) The transitional provisions for revoking and replacing the previous notice are set out in this clause.
(3) On and after the implementation date, this notice applies to persons who are eligible for primary maternity services (whether or not those persons are part way through a module under the previous notice immediately before the implementation date).
(4) If, immediately before the implementation date, a person who is eligible for primary maternity services is part way through a module under the previous notice, the person will continue to receive their care but it will be for the remainder of the corresponding module in this notice.
(5) If, before the implementation date, a claim is made, or may be made, in accordance with the previous notice, the previous notice continues to apply to that claim.
(6) Despite subcluase (5), no claim for services provided before the implementation date will be paid if the claim is received after 30 June 2008.
(7) If, on or after the implementation date, the care of a person who is eligible for primary maternity services is completed under this notice, but the care of that person was started under the previous notice, this notice applies to a claim for the care that has been provided under the previous notice and under this notice.
(8) An authorisation that was granted to an individual practitioner under the previous notice and that is in effect immediately before the implementation date is to be treated as if it were an authorisation that has been granted under clause CA1(1), and this notice applies to the authorisation.
(9) In this clause, unless the context otherwise requires,-
implementation date means 1 July 2007
previous notice means the Maternity Services Notice (which was effective from 1 July 2002) and its amendments.
Defined in this notice: authorisation, claim, module, persons who are eligible for primary maternity services
A6 Definitions and interpretation
(1) The definitions and other interpretation provisions for this notice are set out in Part B.
(2) Some key definitions include the following:
(a) the definition of primary maternity services (see clause B1):
(b) the definition of persons who are eligible for primary maternity services (see clause B2):
(c) the definition of maternity provider (see clause B3).
Defined in this notice: maternity provider, persons who are eligible for primary maternity services, primary maternity services
A7 General requirements for all primary maternity services
(1) The general requirements that apply to all primary maternity services are set out in Part C.
(2) The general requirements cover the following matters:
(a) authorisations (see subpart CA):
(b) the general requirements for providing primary maternity services (see subpart CB):
(c) claims (see subpart CC).
Defined in this notice: authorisation, claim, primary maternity services
A8 Specific requirements for each primary maternity service (including service specifications and payment rules)
(1) The specific requirements that apply to each primary maternity service are set out in Part D.
(2) The specific requirements (which include service specifications and payment rules) cover each of the following primary maternity services:
(a) lead maternity care (see subpart DA):
(b) maternity non-LMC services (see subpart DB):
(c) specialist medical maternity services (see subpart DC).
Defined in this notice: lead maternity care, maternity non-LMC services, primary maternity services, specialist medical maternity services
A9 Fees
(1) The fees that may be claimed under this notice are set out in Schedule 1.
(2) The fees are exclusive of GST.
(3) Schedule 2 sets out the rural area unit classification, which relates to the fees for rural travel.
Defined in this notice: claim, GST, primary maternity services, rural travel
Process for amending or revoking notice
A10 Process for amending or revoking notice (excluding amendments that consist of only fee increases)
(1) This clause applies to a proposal to do any of the following:
(a) make an amendment to this notice that does not consist of only an increase to a fee in Schedule 1:
(b) revoke this notice:
(c) issue a replacement notice.
(2) If this clause applies, the Ministry of Health must notify the following organisations, in writing of a proposal to amend, revoke or replace this notice:
(a) the New Zealand College of Midwives:
(b) the New Zealand Medical Association:
(c) other organisations that are recognised by the Ministry of Health as representing maternity consumers and the professional colleges of practitioners.
(3) The Ministry of Health will send the proposal to amend, revoke of replace this notice and a proposed timeframe and process for consultation on the proposal to the organisations listed in subclause (2)(a) and (b).
(4) The organisations listed in subclause (2)(a) and (b) will then have 10 working days to respond to the proposed timeframe for consultation. If there are no objections to the proposal the proposed timeframe for consultation will be used.
(5) If an objection is received from 1 of the organisations listed in subclause (2)(a) or (b) then-
(a) the timeframe for consultation will be 12 weeks, starting from the date the proposal was provided to the organisations listed in subclause (2)(a) and (b); and
(b) the process for consultation will, to the extent practicable in the circumstances, include-
(i) the giving of adequate and appropriate notice within the 12 week timeframe to those organisations listed in subclause (2)(c) of the proposal to amend the notice;
(ii) the provision of a reasonable opportunity for the organisation listed in subclause (2) to make submissions; and
(iii) adequate and appropriate consideration of those submissions.
(6) If, after the process set out in subclauses (2) to (5) is completed, the Ministry of Health decides to proceed with amending or revoking or replacing this notice (as applicable), the Ministry of Health will give every maternity provider 1 month's notice of the implementation of the amendment or the revocation or the replacement (as applicable).
(7) A failure to comply with this clause does not affect the validity of any amendment to this notice, revocation of this notice, or the issue of a replacement notice (as applicable).
Defined in this notice: maternity provider, practitioner
A11 Streamlined process for amendments consisting of only fee increases
(1) This clause applies to a proposal to make an amendment to this notice that consists of only an increase to a fee in Schedule 1.
(2) If this clause applies, the Ministry of Health must notify the following organisations, in writing:
(a) the New Zealand College of Midwives:
(b) the New Zealand Medical Association:
(c) other organisations that are recognised by the Ministry of Health as representing maternity consumers and the professional colleges of practitioners.
(3) The Ministry of Health will notify the organisations listed in subclause (2) at least 4 weeks before notice of the proposed fee increase is published in the New Zealand Gazette.
(4) The Ministry of Health may, but does not need to, consult on a proposed increase to a fee in Schedule 1.
(5) The Ministry of Health will give every maternity provider 1 month's notice of the implementation of an increase to a fee in Schedule 1.
(6) A failure to comply with this clause does not affect the validity of any increase to a fee in Schedule 1.
Defined in this notice: maternity provider, practitioner
A12 Default transitional provisions for amendments consisting of only fee increases
(1) This clause applies to an amendment to this notice that consists of only an increase to a fee in Schedule 1, unless the amendment expressly states otherwise.
(2) An amendment that expressly states that this clause does not apply (whether or not the amendment also includes its own set of transitional provisions) is to be treated as if it consisted of only an increase to a fee in Schedule 1, and, to avoid doubt, the streamlined process set out in clause A11 still applies to the amendment.
(3) An amendment to which this clause applies must specify a date on which the amendment becomes effective (implementation date).
(4) If the applicable date of service for a payment to a maternity provider occurs before the implementation date, the fees that applied immediately before the implementation date continue to apply.
(5) If the applicable date of service for a payment to a maternity provider occurs on or after the implementation date, the amended fees specified in the amendment apply.
(6) In this clause, unless the context otherwise requires,-
date of service, in relation to a payment for a complete first and second trimester module, complete third trimester module, complete services following birth module, complete rural travel fee, additional home visits fee and non-LMC first trimester services fee, is the last date of the period to which the module or fee applies
date of service, in relation to a payment of a partial first and second trimester module fee, partial third trimester module fee, partial services following birth module fee and partial rural travel fee, is either-
(a) for a first partial module fee claim, the date on which the woman changed lead maternity carer on the registration form; or
(b) for a second partial module fee claim, the last date of the period to which the module applies
date of service, in relation to a payment for labour and birth, labour and birth (exceptional circumstances), labour and birth (rural support), homebirth supplies and support, birthing unit support, urgent normal hours pregnancy care, urgent out of hours pregnancy care, non-LMC labour and birth (rural support), urgent postnatal care and specialist services, is the date on which the service was provided to the woman.
Defined in this notice: birthing unit, claim, homebirth supplies services, labour and birth, maternity provider, module, second trimester, specialist, third trimester
Part B
Definitions and interpretation
B1 Definition of primary maternity services
In this notice, primary maternity services-
(a) means the following services:
(i) lead maternity care:
(ii) maternity non-LMC services:
(iii) specialist medical maternity services; and
(b) does not include any of the following:
(i) a negative pregnancy test:
(ii) a consultation by a practitioner for any other medical condition not related to pregnancy, including medical conditions exacerbated by pregnancy except where the service is included in lead maternity care:
(iii) a service given more than 6 weeks after the birth:
(iv) a service given more than 2 weeks after a miscarriage or termination of pregnancy:
(v) caesarean section:
(vi) dilation and curettage:
(vii) circumcision:
(viii) )termination of pregnancy:
(ix) radiological imaging other than ultrasound:
(x) ultrasound scans not listed in subpart DC:
(xi) the following services, as defined in their respective service specifications for these available from the Ministry of Health:
(A) maternity facility services:
(B) birthing unit facility services:
(C) secondary maternity services:
(D) tertiary maternity services:
(E) specialist neonatal services:
(xii) the product cost of any vaccines provided:
(xiii) if the circumstances described in the service specification for maternity non-LMC services do not apply, a consultation in the second trimester or third trimester with a non-LMC general practitioner for the purpose of a second opinion:
(xiv) other services not specified in this notice.
Defined in this notice: birth, general practitioner, LMC, practitioner, primary maternity services, secondary maternity, second trimester, specialist neonatal services, tertiary maternity, third trimester
B2 Definition of persons who are eligible for primary maternity services
(1) In this notice, unless the context otherwise requires, persons who are eligible for primary maternity services-
(a) means-
(i) a woman who is an eligible person:
(ii) a baby who is an eligible person; and
(b) includes a woman who is not an eligible person but whose baby is an eligible person.
(2) For the purposes of subclause (1), eligible person has the same meaning as the definition of eligible people in section 6(1) of the Act.
B3 Definition of maternity provider
In this notice, unless the context otherwise requires, maternity provider means an organisation or an individual that provides primary maternity services.
Defined in this notice: primary maternity services
B4 Definition of practitioner
In this notice, unless the context otherwise requires, practitioner means a general practitioner, midwife, obstetrician, paediatrician, radiologist or medical radiation technologist who is a maternity provider in his or her own right or is an employee or contractor of a maternity provider and holds a current annual practicing certificate.
Defined in this notice: general practitioner, midwife, maternity provider, obstetrician, paediatrician, radiologist, medical radiation technologist
B5 Other definitions
In this notice, unless the context otherwise requires,-
access agreement means the generic agreement for access to maternity facilities and birthing units as set out in Schedule 3
Act means the New Zealand Public Health and Disability Act 2000
additional postnatal visits means the fee payable to maternity providers if they have provided more than 12 postnatal visits to the mother and baby as a part of services following birth
amniocentesis means a foetal diagnostic procedure to determine foetal normality by aspiration of amniotic fluid through the mother's abdomen
artificial feeding means the baby has had no breast-milk in the past 48 hours but has had alternative liquid such as infant formula with or without solid food in the past 48 hours
authorisation means an authorisation granted by the Ministry of Health under clause CA1
away from her usual place of residence means a woman has stayed for 1 night or more in a location which is at least 1 hour by normal road transport from her usual place of residence
back-up LMC means a midwife, general practitioner with a Diploma in Obstetrics (or equivalent, as determined by the New Zealand College of General Practitioners), or obstetrician who has a formal relationship with the LMC (for example, they may both be employees of the same maternity provider or the back-up LMC is contracted by the LMC) to provide lead maternity care to women registered with the LMC when the LMC is not available to provide these services
BFHI means the baby friendly hospital initiative launched by the World Health Organisation and UNICEF in 1992 and adapted for New Zealand by the New Zealand Breastfeeding Authority in 1999
birth means a delivery of a baby (or babies for a multiple birth) after a minimum of 20 weeks 0 days gestation and/or with a birth weight over 400 grams
birthing unit means a facility that provides birthing unit services in accordance with the service specification for birthing unit services available from the Ministry of Health
birthing unit support mean the payment that maternity providers may claim under this notice if the birth occurs in a birthing unit
care plan means the process by which the LMC and the woman develop a plan of care for the woman and her baby and the documentation of this plan throughout the individual clinical notes pertaining to this woman
caregiver, in relation to a baby,-
(a) means the person who has the primary responsibility for the day to day care of the baby, other than on a temporary basis; but
(b) does not include the mother of the baby
chorionic villous sampling means a foetal diagnostic procedure, which is the aspiration of a sample of chorionic (placental) tissue for biochemical and chromosomal analysis
claim-
(a) means a request for payment for primary maternity services that is forwarded to HealthPAC; and
(b) does not include a registration or change of registration
DHB has the same meaning as in section 6(1) of the Act
DHB provider arm means a provider of health services that is a part of a District Health Board or wholly owned by a District Health Board or Boards
estimated date of delivery (EDD) means either the estimated date of delivery of the baby or the actual date of the delivery of the baby
established labour means the period from when labour is estimated to have commenced as measured by duration, frequency, and strength of each contraction
exclusive breastfeeding means that, to the mother's knowledge,-
(a) the infant has never had any water, formula or other liquid or solid food; and
(b) only breast-milk, from the breast or expressed, and prescribed medicines, defined as per the Medicines Act 1981, have been given to the baby from birth
family planning practitioner means a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of practice of family planning and reproductive health and holds an annual practicing certificate
first birth means that a woman has not previously experienced a birth
first consultation means a consultation with an obstetrician for consulting obstetrician services, as per clause DC12, or a paediatrician for consulting paediatrician services, as per clause DC14, if there has been no previous primary maternity services provided to the same woman by the same specialist involving the same medical problem
first trimester means the period from the LMP date until the end of the fourteenth week of pregnancy (1-12 weeks after conception)
foetal blood sampling means a foetal diagnosis procedure where foetal blood is obtained directly from the umbilical cord performed after 17 weeks of pregnancy
fully breastfeeding means the infant has taken breast-milk only, no other liquids or solids except a minimal amount of water or prescribed medicines, in the previous 48 hours
geographical area, in relation to a DHB, means the geographical area of the DHB as specified in Schedule 1 of the Act
general practitioner means a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of practice of general practice and holds an annual practicing certificate
gravida means the total number of pregnancies the woman has experienced including the current one (for example, a woman who has had one prior pregnancy, and is currently pregnant, is designated 'Gravida 2')
GST means good and services tax payable under the Good and Services Tax Act 1985
HealthPAC means Health Payments Agreements and Compliance, a business unit of the Ministry of Health responsible for processing and payment of claims
homebirth means-
(a) a birth that takes place in a person's home and not in a maternity facility or birthing unit; or
(b) a birth for which management of the labour commences at home and there is a documented plan to birth at home
homebirth supplies and support means the payment that maternity providers may claim for a homebirth
home visit means a postnatal domiciliary consultation between the woman and baby and a practitioner at-
(a) the home where the woman and baby is domiciled; or
(b) a maternity facility where the woman has been discharged as an inpatient but the baby remains as an inpatient
hospital midwifery services means the midwifery component of labour and birth, and postnatal care provided by a DHB employed midwife where the LMC is a general practitioner or obstetrician
inpatient means that the woman and/or baby receives maternity services in an inpatient setting, being either admitted to a maternity facility or a birthing unit or having received a consultation in a maternity facility of more than 3 hours duration
inpatient postnatal care means the 24 hour care a woman and baby receives if the woman remains in the maternity facility for 12 hours or more after the birth
labour and birth means the period from the onset of established labour until 2 hours after delivery of the placenta
last menstrual period (LMP) date means the estimated or actual date of the beginning of the woman's last menstrual period
lead maternity care means to provide a woman and her baby with continuity of care throughout pregnancy, labour and birth and the postnatal period as described in Subpart DA
lead maternity carer (LMC) means a person who-
(a) is-
(i) a general practitioner with a Diploma in Obstetrics (or equivalent, as determined by the New Zealand College of General Practitioners); or
(ii) a midwife; or
(iii) an obstetrician; and
(b) is either-
(i) a maternity provider in his or her own right; or
(ii) an employee or contractor of a maternity provider; and
(c) has been selected by the woman to provide her lead maternity care
maternity facility means a facility that provides maternity facility services in accordance with the service specification for maternity facility services available from the Ministry of Health
maternity non-LMC services means the services that are either in addition to lead maternity care or services sought on a casual basis outside lead maternity care as described in Subpart DB
medical radiation technologist means a health practitioner who is, or is deemed to be, registered with the Medical Radiation Technologists Board (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of sonographer and holds an annual practicing certificate
message standard definition means the current version of the HealthPAC Electronic Claiming: Message Standard Definition applicable to Maternity Providers as approved by the Ministry of Health
midwife means a health practitioner who is, or is deemed to be, registered with the Midwifery Council (established by the Health Practitioners Competence Assurance Act 2003) as a practitioner of the profession of midwifery and holds an annual practicing certificate
miscarriage means a pregnancy that ends spontaneously before 20 weeks gestation
module means the group of services for a phase of pregnancy
National Health Index (NHI) means the unique person identifier number allocated by the New Zealand Health Information Service
National Immunisation Register (NIR) means the computerised information system that has been developed to hold immunisation details of New Zealand children
normal road transport means transport by car or similar motorised vehicle and in accordance with times determined by the Ministry of Health
obstetrician means a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of obstetrics and gynaecology and holds an annual practicing certificate
OMC means online maternity claiming
paediatrician means a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of paediatrics or paediatric surgery and holds an annual practicing certificate
parity means the number of times a woman has borne children counting multiple births as one and including stillbirths
partial breastfeeding means the infant has taken some breast-milk and some infant formula or other solid food in the past 48 hours
pregnancy and parenting education means an antenatal course provided to a group of women as described in the relevant service specification issued by the Ministry of Health
primary health organisation (PHO) means a provider contracted by a DHB for the provision of primary health services
primary health services means the services specified in the service specifications for essential primary health care services available from the Ministry of Health
professional review process means participation in a process that is recognised by the practitioner's relevant professional council or medical college, as providing an assessment of the practitioner's practice and outcomes, including the level of consumer satisfaction
radiologist means a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of diagnostic and interventional radiology and holds an annual practicing certificate
Referral Guidelines means the Guidelines for Consultation with Obstetric and Related Specialist Medical Services that identify clinical reasons for consultation with a specialist and that are published by the Ministry of Health from time to time.
registration is the process by which a woman selects her LMC, the documentation recording this selection, and the forwarding of this information to HealthPAC. By registering with an LMC the woman is also registering with the maternity provider with which the LMC is affiliated
rural travel means the fees payable to maternity providers that provide services following birth to women who are resident in the areas listed in Schedule 2
scope of practice has the same meaning as in section 5(1) of the Health Practitioners Competence Assurance Act 2003
secondary maternity-
(a) means the services specified in the service specification for secondary maternity services available from the Ministry of Health; and
(b) includes ultrasound scans and all midwifery services for elective caesarean sections
second trimester means the period of pregnancy from the beginning of the 15th week until the end of the 28th week of pregnancy
services following birth means the services provided in the period from two hours after the delivery of the placenta until six weeks after the birth
specialist means a practitioner who is an, obstetrician, paediatrician, or radiologist
specialist medical maternity services means the non-LMC services provided by obstetricians, paediatricians and radiologists to support primary maternity care as described in Subpart DC
specialist neonatal services means the specialist services for neonates who are born with additional needs or develop additional needs prior to discharge as described in the service specification for specialist neonatal inpatient and home care services available from the Ministry of Health
stillbirth means a birth where the baby shows no signs of life
subsequent birth means that a woman has previously experienced a birth (excluding a vaginal birth after caesarean section)
subsequent consultation means a consultation with an obstetrician for consulting obstetrician services, as per clause DC12 or a paediatrician for consulting paediatrician services, as per clause DC14, where there has been a previous primary maternity service provided to the same woman by the same specialist involving the same medical problem or involving a medical problem that was detected at the time of any previous maternity service provided by the same specialist
tertiary maternity means the services specified in the service specification for tertiary maternity services available from the Ministry of Health and includes ultrasound scans
third trimester means the period of pregnancy from the beginning of the 29th week of pregnancy until established labour
vaginal birth after caesarean section (VBAC) means a vaginal birth for a woman who has had a previous birth by caesarean section and who has not had a previous vaginal birth
usual place of residence means the place where the woman usually resides
well child provider means a health care provider who provides heath services for families, babies and children as described in the Well Child Tamariki Ora National Schedule
working day means a day of the week other than-
(a) a Saturday, a Sunday, Waitangi Day, Good Friday, Easter Monday, Anzac Day, the Sovereign's Birthday, and Labour Day; and
(b) the day observed in the appropriate area as the anniversary of the province of which the area forms a part; and
(c) a day in the period commencing with 25 December in a year and ending with 2 January in the following year; and
(d) if 1 January falls on a Friday, the following Monday; and
(e) if 1 January falls on a Saturday or a Sunday, the following Monday and Tuesday.
B6 Meanings of terms and expressions defined in Act
Any term or expression that is defined in the Act and used, but not defined, in this notice, has the same meaning as in the Act.
B7 Parts of speech and grammatical forms
Grammatical forms of a word that is defined in this notice have corresponding meanings in this notice.
B8 Numbers
Words in the singular include the plural and words in the plural include the singular.
B9 Time
(1) A period of time described as beginning at, on, or with a specified day, act, or event includes that day or the day of the act or event.
(2) A period of time described as beginning from or after a specified day, act, or event does not include that day or the day of the act or event.
(3) A period of time described as ending by, on, at, or with, or as continuing to or until, a specified day, act, or event includes that day or the day of the act or event.
(4) A period of time described as ending before a specified day, act, or event does not include that day or the day of the act or event.
(5) A reference to a number of days between 2 events does not include the days on which the events happened.
(6) A thing that, under this notice, must or may be done on a particular day or within a limited period of time may, if that day or the last day of that period is not a working day, be done on the next working day.
B10 Interpretational aids: list of defined terms
(1) The list of defined terms following a clause is included in this notice only as interpretational aids. If there is conflict between an interpretational aid and a provision of this notice, the provision prevails.
(2) If a defined term is used in a clause and is not included in the list of defined terms following the clause, the term is nevertheless used in the clause as defined.
Part C
General requirements for all primary maternity services
Subpart CA-Authorisations
CA1 Granting authorisation
(1) The Ministry of Health may grant an authorisation to a maternity provider if the Ministry of Health is satisfied that-
(a) the maternity provider has properly completed the application form; and
(b) any reasonable conditions that the Ministry of Health requires for granting the authorisation have been met or will be met.
(2) An authorisation of a maternity provider applies to the geographical area of a DHB in which the maternity provider will predominantly provide primary maternity services.
Defined in this notice: authorisation, maternity provider
CA2 Duration of authorisation
An authorisation continues in effect until it is terminated or lapses under this subpart.
Defined in this notice: authorisation
CA3 Withdrawal from providing primary maternity services
(1) A maternity provider may, at any time, withdraw from providing primary maternity services under this notice by giving the Ministry of Health not less than 4 weeks' written notification.
(2) Notification under subclause (1) terminates the maternity provider's authorisation and the relationship under this notice between the maternity provider and the Ministry of Health.
Defined in this notice: authorisation, maternity provider, primary maternity services
CA4 Exemptions
(1) The Ministry of Health may exempt a maternity provider from a requirement of this notice, but only if the exemption is necessary to resolve a regional problem in relation to women's access to primary maternity services.
(2) The exemption will be recorded in writing as if it were a variation to the authorisation of the maternity provider.
Defined in this notice: authorisation, maternity provider, primary maternity services
CA5 Termination or variation of authorisation by Ministry of Health
Subject to clause CA6, the Ministry of Health may terminate or vary an authorisation of a maternity provider if-
(a) the maternity provider, or a practitioner who works for the maternity provider, has not complied with that authorisation or this notice; and
(b) in the opinion of the Ministry of Health, it is unlikely that the maternity provider or practitioner (as applicable) will comply with that authorisation or this notice.
Defined in this notice: authorisation, maternity provider, practitioner
CA6 Process for terminating or varying authorisation by Ministry of Health
(1) Before the Ministry of Health may terminate or vary an authorisation of a maternity provider under clause CA5, the Ministry of Health must-
(a) notify the maternity provider in writing of its intention to terminate or vary the authorisation; and
(b) provide written reasons for terminating the authorisation.
(2) The maternity provider has 20 working days from receipt of the notification to-
(a) comply with the authorisation or this notice (as applicable); or
(b) satisfy the Ministry of Health that the authorisation or this notice (as applicable) will be complied with.
(3) If, at the end of the 20 working day period, the Ministry of Health is not satisfied with the response from the maternity provider, it may give final notice of 5 working days of termination or variation of the authorisation.
Defined in this notice: authorisation, maternity provider, working day
CA7 Lapse of authorisation
An authorisation of a maternity provider lapses and ceases to have effect if-
(a) the maternity provider has not made a claim under this notice for a period of 12 months; or
(b) the maternity provider dies; or
(c) the maternity provider becomes bankrupt, or goes into liquidation or receivership (as applicable); or
(d) the maternity provider becomes a mentally disordered person within the meaning of the Mental Health (Compulsory Assessment and Treatment) Act 1992, or becomes a person subject to a property order under the Protection of Personal and Property Rights Act 1988.
Defined in this notice: authorisation, claim, maternity provider
CA8 Consequences of termination or lapse of authorisation
(1) The termination or lapse of a maternity provider's authorisation under this subpart does not affect the rights of-
(a) the Ministry of Health in relation to that authorisation or this notice; or
(b) the maternity provider in relation to a claim that the maternity provider would have been entitled to make, but for the termination or lapse of the authorisation under this subpart.
(2) Subject to subclause (1)(b), a maternity provider is not entitled to claim for primary maternity services that have been provided after the relevant authorisation has terminated or lapsed (as applicable).
Defined in this notice: authorisation, claim, maternity provider, primary maternity services
Subpart CB-General requirements for providing primary maternity services
CB1 Compliance with statutory, regulatory, legal, and professional requirements
(1) A maternity provider must ensure that all statutory, regulatory, legal, and professional requirements that apply to primary maternity services provided by them are complied with.
(2) For the avoidance of doubt, a practitioner who is a maternity provider or who works for a maternity provider must comply with all statutory, regulatory, legal, and professional requirements that apply to the primary maternity services provided by them.
(3) The requirements referred to in subclauses (1) and (2) include, without limitation, the following:
(a) the requirements of the Health Practitioners Competence Assurance Act 2003:
(b) the requirements of the applicable Council, including the code of ethics:
(c) the standards of the applicable professional college:
(d) guidelines or standards relating to maternity or care of the newborn, developed by the Ministry of Health in consultation with maternity and newborn providers, endorsed by the providers professional body, and readily available:
(e) the requirements of the Referral Guidelines (including, safe and timely referral and transfer practices):
(f) the requirements of the Code of Health and Disability Services Consumers' Rights:
(g) the requirements of the Privacy Act 1993 and the Health Information Privacy Code 1994:
(h) the requirements of the Health (Retention of Health Information) Regulations 1996.
Defined in this notice: maternity provider, practitioner, primary maternity services, Referral Guidelines
CB2 Audit
(1) For the purposes of this clause, audit means an audit, investigation, or review of-
(a) the performance and quality of primary maternity services in accordance with this notice; and
(b) any other matter concerning compliance with any of the obligations of the maternity provider under this notice.
(2) A maternity provider must provide the Ministry of Health and its authorised agents (the auditors) with access on 24 hours' notice (or immediate access if the auditor reasonably suspects fraudulent claiming has occurred) to-
(a) all records related to the provision of primary maternity services by the maternity provider; and
(b) the premises where primary maternity services are provided, other than a woman's or baby's or babies' homes; and
(c) the premises where the records are kept.
(3) For the purposes of carrying out an audit, a maternity provider must allow the auditors to interview-
(a) any practitioners providing primary maternity services, and
(b) any women receiving primary maternity services.
(4) If the audit identifies an overpayment or evidence of non or partial service delivery, the Ministry of Health may obtain a full or partial repayment of the service fee, either directly or by using its right to set-off in accordance with clause CC9.
(5) If any protocols have been agreed between the Ministry of Health and the New Zealand College of Midwives or the New Zealand Medical Association, the Ministry of Health will conduct audits of maternity providers in accordance with those protocols.
(6) The Ministry of Health's right to audit under this clause continues after this notice ends but only to the extent that it is relevant to the period during which this notice was in force.
Defined in this notice: claim, maternity provider, practitioner, primary maternity services
CB3 Manner of providing primary maternity services
A maternity provider must ensure that primary maternity services that are provided by the maternity provider-
(a) are provided in a safe, timely, equitable, and efficient manner to meet the assessed needs of the person who is eligible for primary maternity services; and
(b) are provided in a manner which supports and promotes continuity of care; and
(c) are provided by sufficient numbers of suitably skilled and qualified practitioners; and
(d) are provided in a manner that is appropriate to the culture of the person who is eligible for primary maternity services (including their family or whanau).
Defined in this notice: maternity provider, person who is eligible for primary maternity services, practitioner, primary maternity services
CB4 Achieving Maori health outcomes and reducing Maori health inequalities
Primary maternity services will achieve Maori health outcomes and reduce Maori health inequalities by facilitating Maori access to maternity services, ensuring appropriate pathways through those services and that maternity services address the primary maternity needs of Maori.
Defined in this notice: primary maternity services
CB5 Practitioner to have access agreement
A practitioner that uses a maternity facility or a birthing unit must have an access agreement for the use of that maternity facility or birthing unit (as applicable).
Defined in this notice: access agreement, birthing unit, maternity facility, practitioner
CB6 Relationship to be based on informed consent
A maternity provider must ensure that the relationship between the maternity provider (including the practitioners who work for them) and a woman is based on informed consent and the dignity of the woman is respected.
Defined in this notice: maternity provider, person who is eligible for primary maternity services, practitioner
CB7 Information about primary maternity services
(1) A maternity provider must ensure that every person who is eligible for primary maternity services is given the appropriate information on the primary maternity services that they are entitled to receive (including their options).
(2) In all cases woman are entitled to an explanation of the costs of all options for maternity care.
Defined in this notice: maternity provider, persons who is eligible for primary maternity services, primary maternity services
CB8 Maternity provider to advise woman on alternative maternity providers if not providing the primary maternity services
A maternity provider must advise the woman of alternative maternity providers and, if necessary, formally refer the woman to another maternity provider when they themselves are not providing the primary maternity services.
Defined in this notice: maternity provider, primary maternity services
CB9 Maternity provider to co-operate with others in order to promote safe and effective primary maternity services
A maternity provider must maintain a range of linkages with and co-operate with other maternity providers, practitioners, and community agencies to promote safe and effective primary maternity services.
Defined in this notice: maternity provider, primary maternity services
CB10 Ongoing improvement of quality of primary maternity services
A maternity provider must have systems and processes for the ongoing improvement of the quality of primary maternity services that they provide.
Defined in this notice: maternity provider, primary maternity services
CB11 Practitioners to participate in professional review process
(1) A maternity provider who is a practitioner must participate in a professional review process.
(2) A maternity provider must ensure that every practitioner who works for the maternity provider and who provides primary maternity services in that capacity participates in a professional review process.
Defined in this notice: maternity provider, practitioner, primary maternity services, professional review process
CB12 Maternity provider and their practitioners to co-operate with Perinatal and Maternal Mortality Review Committee
(1) A maternity provider must co-operate with the Perinatal and Maternal Mortality Review Committee established under the Act.
(2) A maternity provider must ensure that every practitioner who works for the maternity provider and who provides primary maternity services in that capacity co-operates with the Perinatal and Maternal Mortality Review Committee.
Defined in this notice: Act, maternity provider, practitioner
CB13 Practitioners to include the required information on all prescriptions and referrals
(1) All prescriptions for pharmaceuticals, referrals for laboratory tests, referrals for ultrasound scans and referrals to specialists issued by practitioners must include the following details:
(a) practitioner's details:
(i) the practitioner's type (for example, midwife):
(ii) the practitioner's council number:
(iii) the practitioner's name:
(iv) the practitioner's signature:
(b) woman and/or baby's details:
(i) name and address:
(ii) the woman and baby's NHI:
(iii) the woman or baby's date of birth where they are under 12 years of age or if no NHI number is available:
(iv) the woman or baby's gender if no NHI number is available:
(2) Prescriptions for pharmaceuticals must also include the appropriate patient category (for pharmaceutical subsidy purposes) and comply with any requirements of the pharmaceutical schedule.
(3) Referrals for laboratory tests must also include the date of referral and the name of the laboratory test or test code.
(4) Referrals for ultrasound scans must also include the date of referral and the appropriate clinical indication for ultrasound in pregnancy code, as specified in clause DC10.
(5) Referrals to specialists (other than for ultrasound scans) must be written in hard copy, only made with the woman's informed consent and include the date of referral and the appropriate referral code, as specified in the referral guidelines.
Defined in this notice: NHI, practitioner, referral guidelines, specialist
Subpart CC-Claims
CC1 Basis for claiming under this notice
A maternity provider may claim under this notice for providing a primary maternity service, but only if-
(a) the maternity provider holds a current authorisation for providing the primary maternity service; and
(b) the primary maternity service is provided in New Zealand to a person who is eligible for the primary maternity service; and
(c) the primary maternity service has been provided in accordance with all the applicable requirements of this notice; and
(d) the claim is permitted under this notice.
Defined in this notice: authorisation, claim, maternity provider, person who is eligible for primary maternity services, primary maternity services
CC2 No claim if claim is covered by another arrangement
(1) A maternity provider may not claim under this notice if-
(a) the maternity provider, or a practitioner who works for the maternity provider, is entitled to have the claim satisfied (whether directly or indirectly) under any other arrangement with the Ministry of Health or a DHB; or
(b) the primary maternity services that relate to the claim have been provided by a practitioner in their capacity as an employee of a DHB.
(2) For the purposes of audit, a practitioner employed by a DHB must keep a record of the hours of employment (including on-call hours) with the DHB.
Defined in this notice: audit, claim, DHB, maternity provider, practitioner, primary maternity services
CC3 Claim to be properly completed
(1) A maternity provider must ensure that every claim that the maternity provider makes is properly completed.
(2) A maternity provider must ensure that the NHI numbers and EDD are supplied with each claim.
Defined in this notice: claim, EDD, maternity provider, NHI
CC4 Timing of claims
(1) A maternity provider may make a claim only on completion of the primary maternity service (including the completion of a module) for which the claim is made.
(2) A maternity provider must ensure that HealthPAC receives the maternity provider's claim for a primary maternity service, other than registrations, within 6 months of the service being completed.
(3) HealthPAC will return an improperly completed claim to the maternity provider concerned within 5 working days, but only if the maternity provider can be identified.
Defined in this notice: claim, HealthPAC, maternity provider, module, primary maternity services, registration, working day
CC5 Manual claims
(1) A maternity provider may make a manual claim by submitting either-
(a) a claim on a form approved by the Ministry of Health and available from HealthPAC; or
(b) the claim form printed from a practice management system that is in the same format and contains identical information as the claim forms approved by the Ministry of Health.
(2) A maternity provider who makes a manual claim must sign each claim form submitted.
Defined in this notice: claim, HealthPAC, maternity provider
CC6 On-line maternity claiming
(1) A maternity provider may claim by using the online maternity claiming (OMC) website.
(2) A maternity provider who intends to claim via the OMC must first have the ability to connect to the HealthLink Network and login to the OMC website.
(3) If a claim is submitted via the OMC, the maternity provider must print and retain a copy of the maternity claim submission screen as a record of the claim submitted.
Defined in this notice: claim, HealthPAC, maternity provider, OMC
CC7 Electronic claiming
(1) A maternity provider may claim electronically by submitting an electronic claim file to HealthPAC.
(2) A maternity provider who intends to claim electronically must first have the ability to connect to the HealthLink Network and must submit the file via the Health Intranet.
(3) The electronic claim file must be in a format set out in the message standard definition.
(4) The Ministry of Health may, from time to time, update the message standard definition.
(5) A maternity provider who submits an electronic claim file must-
(a) retain a copy of the claim file in a format that allows the claim to be available to the auditors of the Ministry of Health; and
(b) retain a record of the date the claim file was submitted and the total amount claimed.
Defined in this notice: claim, EDD, HealthPAC, maternity provider, message standard definition, NHI, working day
CC8 Payment of claims
(1) HealthPAC will pay a claim within 22 working days from the receipt of a valid claim.
(2) Payment will be made by way of direct credit.
(3) If a claim has to be returned to the maternity provider for correction of claiming details and a corrected claim has been submitted by the maternity provider, the corrected claim will be paid based on the date of receipt of the corrected claim, not the date of receipt of the initial claim.
(4) If a claim for a primary maternity service is received more than 6 months after the service has been completed, there will be a 10% fee deduction.
(5) No claim for primary maternity services will be paid if the claim is received more than 12 months after the service has been completed.
(6) Subclauses (4) and (5) apply unless, in its sole discretion, the Ministry of Health considers there were circumstances beyond the control of the maternity provider that prevented the claim being submitted any earlier.
Defined in this notice: claim, maternity provider, primary maternity services
CC9 Set-off
(1) If the Ministry of Health determines that a maternity provider has been overpaid or that a maternity provider was not entitled to a payment, or any part of a payment, the Ministry of Health may deduct any over payment from any subsequent payment payable to that maternity provider.
(2) Before making any deduction, the Ministry of Health will advise the maternity provider of the proposed deduction and give the maternity provider-
(a) the reason for the deduction; and
(b) enough time to request the Ministry of Health to reconsider the deduction.
Defined in this notice: maternity provider
CC10 Reconsideration of claim
A maternity provider may, within 3 months from the date on which they receive advice of the outcome of a claim, request, in writing, that the Ministry of Health reconsider the claim.
Defined in this notice: claim, maternity provider
Part D
Specific requirements for each primary maternity service (including service specifications and payment rules)
Subpart DA-Lead maternity care
General information about lead maternity care
DA1 Aim of lead maternity care
(1) The aim of lead maternity care is to provide a woman with continuity of care throughout pregnancy, labour and birth, and the postnatal period.
(2) Lead maternity care is available to women, and their newborn babies.
Defined in this notice: labour and birth, lead maternity care
DA2 Registration
(1) In order to receive lead maternity care a woman who is eligible for primary maternity services must register with a LMC of her choice.
(2) By registering with a LMC, the woman is also registering with a maternity provider.
(3) Registration may occur at any time from the diagnosis of pregnancy until 6 weeks after birth, but no claim for payment may be made for lead maternity care that is provided before the date of registration.
(4) The woman and her LMC must properly complete a registration form in the format specified by the Ministry of Health.
(5) The woman must sign a registration form. Each form must be dated with the date on which the form was signed by the woman (date of registration).
(6) The woman may, at any time, change the LMC with whom she is registered by signing a registration form with the new LMC.
(7) The woman may be registered with only 1 LMC at a time.
(8) If a registration form needs to be re-submitted it is sufficient to have a photocopy of the original registration form containing the signature of the woman.
(9) A maternity provider must submit to HealthPAC the woman's registration or a change of registration no more than 20 working days after the date of registration.
Defined in this notice: claim, HealthPAC, lead maternity care, LMC, maternity provider, working day
DA3 Charging for lead maternity care
(1) Lead maternity care provided by a midwife or general practitioner is to be provided free of charge to persons who are eligible to receive it under this notice.
(2) A part charge may be charged to persons who are eligible for lead maternity care provided by an obstetrician.
Defined in this notice: general practitioner, lead maternity care, midwife, obstetrician
DA4 Where lead maternity care may be provided
Lead maternity care may be provided in a range of places, including the following places:
(a) a woman's home:
(b) a baby's home (if it is different from the mother's home):
(c) the LMC's rooms or practice:
(d) a maternity facility:
(e) a birthing unit.
Defined in this notice: birthing unit, labour and birth, lead maternity care, LMC, maternity facility
LMCs
DA5 Lead maternity carer (LMC)
(1) A LMC provides lead maternity care.
(2) A LMC who cares for a woman in a maternity facility must support the maternity facility in implementing the Baby Friendly Hospital Initiative (BFHI).
Defined in this notice: lead maternity care, lead maternity carer (LMC), maternity facility, BFHI
DA6 General responsibilities of LMCs
(1) The LMC is responsible for-
(a) assessing the woman's and baby's needs; and
(b) planning the woman's care with her and the care of the baby; and
(c) the care provided to the woman throughout her pregnancy and postpartum period, including-
(i) the management of labour and birth; and
(ii) ensuring that all the applicable primary maternity services are provided; and
(iii) ensuring all the applicable well child Tamariki/Ora services are provided to the baby.
(2) The LMC or a backup LMC will be available 24 hours a day, 7 days a week to provide phone advice to the woman and community or hospital based assessment for urgent problems, other than acute emergencies.
Defined in this notice: back-up LMC, labour and birth, LMC, primary maternity services
DA7 Continuity of care
(1) From the time of registration of a woman, a LMC is responsible for co-ordinating for the woman all of the modules of lead maternity care in order to achieve continuity of care.
(2) Subject to subclause (6), if a LMC is unavailable to provide an entire module of lead maternity care because of holiday leave, sick leave, bereavement leave, continuing professional education requirements or other exceptional circumstances, a back-up LMC may provide those services.
(3) Subject to subclause (6), the LMC for a woman may, with the woman's consent, delegate to another midwife, general practitioner, or obstetrician the provision of part of a module, but not the entire module.
(4) However, the responsibility for meeting the requirements of the module remain with the LMC.
(5) The respective responsibilities of the LMC and the practitioner to whom aspects of a module have been delegated will be clearly documented in the care plan.
(6) Despite subclauses (2) and (3), if, because of exceptional reasons, the LMC is unable to be responsible for the ongoing provision of lead maternity care to a woman, the maternity provider must ensure that the woman is registered with another LMC.
(7) A LMC is responsible for ensuring that handover to primary care and well child services takes place.
Defined in this notice: back-up LMC, general practitioner, LMC, maternity provider, midwife, obstetrician
DA8 Transfer of care to secondary maternity services, tertiary maternity services, and specialist neonatal services
(1) If there is a transfer of care to secondary maternity services, tertiary maternity services, or specialist neonatal service, clinical responsibility for the woman and baby transfers, until there is a transfer of care back to the LMC.
(2) Every transfer of care must be documented in the clinical notes, including the date and time of transfer.
(3) If responsibility for a woman's care transfers to a secondary maternity service or tertiary maternity service after established labour, the woman's LMC may continue to support the woman.
Defined in this notice: established labour, LMC, secondary maternity, tertiary maternity, specialist neonatal services
Service linkages
DA9 Service linkages: transfer to well child services
(1) A transfer of the care of the baby from the LMC to a well child provider must take place before 6 weeks from birth.
(2) The LMC must give a written referral to a well child provider that meets the guidelines agreed by the New Zealand College of Midwives and providers of well child services, before the end of the 4th week following birth.
(3) If the baby has unusually high needs, the LMC may request that a well child provider becomes involved as early as 2 weeks from birth to provide concurrent and co-ordinated care with the LMC.
Defined in this notice: birth, LMC, well child provider
DA10 Service linkages: transfer to primary health services
(1) A transfer of the care of the woman and the baby from the LMC to the woman's primary health services provider must take place before 6 weeks from birth.
(2) The LMC must give a written referral to the woman's general practitioner that meets the guidelines agreed by the New Zealand College of Midwives and the Royal New Zealand College of General Practitioners, before discharge from lead maternity care.
(3) If a woman does not have a regular general practitioner, the maternity provider must inform the woman about the primary health services available in the local area.
Defined in this notice: birth, general practitioner, LMC, maternity provider, primary health services
DA11 Linkages with other services
Providers of lead maternity care will also maintain linkages with the following local organisations and providers of health services:
(a) primary health services:
(b) maternity facility services:
(c) secondary maternity services:
(d) antenatal education services:
(e) ultrasound scanning services:
(f) well child services:
(g) maternity consumer organisations:
(h) community or maternal mental health teams
Defined in this notice: maternity facility, primary health services, secondary maternity
Exclusions
DA12 Exclusions
Lead maternity care does not include the following:
(a) maternity facility services:
(b) birthing unit services:
(c) secondary maternity services:
(d) any services provided by a DHB provider arm.
Defined in this notice: birthing unit, DHB provider arm, lead maternity care, maternity facility, secondary maternity
Claims
DA13 General requirements for making claims for lead maternity care
(1) Payments for lead maternity care may be claimed for services provided in accordance with this subpart.
(2) A maternity provider who claims a lead maternity care fee must be the maternity provider with whom the woman is registered through the woman's LMC.
(3) No claims may be made for lead maternity care that has been provided before the date of registration.
(4) No claims for lead maternity care will be accepted before HealthPAC has received the registration form.
(5) A maternity provider may make only 1 claim for each lead maternity care fee per woman per pregnancy.
(6) Claims may be made only once either when-
(a) the module or item of service has been completed; or
(b) the woman has registered with another maternity provider.
(7) Trimester dates will be calculated based upon the EDD supplied by a maternity provider with the claim.
(8) There can be no claim for lead maternity care if a woman has transferred to secondary maternity or tertiary maternity for an entire module.
Defined in this notice: claim, EDD, HealthPAC, LMC, maternity provider, module, secondary maternity, tertiary maternity
Reporting requirements
DA14 Purchase units
(1) The following purchase units apply to lead maternity care.
Purchase unit ID Purchase unit short name
WM1007 Maternity LMC Antenatal Services
WM1008 Maternity LMC Labour and Birth Services
WM1009 Maternity LMC Postnatal Services(Services Following Birth)
(2) Purchase units are defined in the Ministry of Health's data dictionary and correspond to the relevant fees specified in Schedule 1.
Defined in this notice: lead maternity care
DA15 Registration information
A maternity provider must submit the required registration information to HealthPAC within 20 working days of registering the woman in accordance with the registration form, OMC system or message standard definition, approved by the Ministry of Health from time to time.
Defined in this notice: HealthPAC, maternity provider, message standard definition, OMC, registration, working day
DA16 Service delivery information
A maternity provider must submit service delivery information in accordance with the claim forms, OMC system or message standard definition for lead maternity care approved by the Ministry of Health from time to time.
Defined in this notice: claim, maternity provider, message standard definition, OMC
DA17 Health status information
A maternity provider must submit health status information in accordance with the claim forms, OMC system or message standard definition for lead maternity care, approved by the Ministry of Health from time to time, including-
(a) the woman's height, weight, and smoking status at the time of registration; and
(b) the baby's breastfeeding status at 2 weeks of age; and
(c) the woman's smoking status at 2 weeks following birth.
Defined in this notice: birth, claim, lead maternity care, maternity provider, message standard definition, OMC, registration
DA18 NIR information
A maternity provider must give the NIR the following information:
(a) a full and accurate record of birth details to enable valid NIR registration:
(b) information for the NIR of any vaccination given to the baby.
Defined in this notice: birth, maternity provider, NIR
Module: First trimester and second trimester
DA19 Service specifications for first and second trimester
(1) For a woman in the first trimester of pregnancy, the LMC must provide the following services as required:
(a) informing the woman regarding-
(i) the role of the LMC, which includes confirming that the LMC will meet the requirements in clauses DA5, DA6, DA7; and
(ii) the contact details of the LMC and back-up LMC; and
(iii) the standards of care to be expected:
(b) providing appropriate information and education about screening, and offering referral for the appropriate screening tests that the Ministry of Health may, from time to time, notify maternity providers about:
(c) pregnancy care and advice, including-
(i) confirmation of pregnancy; and
(ii) ensuring that the woman has a copy of the Ministry of Health's consumer information on primary maternity services; and
(iii) all appropriate assessment and care of a woman:
(d) care and advice if there is a real and imminent risk of miscarriage, the woman is experiencing a miscarriage or a miscarriage has occurred, including-
(i) all appropriate assessment and care of a woman; and
(ii) referral for diagnostic tests and treatment, if necessary:
(e) assessment, care, and advice provided in relation to a termination of pregnancy, including-
(i) referral for diagnostic tests, if necessary; and
(ii) referral for a termination of pregnancy.
(2) For a woman in the second trimester of pregnancy, the LMC must provide all of the following services:
(a) inform the woman regarding-
(i) the availability of pregnancy and parenting education; and
(ii) the availability of paid parental leave, if applicable; and
(iii) if necessary, any of the items of information listed in clause (1)(a) above:
(b) at the start of the second trimester or at the time of registration-
(i) conduct a comprehensive pregnancy assessment of the woman including, an assessment of her general health, family and obstetric history; a physical examination; and
(ii) commence and document a care plan to be used and updated throughout all modules including post natal that meets the guidelines agreed with the relevant professional bodies; and
(iii) arrange for the woman to hold a copy of her care plan and her clinical notes (or, if the woman prefers, to be given a copy of her clinical notes following the completion of each module):
(c) throughout the second trimester-
(i) monitor progress of pregnancy for the woman and baby, including early detection and management of any problems; and
(ii) update the care plan; and
(iii) provide appropriate information and education; and
(iv) offer referral for the appropriate screening tests that the Ministry of Health may, from time to time, notify maternity providers about:
(d) book in to an appropriate maternity facility or birthing unit (unless a homebirth is planned):
(e) if a general practitioner or obstetrician LMC plans to use hospital midwifery services, make a prior agreement with a maternity facility on the use of its hospital midwifery services.
Defined in this notice: back-up LMC, birthing unit, care plan, first trimester, general practitioner, homebirth, hospital midwifery services, LMC, maternity facility, maternity provider, module, obstetrician, pregnancy and parenting education, primary maternity services, second trimester
DA20 Payment rules: First and second trimester
(1) In accordance with this clause, the full fee, the first partial fee, or the last partial fee may be claimed, as the case may require.
(2) A maternity provider may claim only the first partial fee if the woman was registered with the maternity provider, but changed maternity provider before the start of the 18th week of pregnancy.
(3) A maternity provider may claim only the last partial fee if the woman first registered with the maternity provider after the end of the 17th week of pregnancy.
(4) None of these fees may be claimed if the woman was registered with the maternity provider after the end of the 26th week of pregnancy.
(5) If subclauses (2) to (4) do not apply, the maternity provider may claim the full fee.
Defined in this notice: claim, maternity provider
Module: Third trimester
DA21 Service specification: third trimester
In addition to the requirements set out under the service specifications for the first and second trimester, the LMC must-
(a) organise appropriate arrangements for care during labour and birth and following birth, including, if possible, organising for the woman to meet any other practitioners who are likely to be involved in her care; and
(b) discuss and confirm a plan of care for the baby or babies; and
(c) provide Ministry of Health information on immunisation and the National Immunisation Register (NIR).
Defined in this notice: labour and birth, LMC, module, NIR, practitioner, second trimester, third trimester
DA22 Payment rules: third trimester
(1) In accordance with this clause, either the full fee or first partial fee may be claimed, as the case may require.
(2) None of these fees may be claimed if the woman was registered with the maternity provider, but changed maternity provider before the start of the 31st week of pregnancy.
(3) A maternity provider may claim only the first partial fee if the woman was registered with the maternity provider, but changed maternity provider before the start of the 35th week of pregnancy.
(4) A maternity provider may claim only the last partial fee if the woman first registered with the maternity provider after the end of the 34th week of pregnancy.
(5) If subclauses (2) to (4) do not apply, the maternity provider may claim the full fee.
Defined in this notice: claim, maternity provider, third trimester
Module: Labour and birth
DA23 Service specification: labour and birth
(1) The LMC is responsible for ensuring that all of the following services are provided:
(a) all primary maternity services from the time of established labour, including initial assessment of the woman at her home or at a maternity facility and regular monitoring of the progress of the woman and baby:
(b) management of the birth:
(c) all primary maternity care until 2 hours after delivery of the placenta, including updating the care plan, attending the birth and delivery of the placenta, suturing of the perineum (if required), initial examination and identification of the baby at birth, initiation of breast feeding (or feeding), care of the placenta, and attending to any legislative requirements regarding birth notification by health professionals:
(d) the LMC must make every effort to attend, as necessary, during labour and to attend the birth, including making every effort to attend a woman as soon as practicable -
(i) after the woman's arrival at the maternity facility or birthing unit where she will give birth; or
(ii) when requested by the woman, for a homebirth:
(e) if a LMC is unable to attend the birth because of holiday leave, sick leave, bereavement leave, continuing professional education requirements or other exceptional circumstances, the LMC must make appropriate other arrangements with a back-up LMC:
(2) For a homebirth, in addition to clause (1), the LMC must-
(a) arrange for another midwife, general practitioner, or obstetrician to be available to attend the birth; and
(b) maintain equipment (including neonatal resuscitation equipment) and provide the delivery pack and consumable supplies; and
(c) ensure that a midwife, general practitioner, or obstetrician remains with the woman for at least 2 hours following the birth.
(3) For a birthing unit, in addition to clause (1), the LMC must-
(a) arrange for a midwife, general practitioner, or obstetrician to be available to attend the birth; and
(b) ensure that a midwife, general practitioner, or obstetrician remains with the woman until she is discharged.
(4) A general practitioner or obstetrician LMC who uses hospital midwifery services in order to provide the full service required during labour and birth must-
(a) ensure that the respective responsibilities of the LMC and the hospital midwifery services are clearly documented in the care plan, and that a copy of the care plan is given to the hospital midwifery services and to the woman; and
(b) monitor progress of labour; and
(c) be available to attend as soon as required at any time during the labour; and
(d) attend the birth and the delivery of the placenta.
Defined in this notice: back-up LMC, birth, birthing unit, care plan, established labour, general practitioner, homebirth, hospital midwifery services, labour and birth, LMC, maternity facility, midwife, obstetrician, primary maternity services
DA24 Payment rules: labour and birth
(1) Only 1 labour and birth fee is payable for a birth (including a multiple birth).
(2) The payment to be claimed depends on whether the birth is a first birth, VBAC, or subsequent birth.
(3) If an LMC utilises hospital midwifery services the maternity provider must claim the fee that applies if a general practitioner or obstetrician has used hospital midwifery services.
(4) A maternity provider may claim the labour and birth fee if the LMC anticipates that clinical responsibility for the labour and birth is to remain with the LMC and circumstances change and clinical responsibility transfers after established labour to secondary maternity.
(5) The payment for homebirth supplies and support may be claimed only once per woman per pregnancy if a homebirth has occurred.
(6) The payment for birthing unit support may only be claimed once per woman per pregnancy if the birth occurs in a birthing unit.
Defined in this notice: birth, birthing unit, birthing unit support, claim, established labour, first birth, general practitioner, homebirth, homebirth supplies and support, hospital midwifery services, labour and birth, LMC, maternity provider, obstetrician, secondary maternity, subsequent birth, VBAC
DA25 Service specification: labour and birth (exceptional circumstances)
The LMC or a back-up LMC must provide a woman with continuing support and continuity of care during the labour and birth, including-
(a) attendance at the birth if clinical responsibility for the woman is transferred to secondary maternity not more than 48 hours before established labour or birth; or
(b) if there is no labour and it was anticipated that clinical responsibility for the labour and birth would remain with the LMC, but circumstances change, giving no opportunity for a planned transfer; or
(c) attendance at an elective caesarean section where requested by the woman and where the LMC has provided second and third trimester care; or
(d) if there are other exceptional circumstances during labour and birth and the maternity provider makes a written application to the Ministry of Health for a discretionary decision on payment and receives approval.
Defined in this notice: back-up LMC, birth, established labour, labour and birth, LMC, maternity provider, practitioner, secondary maternity
DA26 Payment rules: labour and birth (exceptional circumstances)
(1) This fee may be claimed once per woman per pregnancy.
(2) A maternity provider may not claim this fee if the maternity provider is claiming a labour and birth fee for the same woman for the same pregnancy.
(3) If a maternity provider has made a written application to the Ministry of Health for a discretionary decision on payment, the Ministry of Health may approve or decline the application at its sole discretion.
Defined in this notice: claim, labour and birth, maternity provider
DA27 Service specification: labour and birth (rural support)
A general practitioner or midwife must provide the following services as required to women during labour and birth:
(a) urgent care and treatment to support a LMC in a rural or remote rural domicile (as defined in Schedule 2) if the services of an obstetrician or paediatrician are needed but are not available and the LMC requires assistance from another practitioner who has additional maternity skills:
(b) accompany the woman in an air/road ambulance from a rural or remote rural domicile area (as defined in Schedule 2).
Defined in this notice: general practitioner, labour and birth, LMC, midwife, obstetrician, paediatrician, practitioner
DA28 Payment rules: labour and birth (rural support)
Notwithstanding clause DA13(5), a maternity provider may claim 1 labour and birth (rural support) fee per woman per day.
Defined in this notice: claim, labour and birth, maternity provider
Module: Services following birth
DA29 Service specification: services following birth
(1) A LMC is responsible for ensuring that all of the following services are provided for both the mother and baby:
(a) reviewing and updating the care plan and document progress, care given and outcomes, and ensuring that the maternity facility has a copy of the care plan if the woman is receiving inpatient postnatal care:
(b) postnatal visits to assess and care for the mother and baby in a maternity facility and at home until 6 weeks after the birth, including-
(i) a daily visit while the woman is receiving inpatient postnatal care, unless otherwise agreed by the woman and the maternity facility; and
(ii) between 5 and 10 home visits by a midwife (and more if clinically needed) including 1 home visit within 24 hours of discharge from a maternity facility; and
(iii) a minimum of 7 postnatal visits as an aggregate of DA29 (1) (b) (i) and (ii):
(c) as a part of the visits in clause (b), examinations of the woman and baby including-
(i) a detailed clinical examination of the baby within the first 24 hours of birth; and
(ii) a detailed clinical examination of the baby within 7 days of birth; and
(iii) a detailed clinical examination of the baby as defined by the Well Child Tamariki Ora National Schedule before transfer to a well child provider; and
(iv) a postnatal examination of the woman at a clinically appropriate time and before transfer to the woman's primary care provider:
(d) as a part of the visits in clause (b), the provision of care and advice to the woman, including-
(i) assistance with and advice about breastfeeding and the nutritional needs of the woman and baby; and
(ii) assessment for risk of postnatal depression and/or family violence, with appropriate advice and referral; and
(iii) provide appropriate information and education about screening; and
(iv) offer to provide or refer the baby for the appropriate screening tests specified by the Ministry of Health and receive and follow up the results of these tests as necessary:
(v) provision of Ministry of Health information on immunisation and the National Immunisation Register (NIR) and provision of any appropriate or scheduled immunisations consented to; and
(vi) provision of or access to services, as outlined in the Well Child Tamariki Ora National Schedule; and
(vii) advice regarding contraception; and
(viii) parenting advice and education.
(2) If a birth has occurred in a maternity facility, the LMC, in discussion with the woman and the maternity facility, must determine when the woman is clinically ready for discharge.
(3) If a general practitioner or obstetrician LMC uses hospital midwifery services, the LMC must-
(a) make a prior agreement with the maternity facility on the use of the hospital midwifery services; and
(b) ensure that the respective responsibilities of the LMC and the hospital midwifery services are clearly documented in the care plan and that a copy of the care plan is given to the hospital midwifery services and to the woman; and
(c) be available to provide consultation and treatment on request.
Defined in this notice: birth, care plan, general practitioner, home visit, hospital midwifery services, inpatient postnatal care, LMC, maternity facility, maternity provider, midwife, NIR, obstetrician, well child provider
DA30 Payment rules: services following birth
(1) The fees for inpatient postnatal care may be claimed only if the woman receives inpatient postnatal care.
(2) The fees for no inpatient postnatal care may be claimed only if the woman does not receive inpatient postnatal care.
(3) In addition, in accordance with this clause, the full fee, the first partial fee or the last partial fee may be claimed, as the case may require.
(4) If a LMC uses hospital midwifery services the maternity provider must claim the fee that applies if a general practitioner or obstetrician has used hospital midwifery services.
(5) A maternity provider may claim only the first partial fee if the woman was registered with the maternity provider, but changed maternity provider during the first, second or third week following birth.
(6) A maternity provider may claim only the last partial fee if the woman first registered with the maternity provider during the fourth, fifth or sixth week following birth.
(7) If subclauses (5) and (6) do not apply, the maternity provider may claim the full fee.
(8) Only 1 payment for services following birth will be paid per woman, per pregnancy except where the mother and baby have different residential addresses. If separate fees for services following birth are sought, details of the circumstances must be provided with the claim. In particular:
(a) for the claim for services following birth for the birth mother, the birth mother's NHI and the baby's NHI must be provided on the claim;
(b) for the claim for services following birth for the baby and its caregiver, the caregiver's NHI and the baby's NHI must be provided on the claim. In addition, the caregiver must be registered with the maternity provider.
(9) The fee for additional postnatal visits may be claimed only once per woman if the LMC has provided 12 or more postnatal visits. This fee may not be claimed by an LMC who has used hospital midwifery services.
Defined in this notice: additional postnatal visits, birth, claim, general practitioner, hospital midwifery services, inpatient postnatal care, LMC, maternity provider, NHI, obstetrician, services following birth
DA31 Payment rules: services following birth: rural travel
(1) Payment for rural travel relates to the provision of services following birth and may be claimed only after the services following birth module is completed.
(2) A maternity provider may claim payment for rural travel if the woman's usual place of residence is in a domicile identified as semi rural, rural or remote rural as listed in Schedule 2.
(3) The semi-rural, rural, and remote rural fees are separate fees and not cumulative. In addition, in accordance with this clause, the full fee, the first partial fee or the last partial fee may be claimed, as the case requires.
(4) A maternity provider may claim only the first partial fee if the woman concerned was registered with the maternity provider, but changed maternity provider during the first, second or third week following birth.
(5) A maternity provider may claim only the last partial fee if the woman concerned first registered with the maternity provider during the fourth, fifth or sixth week following birth.
(6) If subclauses (4) and (5) do not apply, a maternity provider may claim the full fee.
(7) Only 1 payment for rural travel will be paid per woman, per pregnancy except where the mother and baby have different residential addresses. If separate fees for rural travel are sought, details of the circumstances must be provided with the claim. In particular:
(a) for the claim for rural travel for the birth mother, the birth mother's NHI and the baby(s) NHI must be provided on the claim;
(b) for the claim for rural travel for the baby(s) and its caregiver, the caregiver's NHI and the baby's NHI must be provided on the claim. In addition, the caregiver must be registered with the maternity provider.
(8) A rural travel fee may not be claimed by a LMC who has used hospital midwifery services.
Defined in this notice: birth, caregiver, claim, hospital midwifery services, LMC, maternity provider, module, NHI, rural travel, services following birth, usual place of residence
Subpart DB-Maternity non-LMC services
General information about maternity non-LMC services
DB1 Aim of maternity non-LMC services
(1) The aim of maternity non-LMC services is to support the provision of lead maternity care.
(2) Maternity non-LMC services are services that are either an addition to lead maternity care or represent services sought on a casual basis outside lead maternity care.
(3) Maternity non-LMC services do not include specialist medical maternity services (see subpart DC).
(4) Maternity non-LMC services are available to child-bearing women and their newborn babies.
Defined in this notice: lead maternity care, maternity non-LMC services, specialist medical maternity services
DB2 Charging for maternity non-LMC services
(1) Maternity non-LMC services provided by a practitioner who is not an obstetrician must be provided free of charge to persons who are eligible to receive them.
(2) A part charge may be charged to eligible people for maternity non-LMC services provided by an obstetrician.
Defined in this notice: maternity non-LMC services, obstetrician, practitioner
DB3 Where maternity non-LMC services may be provided
Maternity non-LMC services may be provided in-
(a) the woman's home; or
(b) the baby's home (if it different from the mother's home); or
(c) the practitioner's rooms or practice.
Defined in this notice: maternity non-LMC services, practitioner
DB4 Practitioners who may not provide maternity non-LMC services
None of the following practitioners may provide maternity non-LMC services:
(a) a practitioner who is the woman's LMC:
(b) an employee [or contractor] of the same maternity provider as the woman's LMC.
Defined in this notice: LMC, maternity non-LMC services, practitioner
DB5 Service linkages
Providers of maternity non-LMC services will also maintain linkages with local providers of the following services:
(a) primary health services:
(b) lead maternity care:
(c) secondary maternity services:
(d) ultrasound scanning services.
Defined in this notice: lead maternity care, maternity non-LMC services, primary health services, secondary maternity
DB6 Exclusions
Maternity non-LMC services do not include the following:
(a) lead maternity care:
(b) ultrasound scanning:
(c) any services provided by a DHB provider arm.
Defined in this notice: DHB provider arm, lead maternity care, maternity non-LMC services
DB7 General requirements for making claims for maternity non-LMC services
(1) Payments for maternity non-LMC services may be claimed for services provided in accordance with subpart DB.
(2) A maternity provider with whom the woman, through her LMC, is registered may not claim maternity non-LMC services.
(3) Claims may be made only after the item of service has been completed.
Defined in this notice: claim, LMC, maternity non-LMC services, maternity provider
DB8 Reporting requirements: purchase units
(1) The following purchase unit applies to maternity non-LMC services
Purchase unit ID Purchase unit short name
WM1000 Maternity non-LMC services
(2) Purchase units are defined in the Ministry of Health data dictionary and correspond to the relevant fees specified in Schedule 1.
Defined in this notice: maternity non-LMC services
DB9 Reporting requirements: service delivery information
A maternity provider must submit service delivery information in accordance with the claim forms, OMC system or message standard definition for maternity non-LMC services approved by the Ministry of Health from time to time.
Defined in this notice: claim, maternity provider, maternity non-LMC services, message standard definition, OMC
Module: Non LMC first trimester
DB10 Service specification: first trimester
For a woman in the first trimester of pregnancy a general practitioner or midwife, who works for the PHO practice with whom the woman is enrolled for primary health services, must provide the following services as required:
(a) informing the woman regarding her options for choosing a LMC:
(b) providing appropriate information and education about screening, and offering referrals to a provider for the appropriate screening tests that the Ministry of Health may, from time to time, notify maternity providers about:
(c) providing written information including screening test results and relevant health information to the woman and her LMC on the care provided:
(d) pregnancy care and advice, including-
(i) confirmation of pregnancy; and
(ii) review of current and past health status; and
(iii) health information and education including nutrition, smoking, alcohol and drugs; and
(iv) ensuring that the woman has a copy of the Ministry of Health's consumer information on primary maternity services; and
(v) all appropriate assessment of a woman including blood pressure and assessment of uterine size:
(e) care and advice if there is a real and imminent risk of miscarriage, the woman is experiencing a miscarriage or a miscarriage has occurred, including-
(i) all appropriate assessment and care of a woman; and
(ii) referral for diagnostic tests and treatment, if necessary:
(f) assessment, care, and advice provided in relation to a termination of pregnancy, including-
(i) referral for diagnostic tests, if necessary; and
(ii) referral for a termination of pregnancy.
Defined in this notice: first trimester, general practitioner, LMC, maternity provider, midwife, PHO, primary health services, primary maternity services
DB11 Payment rules: first trimester
(1) This fee may not be claimed if the woman was enrolled with the maternity provider, who is a PHO, after the end of the 12th week of pregnancy.
(2) The maternity provider may claim the first trimester services with threatened miscarriage, miscarriage or termination fee if the woman requires services in accordance with clause DB10(e) or (f).
(3) If subclause (2) does not apply then the maternity provider may claim the first trimester services without threatened miscarriage, miscarriage or termination fee.
(4) A maternity provider may only claim one non-LMC first trimester services fee per woman per pregnancy.
Defined in this notice: claim, first trimester, maternity provider, miscarriage, PHO
Module: Urgent pregnancy care (non-LMC maternity care)
DB12 Service specification: urgent normal hours pregnancy care
(1) A general practitioner, midwife, or obstetrician must provide the services listed in clause (2) to a woman who-
(a) is in the first, second or third trimester; and
(b) presents between the hours of 8am and 6pm on weekdays, excluding public holidays; and
(c) has either made an attempt and failed to access:
(i) her LMC (where the women is registered with a LMC); or
(ii) her enrolling PHO practice (where the woman is in the first trimester); or
(d) is away from her usual place of residence.
(2) The services that must be provided include-
(a) pregnancy care and advice in response to an urgent request received where the nature of the request is urgent (but not necessarily the service ultimately provided); and
(b) emergency referral to a specialist if necessary; and
(c) if the woman has an LMC, the provision of information to the woman's LMC on the care provided.
Defined in this notice: away from her usual place of residence, first trimester, general practitioner, LMC, maternity provider, midwife, obstetrician, PHO, second trimester, specialist, third trimester, usual place of residence
DB13 Service specification: urgent out of hours pregnancy care
(1) A general practitioner, midwife, or obstetrician must provide the services listed in clause (2) to a woman who-
(a) is in the first, second or third trimester; and
(b) presents between the hours of 6pm and 8am on weekdays or at all times on Saturday, Sunday, and public holidays; and
(c) has either made an attempt and failed to access:
(i) her LMC (where the women is registered with a LMC); or
(ii) her enrolling PHO practice (where the woman is in the first trimester); or
(d) is away from her usual place of residence.
(2) The services that must be provided include-
(a) pregnancy care and advice in response to an urgent request received where the nature of the request is urgent (but not necessarily the service ultimately provided); and
(b) emergency referral to a specialist if necessary; and
(c) if the woman has an LMC, the provision of information to the woman's LMC on the care provided.
Defined in this notice: away from her usual place of residence, first trimester, general practitioner, LMC, midwife, obstetrician, PHO, second trimester, specialist, third trimester, usual place of residence
DB14 Payment rules: urgent pregnancy care
(1) A maternity provider may claim only 1 urgent pregnancy care fee per woman per day.
(2) These fees may not be claimed for services provided to a woman in the first trimester by that woman's enrolling PHO practice.
Defined in this notice: claim, first trimester, maternity provider, PHO
Module: Non-LMC labour and birth (rural support)
DB15 Service specification: Non-LMC labour and birth (rural support)
A general practitioner or midwife must provide the following services as required to women during labour and birth:
(a) urgent care and treatment to support a LMC in a rural or remote rural domicile (as defined in Schedule 2) if the services of an obstetrician or paediatrician are needed but are not available and the LMC requires assistance from another practitioner who has additional maternity skills:
(b) accompany the woman in an air/road ambulance from a rural or remote rural domicile area (as defined in Schedule 2).
Defined in this notice: general practitioner, labour and birth, LMC, midwife, obstetrician, paediatrician, practitioner
DB16 Payment rules: labour and birth (rural support)
A maternity provider may only claim 1 non-LMC labour and birth (rural support) fee per woman per day.
Defined in this notice: claim, labour and birth, maternity provider
Module: Urgent postnatal care
DB17 Service specification: urgent postnatal care
(1) A general practitioner, midwife or obstetrician must provide the services listed in clause (2) to postnatal women and their babies who-
(a) have made an attempt and failed to access their LMC (where the women is registered with a LMC), or
(b) are away from their usual place of residence.
(2) The services that must be provided include-
(a) an appropriate assessment, care and treatment for a woman and her baby who present to the practitioner for care during the 6 week period following birth; and
(b) provision of information to the LMC on the care provided.
Defined in this notice: birth, general practitioner, LMC, practitioner, midwife, obstetrician, practitioner, usual place of residence
DB18 Payment rules: urgent postnatal care
A maternity provider may only claim 1 urgent postnatal care fee for each eligible person per day for who care is provided.
Defined in this notice: claim, maternity provider
Subpart DC-Specialist medical maternity services
General information about specialist medical maternity services
DC1 Aim of specialist medical maternity services
(1) The aim of specialist medical maternity services is for specialists to provide services that support primary maternity care.
(2) Specialist medical maternity services are available to child-bearing women and their newborn babies.
Defined in this notice: specialist, primary maternity services
DC2 Charging for specialist medical maternity services
A part charge may be charged for specialist medical maternity services.
Defined in this notice: specialist medical maternity services
DC3 Where specialist medical maternity services may be provided
Specialist medical maternity services may be provided in the following places, except where these settings are a part of a facility owned or operated by a DHB provider arm:
(a) the specialist's rooms:
(b) a maternity facility:
(c) a birthing unit:
(d) a woman's or baby's home.
Defined in this notice: birthing unit, DHB provider arm, maternity facility, specialist, specialist medical maternity services
DC4 Referral criteria
Specialist medical maternity services may only be provided to women and babies on referral from another practitioner or a family planning practitioner if the specialist who provides the specialist medical maternity services is not the practitioner or family planning practitioner making the referral, and-
(a) for ultrasound scans, there is a written referral signed by a midwife, general practitioner, obstetrician, or family planning practitioner specifying a clinical reason for the referral that is in accordance with clause DC11; or
(b) for consulting obstetrician services, there is a written referral from a general practitioner or midwife and the referral specifies a clinical reason for the referral that is in accordance with the Referral Guidelines; or
(c) for consulting paediatrician services, if there is a written referral from the LMC or the back-up LMC and-
(i) the referral specifies a clinical reason for the referral that is in accordance with referral guidelines; and
(ii) if a back-up LMC makes a referral, the referral should be identified as being signed by the back-up LMC on behalf of the LMC.
Defined in this notice: back-up LMC, family planning practitioner, general practitioner, LMC, midwife, obstetrician, paediatrician, practitioner, referral guidelines, specialist, specialist medical maternity services
DC5 Quality of service requirements
(1) A nuchal translucency ultrasound scan must be undertaken by a practitioner with the appropriate training and access to risk estimation software, and appropriate quality of equipment.
(2) Practitioners performing or supervising nuchal translucency ultrasound scans must have obtained the appropriate accreditation recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Royal Australian and New Zealand College of Radiologists.
Defined in this notice: maternity provider, practitioner
DC6 Service linkages
Providers of specialist medical maternity services will also maintain linkages with local providers of the following services:
(a) primary health services
(b) lead maternity care
(c) secondary maternity services
Defined in this notice: lead maternity care, primary health services, secondary maternity, specialist medical maternity services
DC7 Exclusions
Specialist medical maternity services do not include the following:
(a) lead maternity care
(b) ultrasound scanning except for reasons listed in clause DC11(3)
(c) any services provided by the provider arm of a DHB
(d) any services provided by a practitioner if-
(i) the practitioner is an employee of a DHB provider arm; and
(ii) the practitioner provides the maternity service in their capacity as an employee of a DHB provider arm.
Defined in this notice: DHB provider arm, lead maternity care, practitioner, specialist medical maternity services
DC8 Reporting requirements: purchase units
(1) The following purchase units apply to specialist medical maternity services.
Purchase unit ID Purchase unit short name
WM1005 Maternity radiology specialist consult
WM1002 Maternity obstetrician specialist consult
WM1004 Maternity paediatrician specialist consult
(2) Purchase units are defined in the Ministry of Health data dictionary and correspond to the relevant fees specified in Schedule 1.
Defined in this notice: specialist medical maternity services
DC9 Reporting requirements: service delivery information
A maternity provider must give service delivery information in accordance with the claim forms, OMC system or message standard definition for specialist medical maternity services approved by the Ministry of Health from time to time.
Defined in this notice: claim, maternity provider, message standard definition, OMC, specialist medical maternity services
Module: Ultrasound scans
DC10 Service specification: ultrasound scan
A maternity provider who provides an ultrasound scan must provide the following services if a payment for services is claimed:
(a) conduct an ultrasound scan according to quality standards recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Royal Australian and New Zealand College of Radiologists:
(b) ensure that a radiologist or an obstetrician with a Diploma of Diagnostic Ultrasound (or equivalent as determined by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) is available to tailor the radiological examination to the clinical situation by-
(i) being physically present at the place where the examination is being performed; or
(ii) when using teleradiology, being available to review the transmitted diagnostic images before the woman's departure from the place where the scan is conducted:
(c) obtain a permanent visual record of the scan:
(d) provide the referring general practitioner, midwife, obstetrician, or family planning practitioner with a written interpretation of the scan by a radiologist or an obstetrician with a Diploma of Diagnostic Ultrasound (or equivalent as determined by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) in a timely manner.
Defined in this notice: claim, family planning practitioner, general practitioner, maternity provider, midwife, obstetrician, radiologist
DC11 Payment rules: ultrasound scan
(1) This fee may be claimed only if an appropriate referral has been received in accordance with clause DC4(a).
(2) A code corresponding to the relevant indication in subclause (3) must be stated on both the referral form and on the claim.
(3) The following list identifies the approved clinical indications for ultrasound in pregnancy. The listed conditions are mandatory indications and must be included on the referral form:
Code Clinical indication Comment
TA Threatened abortion Scan at time of bleeding. Serial scans may be necessary if bleeding persists.
EP Suspected ectopic pregnancy e.g. Previous tubal surgery, PID or ectopic. Suggestive symptoms (e.g. abdominal pain).
PM Pelvic mass in pregnancy Any palpable abnormality in early pregnancy.
UD Uterus not equal to dates If discrepancy > 4 weeks, or discrepancy in amniotic fluid.
BA Prior to booking CVS or amniocentesis or Nuchal Translucency When unsure dates.
CT Consideration of termination
NT Dating and early evaluation for chromosomal abnormality Nuchal translucency assessment at 11-13+6 weeks, assessment for gestational age, diagnosis of multiple pregnancy.
NF Early evaluation for chromosomal abnormality follow up In cases where the first scan was technically unsuccessful.
AN Anatomy Scan to confirm dates, assess foetal anatomy and placental position. Performed at 18-20 weeks ideally.
AF Anatomy follow up In cases where the first scan was technically unsuccessful.
GR Suspected growth abnormality (IUGR or macrosomia) Clinical suspicion of abnormal growth of foetus (IUGR or macrosomia) or abnormal volume of amniotic fluid.
GF Suspected growth abnormality (IUGR or macrosomia) follow up To assess growth trend (2 weeks after GR scan).
PL Check placenta To check placental site at around 36 weeks.
AH Antepartum haemorhage Bleeding in pregnancy. If serial scans are required refer to secondary maternity services.
AP Abdominal pain Abdominal pain in pregnancy.
MP Malpresentation To assess fetal position and size, after 36 weeks.
FC Suspected foetal compromise Significant reduction in foetal movements.
FD Suspected intrauterine foetal death
PP Maternal postpartum For suspected retained products or postpartum bleeding.
(4) A maternity provider may claim only 1 ultrasound scan fee per woman per date of service.
(5) A claim for a subsequent scan requires a new referral in accordance with DC4(a).
Defined in this notice: claim, maternity provider
Module: Obstetrician services
DC12 Service specification: obstetrician services
(1) An obstetrician will provide the following services if a payment for consulting obstetrician services is claimed:
(a) advising, caring for, and treating, a woman:
(b) referring a woman to other specialist maternity services, if clinically warranted:
(c) forwarding to the woman's LMC documentation detailing advice and treatment given or recommended.
Defined in this notice: claim, LMC, obstetrician
DC13 Payment rules: obstetrician services
(1) A fee for consulting obstetrician services may be claimed for consulting obstetrician services only if an appropriate referral has been received in accordance with DC4(c).
(2) A fee for consulting obstetrician services may be claimed only if the obstetrician attends the woman in person.
(3) Payment of a fee for consulting obstetrician services will be made according to whether it is a first consultation or a subsequent consultation.
(4) Each claim for either a first consultation or a subsequent consultation requires a separate referral in accordance with clause DC4(c).
(5) A maternity provider may claim only 1 consulting obstetrician services fee per woman per referral reason per date of service, regardless of whether it is a first consultation or subsequent consultation.
Defined in this notice: claim, first consultation, maternity provider, obstetrician, subsequent consultation
Module: Paediatrician services
DC14 Service specification: paediatrician services
A paediatrician must provide the following services if a fee for consulting paediatrician services is claimed:
(a) advising, caring for, and treating a woman, foetus, or baby:
(b) forwarding documentation to the LMC of the advice and treatment given or recommended.
Defined in this notice: claim, LMC, paediatrician
DC15 Payment rules: paediatrician services
(1) A fee for consulting paediatrician services may be claimed only if an appropriate referral has been received in accordance with clause DC4(c).
(2) A fee for paediatrician services may be claimed only if the paediatrician attends the baby in person.
(3) Payment of a fee for paediatrician services will be made according to whether it is a first consultation or a subsequent consultation.
(4) Each claim for either a first consultation or a subsequent consultation requires a separate referral in accordance with clause DC4(c).
(5) A maternity provider may claim only 1 consulting paediatrician services fee per baby per referral reason per date of service, regardless of whether it is a first consultation or subsequent consultation.
Defined in this notice: claim, first consultation, maternity provider, paediatrician, subsequent consultation
---------
Schedule 1
Fees
1 Maternity LMC Antenatal Services (WM1007) Fees (GST Excl)
(1) first and second trimester
(a) full fee $300.00
(b) first partial fee $175.00
(c) last partial fee $125.00
(2) third trimester
(a) full fee $290.00
(b) first partial fee $125.00
(c) last partial fee $165.00
2 Maternity LMC Labour and Birth Services (WM1008) Fees (GST Excl)
(1) labour and birth
(a) first birth $1,090.00
(b) VBAC $1,090.00
(c) subsequent birth $855.00
(2) labour and birth if a general practitioner or obstetrician has used hospital midwifery services
(a) first birth $470.00
(b) VBAC $470.00
(c) subsequent birth $360.00
(3) homebirth supplies and support $440.00
(4) birthing unit support $250.00
(5) labour and birth (exceptional circumstances) $310.00
(6) labour and birth (rural support) $500.00
3 Maternity LMC Postnatal Services (WM1009)(Services Following Birth) Fees (GST Excl)
(1) services following birth
(a) received inpatient postnatal care
(i) full fee $480.00
(ii) first partial fee $240.00
(iii) last partial fee $240.00
(b) no inpatient postnatal care
(i) full fee $540.00
(ii) first partial fee $270.00
(iii) last partial fee $270.00
(c) additional postnatal visits $155.00
(2) services following birth if a general practitioner or obstetrician has used hospital midwifery services
(a) received inpatient postnatal care
(i) full fee $90.00
(ii) first partial fee $45.00
(iii) last partial fee $45.00
(b) no inpatient postnatal care
(i) full fee $120.00
(ii) first partial fee $60.00
(iii) last partial fee $60.00
(3) rural travel
(a) semi rural
(i) full fee $150.00
(ii) first partial fee $75.00
(iii) last partial fee $75.00
(b) rural
(i) full fee $225.00
(ii) first partial fee $112.50
(iii) last partial fee $112.50
(c) remote rural
(i) full fee $400.00
(ii) first partial fee $200.00
(iii) last partial fee $200.00
4 Maternity Non-LMC Services (WM1000) Fees (GST Excl)
(1) first trimester services
(a) without threatened miscarriage, miscarriage or termination $110.00
(b) with threatened miscarriage, miscarriage or termination $150.00
(2) urgent normal hours pregnancy care $40.00
(3) urgent out of hours pregnancy care $60.00
(4) non-LMC labour and birth (rural support) $500.00
(5) urgent postnatal care $40.00
5 Maternity radiology specialist consult (WM1005) Fees (GST Excl)
(1) ultrasound scans $78.00
6 Maternity obstetrician specialist consult (WM1002) Fees (GST Excl)
(1) consulting obstetrician services
(a) first consultation $80.00
(b) subsequent consultation $40.00
7 Maternity paediatrician specialist consult (WM1004) Fees (GST Excl)
(1) consulting paediatrician services
(a) first consultation $90.00
(b) subsequent consultation $40.00
Schedule 2
Rural travel
1 General information
(1) The fees for rural travel are stated in Schedule 2 and payment rules for rural travel are stated in clause DA31.
(2) The area units contained in clause 2 are based on the census area unit boundaries as set by Statistics New Zealand and as updated by Statistics New Zealand from time to time. Changes are generally only made:
(a) following an alteration of local authority boundaries; or
(b) as part of a general review carried out in the year prior to each census of population and dwellings; or
(c) during the fifteen or twenty year review of statistically defined urban areas.
(3) If an area unit in the following table is deleted by Statistics New Zealand it is deemed to have been deleted from clause 2.
(4) If a new area unit is created by Statistics New Zealand the Ministry, at its discretion, may decide what rural status to assign to the new area unit, if any.
(5) If an area unit is not in clause 2 and has a description that includes water (such as inland water, harbour, inlet, etc.) then the maternity provider may apply to the Ministry of Health and the Ministry of Health may decide what rural status to assign to the area unit, if any.
Defined in this notice: maternity provider, rural travel
2 Rural Area Unit Classifications
DHB Territorial Authority Area Unit Description Area Unit Semi Rural Rural Remote Rural
Auckland DHB Auckland City Aiguilles Island 616400 X
Browns Island 616300 X
Cape Barrier 616100 X
Great Barrier Island 521000 X
Islands-Motutapu, Rangitoto, Rakino 520900 X
Kaikoura and Rangiahua Islands 616001 X
Little Barrier Island 615900 X
Mokohinau Island 615800 X
Rakitu Island 616200 X
Waiheke Island 520801 X
Bay of Plenty DHB Kawerau District Kawerau 542600 X
Opotiki District Cape Runaway 542903 X
Oponae 542904 X
Opotiki 542800 X
Te Kaha 542901 X
Waiotahi 542906 X
White Island 619900 X
Tauranga District Bethlehem 536514 X
Kairua 536512 X
Motiti Island 618400 X
Motuopae Island 536510 X
Papamoa Beach East 536200 X
Western Bay of Plenty District Aongatete 536615 X
Athenree 535700 X
Island View-Pios Beach 536400 X
Kaimai 536630 X
Katikati Community 535800 X
Maketu Community 535900 X
Matakana Island 536611 X
Mayor Island 618500 X
Minden 536620 X
Ohauiti-Ngapeke 536641 X
Omokoroa Community 536000 X
Paengaroa 536651 X
Pongakawa 536654 X
Rangiuru 536653 X
Tahawai 536614 X
Te Puke East 538502 X
Te Puke West 538501 X
Te Puna 536503 X
Upper Papamoa 536642 X
Waihi Beach 534100 X
Whakatane District Allandale-Mokorua 542440 X
Coastlands 542421 X
Edgecumbe Community 542200 X
Maraetotara 542514 X
Matahina-Minginui 542550 X
Matata 542000 X
Moutohora Island 619701 X
Murupara 542700 X
Ohope 541900 X
Orini 542511 X
Otakiri 542530 X
Poroporo 542520 X
Rotoma 542540 X
Taneatua Community 542100 X
Te Teko 542300 X
Trident 542430 X
Urewera 542562 X
Waimana 542561 X
Whakatane North 542410 X
Whakatane West 542422 X
Canterbury DHB Ashburton District Allenton 597810 X
Central Ashburton East 597840 X
Central Ashburton West 597820 X
Chertsey 597741 X
Fairton 597711 X
Hampstead 597850 X
Hinds 597730 X
Methven 597600 X
Mt Somers 597720 X
Netherby 597830 X
Plains Railway 597712 X
Rakaia 597742 X
Tinwald 597860 X
Banks Peninsula District Akaroa 596800 X
Diamond Harbour 596502 X
Governors Bay 596503 X
Little River 597101 X
Lyttelton 596400 X
Okains Bay 596900 X
Port Levy 596600 X
Quail Island 596504 X
Christchurch City Belfast 590400 X
Mcleans Island 587902 X
Styx 590601 X
Templeton 587820 X
Hurunui District Amberley 585802 X
Amuri 585503 X
Cheviot 585602 X
Culverden 585504 X
Hanmer Springs 585502 X
Hurunui 585700 X
Lake Tennyson 580900 X
Leithfield 585803 X
Parnassus 585601 X
Kaikoura District Kaikoura Rural 581500 X
Kaikoura Township 581400 X
Selwyn District Burnham Military Camp 587020 X
Darfield 586900 X
Dunsandel 597503 X
Kirwee 587010 X
Leeston 597300 X
Lincoln 597200 X
Malvern 587100 X
Prebbleton 587841 X
Rolleston 597502 X
Selwyn-Rakaia 597506 X
Southbridge 597400 X
Springston 597504 X
Taitapu 587905 X
West Melton 587904 X
Waimakariri District Ashley 585808 X
Ashley Gorge 586801 X
Camside 586001 X
Clarkville 586501 X
Coldstream 586118 X
Cust 586114 X
Eyreton 586602 X
Fernside 586116 X
Kaiapoi North 586401 X
Kaiapoi South 586402 X
Kaiapoi West 586502 X
Loburn 585807 X
Mairaki 586115 X
Okuku 585806 X
Oxford 586802 X
Pines-Kairaki Beach 586002 X
Rangiora East 586303 X
Rangiora North 586301 X
Rangiora West 586302 X
Sefton 585805 X
Southbrook 586304 X
Tuahiwi 586117 X
Waikuku 586112 X
West Eyreton 586601 X
Woodend 586120 X
Capital and Coast DHB Kapiti Coast District Kaitawa 563920 X
Kapiti Island 566301 X
Maungakotukutuku 566302 X
Otaihanga 565902 X
Paekakariki 566200 X
Paraparaumu Beach North 565901 X
Paraparaumu Beach South 565903 X
Paraparaumu Central 566000 X
Raumati Beach 566101 X
Raumati South 566102 X
Waikanae Beach 563701 X
Waikanae East 563703 X
Porirua City Endeavour 565602 X
Mana Island 572300 X
Paekakariki Hill 565700 X
Pauatahanui 565601 X
Plimmerton 571900 X
Pukerua Bay 571800 X
Resolution 565603 X
Wellington City Grenada 573521 X
Makara-Ohariu 577700 X
Counties Manakau DHB Areas Outside Territorial Authorities Hingaia 521201 X
Franklin District Awhitu 521151 X
Bledisloe Park 525922 X
Bombay 521160 X
Buckland 521113 X
Eden Road-Hill Top 521112 X
Glenbrook 521152 X
Hunua 521132 X
Kingseat 521122 X
Mangatawhiri 521133 X
Onewhero 526701 X
Opuawhanga 521115 X
Otaua 521153 X
Paerata-Cape Hill 521111 X
Patumahoe 521121 X
Pokeno 521131 X
Pukekohe North 525910 X
Pukekohe West 525921 X
Redoubt 521114 X
Runciman 521302 X
South Waiuku 526102 X
Tuakau 526200 X
Waiuku 526101 X
Whangapouri Creek 521202 X
Manukau City Beachlands-Maraetai 523300 X
Clevedon 525200 X
Turanga 523202 X
Papakura District Bremner 521203 X
Drury 521301 X
Hawkes Bay DHB Central Hawke's Bay District Elsthorpe-Flemington 549602 X
Otane 549400 X
Porangahau 549601 X
Takapau 549000 X
Tikokino 549200 X
Waipawa 549100 X
Waipukurau 549500 X
Chatham Islands County Chatham Islands 597000 X
Hastings District Bare Island 620904 X
Bridge Pa 545842 X
Eskdale 545812 X
Haumoana 545740 X
Iona 548820 X
Maraekakaho 545841 X
Omahu 545822 X
Pakipaki 545852 X
Pakowhai 545832 X
Poukawa 545851 X
Puketitiri 545912 X
Sherenden-Puketapu 545821 X
Tangoio 545811 X
Te Mata 548830 X
Tutira 545911 X
Waimarama 545860 X
Waiohiki 545831 X
Whanawhana 545913 X
Napier City Ahuriri 546200 X
Awatoto 545632 X
Bay View 545611 X
Bluff Hill 546802 X
Greenmeadows 547100 X
Hospital Hill 546801 X
Maraenui 546700 X
Marewa 546600 X
Mclean Park 546902 X
Meeanee 545631 X
Nelson Park 546901 X
Onekawa Central 546300 X
Onekawa South 546500 X
Onekawa West 546400 X
Pirimai 547400 X
Poraiti 545621 X
Tamatea North 547001 X
Tamatea South 547002 X
Taradale North 547200 X
Taradale South 547300 X
Westshore 546100 X
Wairoa District Frasertown 545202 X
Mahia 545304 X
Maungataniwha 545205 X
Nuhaka 545303 X
Raupunga 545301 X
Ruakituri-Morere 545204 X
Tuai 545201 X
Wairoa 545500 X
Whakaki 545302 X
Hutt DHB Lower Hutt City Belmont 569400 X
Eastbourne 570300 X
Fernlea 565000 X
Glendale 564800 X
Haywards-Manor Park 569600 X
Homedale East 565300 X
Homedale West 565200 X
Kelson 569500 X
Manuka 568104 X
Naenae North 568302 X
Pencarrow 565400 X
Tawhai 568101 X
Upper Hutt City Akatarawa 566610 X
Cloustonville 567901 X
Heretaunga Park 564510 X
Mangaroa 567902 X
Maoribank 566700 X
Nabhra 564600 X
Pinehaven 564530 X
Te Marua 566500 X
Trentham South 564520 X
Lakes DHB Rotorua District Arahiwi 538861 X
Golden Springs 538841 X
Hamurana 538811 X
Kaingaroa Forest 538831 X
Lynmore 538732 X
Mamaku 538864 X
Ngakuru 538850 X
Ngongotaha North 538601 X
Ngongotaha South 538602 X
Owhata East 538742 X
Reporoa 538842 X
Tarawera 538832 X
Tikitere 538820 X
Waiwhero 538863 X
Taupo District Acacia Bay 541311 X
Central Taupo 541720 X
Hilltop 541740 X
Iwitahi 541343 X
Kuratau 532502 X
Lakewood 541319 X
Mangakino 540900 X
Marotiri 541320 X
Maunganamu 541313 X
Nukuhau 541710 X
Omori 532200 X
Oruanui 541331 X
Rangatira 541318 X
Rangatira Park 541317 X
Rangipo 541501 X
Rangitaiki 541342 X
Richmond Heights 541760 X
Taharua 541503 X
Tauhara 541730 X
Taupo East 541315 X
Te More 541502 X
Turangi 541000 X
Waipahihi 541750 X
Wairakei-Aratiatia 541312 X
Wharewaka 541316 X
Midcentral DHB Horowhenua District Foxton 561700 X
Foxton Beach 561300 X
Kohitere 564013 X
Lake Horowhenua 564011 X
Levin East 564240 X
Levin North 564210 X
Levin South 564232 X
Levin West 564220 X
Mangaore-Manakau 564021 X
Moutoa 561500 X
Opiki 563802 X
Playford Park 564231 X
Shannon 563500 X
Tokomaru 563801 X
Waiopehu 564012 X
Waitarere 563600 X
Kapiti Coast District Otaki 564400 X
Otaki Forks 564022 X
Te Horo 564023 X
Manawatu District Feilding Central 560730 X
Feilding East 560740 X
Feilding North 560710 X
Feilding West 560720 X
Halcombe 560421 X
Himatangi Beach 561200 X
Kairanga 561811 X
Kauwhata 561901 X
Kiwitea 559700 X
Longburn 561812 X
Maewa 560412 X
Ohakea 561421 X
Oroua Bridge 560411 X
Oroua Downs-Waitohi 561422 X
Pohangina 560000 X
Rakiraki 561410 X
Rongotea 561000 X
Sanson 560900 X
Stoney Creek 560301 X
Tangimoana 561100 X
Tokorangi-Hiwinui 560422 X
Palmerston North City Aokautere 563300 X
Ashhurst 560200 X
Linton Military Camp 561820 X
Massey University 561813 X
Turitea 561902 X
Whakarongo 560302 X
Tararua District Dannevirke East 550102 X
Dannevirke West 550101 X
Eketahuna 578100 X
Mangatainoka 577900 X
Mara 549902 X
Nireaha-Tiraumea 578200 X
Norsewood-Herbertville 549800 X
Owahanga 549901 X
Pahiatua 578000 X
Papatawa 550200 X
Woodville 550500 X
Nelson Marlborough DHB Marlborough District Blenheim Central 581230 X
Havelock 580200 X
Marlborough Sounds Terrestrial 580446 X
Mayfield 581220 X
Omaka 580420 X
Picton 581100 X
Redwoodtown 581250 X
Renwick 580300 X
Seddon 580802 X
Severn 580600 X
Spring Creek-Riverlands 580430 X
Springlands 581210 X
Waikawa 580442 X
Wairau 580444 X
Ward 580801 X
Whitney 581240 X
Witherlea 581260 X
Woodbourne 580410 X
Nelson City Atawhai 582100 X
Clifton 582000 X
Glenduan 581713 X
Saxton Island 581721 X
Whangamoa 581812 X
Tasman District Aniseed Hill 581717 X
Bell Island 581725 X
Best Island 581724 X
Brightwater 581822 X
Golden Bay 581601 X
Golden Downs 581841 X
Jackett Island 584305 X
Kaiteriteri 581832 X
Lake Rotoroa 581842 X
Mapua 581825 X
Motueka East 584303 X
Motueka Outer 581833 X
Motueka West 584301 X
Murchison 581843 X
Rabbit Island 581834 X
Ranzau 581726 X
Richmond Hill 581811 X
Riwaka 581850 X
Takaka 581602 X
Tapawera 581844 X
Wai-Iti 581836 X
Wakefield 581823 X
Northland DHB Far North District Ahipara 500205 X
Awanui 500100 X
East Opua 501300 X
Haruru Falls 501200 X
Hokianga North 500801 X
Hokianga South 500802 X
Houhora 500207 X
Kaeo 500401 X
Kaikohe 501700 X
Kaitaia East 500302 X
Kaitaia West 500301 X
Kawakawa 501400 X
Kerikeri 500900 X
Kohukohu 500500 X
Mangapa-Matauri Bay 500402 X
Mangonui East 500202 X
Mangonui West 500204 X
Moerewa 501500 X
Motutangi-Kareponia 500208 X
Ngapuhi-Kaikou 501634 X
North Cape 500206 X
Ohaeawai 501632 X
Okaihau 501631 X
Omapere and Opononi 500700 X
Paihia 501100 X
Pokere-Waihaha 501620 X
Rawene 500600 X
Russell 501000 X
Taipa Bay-Mangonui 500203 X
Waihou Valley-Hupara 501633 X
Waitangi-Te Tii 501611 X
West Opua 501612 X
Kaipara District Dargaville 504600 X
Kaipara Coastal 504501 X
Kaiwaka 504900 X
Mangawhai 505021 X
Mangawhai Heads 505022 X
Maungaru 504502 X
Maungaturoto 504700 X
Rehia-Oneriri 505010 X
Ruawai 504800 X
Te Kopuru 504400 X
Whangarei District Abbey Caves 502004 X
Bream Head 501805 X
Hikurangi 504300 X
Marsden Point-Ruakaka 501806 X
Maungatapere 501810 X
Ngunguru 501807 X
Onerahi 504100 X
Opouteke-Tanekaha 501802 X
Otaika-Portland 502005 X
Punaruku-Kiripaka 501814 X
Sherwood Rise 504000 X
Springs Flat 502001 X
Te Hihi 502003 X
Three Mile Bush 502002 X
Waiotira-Springfield 501811 X
Waipu 501812 X
Wharekohe-Oakleigh 501809 X
Otago DHB Central Otago District Alexandra 608500 X
Clyde 608303 X
Cromwell 608600 X
Dunstan 608302 X
Maniototo 608000 X
Naseby 608100 X
Ranfurly 607900 X
Roxburgh 607800 X
Teviot 607501 X
Clutha District Balclutha 607400 X
Benhar 606500 X
Bruce 606700 X
Clinton 607000 X
Clutha 607300 X
Kaitangata 606900 X
Kaka Point 607100 X
Lawrence 607700 X
Milton 606800 X
Owaka 607200 X
Stirling 606600 X
Tapanui 607600 X
Tuapeka 607502 X
Dunedin City Aramoana 601500 X
Brighton 602000 X
Broad Bay-Portobello 604830 X
Bush Road 606300 X
East Taieri 606220 X
Evansdale 601603 X
Hyde 601302 X
Kaikorai Lagoon 602422 X
Karitane 601604 X
Macandrew Bay 604822 X
Middlemarch 602300 X
Momona 602500 X
Mosgiel East 606100 X
Mosgiel South 606210 X
Outram 602200 X
Port Chalmers 605200 X
Raynbirds Bay 604821 X
Sandymount 604902 X
Sawyers Bay 605100 X
Silverpeaks 602600 X
Taiaroa-Cape Saunders 604901 X
Waikouaiti 601400 X
Waitati 601602 X
Waldronville 602100 X
Warrington 601605 X
Wingatui 602412 X
Wyllies Crossing 602411 X
Queenstown-Lakes District Hawea 608304 X
Matukituki 609029 X
Wanaka 608800 X
Waitaki District Ardgowan 600812 X
Aviemore 600831 X
Cape Wanbrow 600813 X
Duntroon 600822 X
Hampden 600840 X
Kakanui 600828 X
Kurow 600824 X
Maheno 600826 X
Nenthorn 601700 X
Oamaru Central 601030 X
Oamaru North 601010 X
Oamaru South 601040 X
Omarama 600827 X
Orana Park 601020 X
Otematata 600830 X
Palmerston 601200 X
Pukeuri 600811 X
Waihemo 601301 X
Weston 600600 X
Southland DHB Gore District Central Gore 610230 X
Charlton 610010 X
Chatton 610032 X
East Gore 610220 X
Kaiwera 610033 X
Mataura 610400 X
North Gore 610210 X
South Gore 610250 X
West Gore 610240 X
Invercargill City Bluff 612100 X
Dog Island 626500 X
Greenhills 610074 X
Myross Bush 610062 X
Oreti Beach 610052 X
Tiwai Point 610075 X
Queenstown-Lakes District Arrowtown 609200 X
Earnslaw 609302 X
Frankton 608700 X
Glenorchy 609012 X
Kelvin Heights 609022 X
Lake Hayes 609028 X
Queenstown Bay 609301 X
Skippers 609026 X
Sunshine Bay 609023 X
Southland District Balfour Community 609400 X
Centre Island 626700 X
Dacre 610061 X
Edendale Community 609700 X
Fairfax 612740 X
Fiordland 612901 X
Hokonui 610040 X
Kaweku 610031 X
Lumsden Community 609600 X
Makarewa North 609911 X
Manapouri 612712 X
Mararoa River 612714 X
Milford 609011 X
Mossburn 612713 X
Nightcaps 612200 X
Ohai 612300 X
Otautau 612600 X
Riversdale Community 609500 X
Riverton East 612801 X
Riverton West 612802 X
Stewart Island 613000 X
Te Anau 612400 X
Te Waewae 612730 X
Toetoes 610080 X
Tuatapere 612500 X
Waianiwa 610051 X
Waikaia 610020 X
Wairio 612720 X
Waituna 610072 X
Wallacetown 610090 X
Winton 610500 X
Woodlands 610073 X
Wyndham 609800 X
South Canterbury DHB Mackenzie District Fairlie 600200 X
Lake Tekapo 600320 X
Mackenzie 600323 X
Mt Cook 600312 X
Twizel Community 600100 X
Timaru District Ben Mcleod 598311 X
Fairview-Scarborough 598201 X
Fraser Park 599400 X
Geraldine 598500 X
Gleniti 599300 X
Glenwood 599200 X
Highfield 599100 X
Levels 598313 X
Maori Park 599000 X
Marchwiel 598900 X
Orari 598312 X
Otipua Creek-Washdyke Flat 598202 X
Pareora 598314 X
Parkside 599700 X
Pleasant Point 598320 X
Redruth 599900 X
Seaview 599500 X
Temuka 598600 X
Timaru Gardens 599800 X
Waimataitai 598800 X
Washdyke 598700 X
Watlington 599600 X
Winchester 598000 X
Waimate District St Andrews 600420 X
Waihao 600410 X
Waimate 600500 X
Tairawhiti DHB Gisborne District East Cape 543301 X
Makaraka 543901 X
Manutuke 544003 X
Matokitoki 543902 X
Patutahi 543800 X
Ruatoria 543302 X
Tarndale-Rakauroa 543601 X
Te Karaka 543602 X
Tiniroto 544002 X
Tokomaru Bay 543303 X
Tolaga Bay 544004 X
Wainui 543903 X
Wharekaka 544001 X
Taranaki DHB New Plymouth District Bowden 551013 X
Egmont Village 552701 X
Inglewood 552800 X
Kaimata 552702 X
Kaitake 551112 X
Lepperton 551111 X
Mangaoraka 551014 X
Oakura 550800 X
Okato 551120 X
Okoki-Okau 550700 X
Omata 551030 X
Urenui 550600 X
Waitara East 551302 X
Waitara West 551301 X
South Taranaki District Eltham 553601 X
Hawera North 554010 X
Hawera South 554020 X
Hawera West 554115 X
Kahui 553302 X
Kaponga 553400 X
Kapuni 553700 X
Makakaho 554500 X
Manaia 553800 X
Mangatoki-Moeroa 553500 X
Normanby 553900 X
Ohangai 554120 X
Ohawe Beach 554111 X
Okaiawa 554130 X
Opunake 553200 X
Patea 554700 X
Rahotu 553301 X
Tawhiti 554113 X
Waingongoro 554114 X
Waitotara 554300 X
Waverley 554800 X
Whenuakura 554400 X
Stratford District Douglas 553002 X
Midhirst 552900 X
Pembroke 553004 X
Stratford East 553102 X
Stratford West 553101 X
Toko 553003 X
Whangamomona 553001 X
Waikato DHB Hauraki District Hauraki Plains 533901 X
Kerepehi 533903 X
Ngatea 533800 X
Ohinemuri 534200 X
Paeroa 534300 X
Turua 533902 X
Waihi 534400 X
Matamata-Piako District Hinuera 535242 X
Matamata 535500 X
Morrinsville East 534902 X
Morrinsville West 534901 X
Okauia 535220 X
Springdale 534603 X
Tahuroa 534500 X
Te Aroha 534800 X
Te Poi 535231 X
Waharoa 535000 X
Waihou-Walton 534604 X
Waitoa 534602 X
Otorohanga District Kawhia Community 531100 X
Otorohanga 531200 X
Otorohanga Rural East 531304 X
Otorohanga Rural West 531301 X
Te Kawa 531303 X
Ruapehu District Manunui 532904 X
National Park 532602 X
Ngapuke 532501 X
Ohura 532400 X
Otangiwai-Heao 532700 X
Owhango 532300 X
Raurimu 532601 X
Sunshine-Hospital Hill 532903 X
Tarrangower 532901 X
Taumarunui Central 532902 X
South Waikato District Amisfield 535380 X
Aotea 535360 X
Arapuni 535250 X
Kinleith 535212 X
Lichfield 535261 X
Mangakaretu 535211 X
Matarawa 535330 X
Paraonui 535310 X
Parkdale 535320 X
Putaruru 535600 X
Stanley Park 535340 X
Strathmore 535370 X
Tapapa 535232 X
Tirau 535100 X
Tokoroa Central 535350 X
Wawa 535262 X
Thames-Coromandel District Coromandel 533100 X
Hikuai 533603 X
Islands-Thames-Coromandel District 619302 X
Moanataiari 533501 X
Parawai 533502 X
Pauanui Beach 533602 X
Tairua 533400 X
Te Puru-Thornton Bay 533604 X
Te Rerenga 533200 X
Whangamata 533300 X
Whitianga 533000 X
Waikato District Eureka 527121 X
Gordonton 527122 X
Huntly East 527402 X
Huntly West 527401 X
Kainui 527123 X
Maramarua 527221 X
Meremere 527222 X
Ngaruawahia 528200 X
Raglan 526500 X
Rotowaro 526400 X
Tamahere-Tauwhare 527131 X
Taupiri Community 527112 X
Te Akau 526702 X
Te Kauwhata 526900 X
Te Kowhai 527912 X
Te Uku 526602 X
Waerenga 527210 X
Waikato Western Hills 526601 X
Whatawhata 527913 X
Whitikahu 527111 X
Waipa District Allen Road 527937 X
Cambridge Central 527503 X
Cambridge North 527501 X
Cambridge West 527502 X
Hautapu 527132 X
Kaipaki 527932 X
Karapiro 535241 X
Kihikihi 527700 X
Kihikihi Flat 527936 X
Lake Ngaroto 527924 X
Leamington East 527505 X
Leamington West 527504 X
Ngahinapouri 527914 X
Ohaupo 527600 X
Pirongia 527922 X
Pokuru 527923 X
Pukerimu 527931 X
Rotongata 528000 X
Rotoorangi 527934 X
Te Awamutu Central 531002 X
Te Awamutu East 531003 X
Te Awamutu South 531004 X
Te Awamutu West 531001 X
Te Pahu 526603 X
Te Rahu 527935 X
Te Rore 527921 X
Tokanui 527925 X
Waitomo District Mahoenui 531710 X
Marokopa 531720 X
Mokauiti 531800 X
Piopio 531500 X
Taharoa 531600 X
Te Kuiti 532000 X
Te Motu Island 618300 X
Tiroa 531732 X
Waipa Valley 531731 X
Wairarapa DHB Carterton District Carterton 579700 X
Mt Holdsworth 579501 X
Te Wharau 579502 X
Waingawa 579400 X
Masterton District Homebush-Te Ore Ore 578301 X
Kopuaranga 578401 X
Lansdowne 579200 X
Masterton Central 578600 X
Masterton East 578800 X
Masterton Railway 579100 X
Masterton West 578700 X
Ngaumutawa 579000 X
Opaki-Fernridge 578302 X
Solway North 578901 X
Solway South 578902 X
Whareama 578402 X
South Wairarapa District Featherston 580000 X
Greytown 579900 X
Kahutara 579803 X
Martinborough 580100 X
Tuturumuri 579802 X
Waitemata DHB North Shore City Paremoremo East 509000 X
Rodney District Algies Bay-Mahurangi 506632 X
Cape Rodney 506615 X
Dairy Flat-Redvale 506300 X
Hatfields Beach 505804 X
Helensville 506800 X
Kaukapakapa 506643 X
Kawau 506620 X
Kumeu 505600 X
Leigh 505400 X
Manly 505902 X
Matheson Bay 506616 X
Muriwai Beach 506651 X
Orewa 505805 X
Parakai 506641 X
Paremoremo West 506400 X
Red Beach 505802 X
Rewiti 506652 X
Riverhead 506653 X
Silverdale North 506200 X
Silverdale South 506000 X
Snells Beach 506631 X
South Head 506642 X
Stanmore Bay 505901 X
Tahekeroa 506614 X
Tauhoa-Puhoi 506613 X
Taupaki 513701 X
Waipareira West 505700 X
Waiwera 505803 X
Warkworth 505500 X
Wellsford 505300 X
Waitakere City Armour Bay 512802 X
Karekare 513800 X
Laingholm 512801 X
Opanuku 513020 X
Otimai 512902 X
Swanson 513100 X
Waitakere 513702 X
West Coast DHB Buller District Buller Coalfields 584409 X
Charleston 584411 X
Granity 584404 X
Hector-Ngakawau 584403 X
Inangahua Junction 584412 X
Inangahua Valley 584701 X
Karamea 584402 X
Little Wanganui 584407 X
Maruia 584703 X
Mawheraiti 584702 X
Mokihinui 584408 X
Orowaiti 584405 X
Reefton 584600 X
Westport Rural 584410 X
Westport Urban 584500 X
Grey District Ahaura 584938 X
Arnold Valley 584936 X
Atarau 584933 X
Barrytown 584931 X
Blackball 584922 X
Blaketown 585120 X
Coal Creek 584932 X
Cobden 585110 X
Dobson 584930 X
Greymouth Central 585130 X
Greymouth Rural 584934 X
Greymouth South 585140 X
Haupiri 584940 X
Kaiata 584911 X
Karoro 584800 X
Lake Brunner 584939 X
Marsden-Hohonu 584935 X
Nelson Creek-Ngahere 584937 X
Point Elizabeth 584923 X
Runanga-Rapahoe 585000 X
South Beach-Camerons 584912 X
Westland District Bruce Bay-Paringa 585324 X
Fox Glacier 585313 X
Franz Josef 585312 X
Haast 585325 X
Harihari 585311 X
Hokitika Rural 585317 X
Hokitika Urban 585400 X
Hokitika Valley 585318 X
Kaniere 585307 X
Karangarua 585323 X
Kumara 585306 X
Otira 585315 X
Ross 585309 X
Taramakau 585314 X
Totara River 585319 X
Waiho 585322 X
Waimea-Arahura 585316 X
Waitaha 585320 X
Whataroa 585321 X
Whanganui DHB Rangitikei District Bulls 558900 X
Hunterville 558700 X
Koitiata 559240 X
Lake Alice 559230 X
Mangaweka 558600 X
Marton 559500 X
Moawhango 559210 X
Ngamatea 559000 X
Pohonui-Porewa 559220 X
Ratana Community 558800 X
Taihape 559400 X
Ruapehu District Ohakune 555000 X
Raetihi 555100 X
Tangiwai 554900 X
Waiouru 558500 X
Wanganui District Blueskin 555300 X
Castlecliff North 555700 X
Castlecliff South 555800 X
Fordell-Kakatahi 558300 X
Marybank-Gordon Park 558200 X
Maxwell 555400 X
Schedule 3
Access Agreement
AGREEMENT FOR ACCESS TO:(names of maternity facilities and/or birthing units)
Practitioner's full name:
Address:
Contact details:(phone, work phone, pager, cellphone, facsimile, email)
Professional qualifications:
Does the practitioner currently work for any of the maternity facilities or birthing units listed above? Yes / No
The practitioner must attach to this access agreement:
(a) the names and addresses of two referees who can verify the identity of the practitioner;
(b) a copy of their New Zealand practising certificate; and
(c) confirmation of their indemnity protection
The practitioner confirms that all the information provided above is true and correct and agrees to be bound by the terms and conditions of this access agreement.
Practitioner's signature:
Date:
The provider of the maternity facilities and birthing units listed above agrees to be bound by the terms and conditions of this access agreement.
Signed for and on behalf of the provider of the maternity facilities and birthing units listed above:
Provider:
Signature:
Name:
Position:
Date:
The information provided in this access agreement is collected by the maternity facility for the purpose of issuing and maintaining the agreement, and will not be used for any other purpose.
Terms and conditions of access to a maternity facility
or birthing unit
Purpose of this agreement
1 Purpose
(1) The practitioner named above is a practitioner as defined by the Primary Maternity Services Notice 2007 issued pursuant to Section 88 of the New Zealand Public Health and Disability Act 2000 (the "Notice"). The practitioner has requested access to the maternity facilities and/or birthing units listed above (the "facility" or "facilities") for the purpose of providing labour and birth and inpatient postnatal care to the practitioner's maternity clients.
(2) This access agreement provides the practitioner with access to the services of the facilities as specified in the service specifications for Maternity Facility Services and Birthing Unit Services issued by the Ministry of Health, in accordance with the terms and conditions set out in this access agreement.
Obligations of both parties
2 Clinical safety
Primary maternity services will be provided in a clinically safe manner. This means that primary maternity care provided by the practitioner or the facilities must be based on the application of the best available knowledge derived from research and clinical expertise that incorporates the skills and standards of the relevant profession.
3 Cultural safety
Primary maternity services will be provided in a manner that recognises cultural differences and is sensitive to the cultural traditions, protocols and customs of the woman.
4 Maori health outcomes
Primary maternity services are intended to achieve Maori health outcomes and reduce Maori health inequalities by facilitating access to maternity services by Maori, ensuring appropriate pathways through those services and that maternity services address the primary maternity needs of Maori.
5 Referral guidelines
Both parties will take into account the Guidelines for Consultation with Obstetric and Related Specialist Medical Services that identify clinical reasons for consultation with a specialist and that are published by the Ministry of Health from time to time, when providing primary maternity services.
6 Policies and procedures
(1) All relevant administrative policies of the facilities are to be available to the practitioner in those facilities.
(2) All clinical policies and procedures of the facilities regarding the provision of primary maternity services will be developed, reviewed or updated by the facilities through the establishment of a working group. The working group will be established by the provider of the facilities from time to time, and will be comprised of representatives of the facility, representatives of the practitioners who have access agreements in respect of the facility, and the professional organisations of those practitioners. All clinical policies and procedures should be evidence based and consistent with any nationally developed guidelines.
(3) All clinical policies and procedures of the facilities will form the basis of primary maternity care provided in the facilities, and must be available to the practitioner.
7 Relationship between the maternity facility or birthing unit and the practitioner
(1) The relationship between the facilities and the practitioner gives the practitioner access to the facilities upon these terms and conditions, and is not to be construed as one of employment or a contract for service by the practitioner.
(2) Subject to its obligations under the Health and Safety in Employment Act 1992, the facilities shall not inquire into or specify matters relating to the operation or administration of the practitioner's practice.
8 Complaints management
(1) Where a woman makes a complaint about a primary maternity service provided to her in the facilities, the party receiving the complaint will advise the woman of the appropriate avenues for complaint.
(2) If the practitioner and the facilities both have responsibilities in respect of the service complained about then, with the consent of the woman, the party who receives the complaint shall discuss the issue with the other party.
9 Dispute management
(1) If any issue arises between the practitioner and the facilities in relation to the interpretation of, obligations under or compliance by either party to the terms of this access agreement, the practitioner and the facilities shall use their best endeavours to settle the dispute by agreement. The management of any dispute must be by a process that is mutually agreed by both parties.
(2) The relevant professional organisation should be considered as a resource in preventing or managing any dispute.
10 Suspension
(1) The General Manager of the facilities shall have the right and complete discretion to immediately suspend access by the practitioner to the facility in the event of a serious complaint being made of gross misconduct, negligence, or a substantial or repeated breach of this agreement by the practitioner.
(2) Within 48 hours of the suspension, the facilities will provide the practitioner with written reasons for the suspension.
(3) The practitioner and the facilities shall use their best endeavours to manage the suspension by a process that is mutually agreed by both parties. The relevant professional organisation should be considered as a resource in managing the suspension.
Obligations of the practitioner
11 Compliance with Statutes and Regulations
The practitioner undertakes and agrees that all statutory, regulatory, legal, and professional requirements that apply to primary maternity services provided by them are complied with.
12 Qualifications
(1) The practitioner shall at all times be one of the following:
(a) a general practitioner, meaning a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of practice of general practice and holds an annual practicing certificate and a Diploma in Obstetrics (or equivalent, as determined by the New Zealand College of General Practitioners); or
(b) a midwife, meaning a health practitioner who is, or is deemed to be, registered with the Midwifery Council (established by the Health Practitioners Competence Assurance Act 2003) as a practitioner of the profession of midwifery and holds an annual practicing certificate; or
(c) an obstetrician, meaning a health practitioner who is, or is deemed to be, registered with the Medical Council of New Zealand (established by the Health Practitioners Competence Assurance Act 2003) in the vocational scope of obstetrics and gynaecology and holds an annual practicing certificate.
(2) The practitioner will inform the facilities of any change in their practising status or any conditions attached to their annual practising certificate.
13 Professional responsibilities
(1) The practitioner agrees that he or she is fully responsible for his or her own professional practice.
(2) The practitioner will explain to the woman the relationship between the practitioner and the facility.
14 Clinical competencies
(1) The practitioner is responsible for having the appropriate clinical competencies if the practitioner provides a woman with any one of the procedures listed below during labour and birth in consultation with a specialist:
(a) management of women with epidurals;
(b) management of women requiring induction and augmentation;
(c) management of women requiring instrumental vaginal deliveries;
(d) interpretation of CTGs.
(2) The practitioner must inform the facilities whether they have the appropriate clinical competencies to provide women in their care with any of the procedures listed in subclause (1) above.
15 Participation in protected quality assurance activities
(1) The practitioner will participate in quality assurance activities declared by the Ministry of Health to be protected quality assurance activities under section 54 of the Health Practitioners Competence Assurance Act 2003 that are relevant to the provision of primary maternity services in the facilities, including perinatal mortality review meetings where such meetings are protected quality assurance activities.
(2) A list of all the protected quality assurance activities that are relevant to that facility must be available to the practitioner in the facility.
16 Indemnity Protection
The practitioner shall maintain appropriate professional indemnity protection at all times during the term of this agreement.
17 Students
The practitioner shall be responsible for any student accompanying the practitioner in conjunction with a School of Midwifery or a School of Medicine.
18 Availability
(1) The practitioner, or a back-up Lead Maternity Carer, will be available 24 hours a day, 7 days a week to provide community or hospital based assessment for urgent problems, other than acute emergencies, in accordance with clause DA6(2) of the Notice.
(2) The practitioner must ensure that the back-up Lead Maternity Carer has a current access agreement with the facilities.
19 Administrative Requirements
The practitioner will meet any reasonable administrative requirements of the facilities to the extent necessary to enable the facilities to run an efficient and co-ordinated service.
20 Contact Details
The practitioner shall notify the facilities of any changes in their contact details.
Obligations of the facility
21 Health and Safety
The facilities will comply with their obligations under the Health and Safety in Employment Act 1992, including taking all practicable steps to ensure that no hazard in or arising in the facilities harms a practitioner working on the premises, and warning practitioners of significant hazards in the facilities that would not normally be expected to arise in that type of place or work.
22 Orientation
The facility shall provide the practitioner with an orientation to its facility at a time mutually agreeable to both parties.
23 Education forums
Where a practitioner provides care that includes any one of the procedures listed below (and in clause 14 of this access agreement), where the facilities provides access to educational courses or forums to its employees, the facilities will make available to the practitioner these updates and refresher courses;
(a) management of women with epidurals;
(b) management of women requiring induction and augmentation;
(c) management of women requiring instrumental vaginal deliveries; or
(d) interpretation of CTGs.
24 Administrative requirements
The facility shall facilitate the practitioner's compliance with any administrative requirements.
25 Availability of facilities
The facility shall ensure that reasonable notice is given prior to any reduction or cessation of the facility's services.
Other terms and conditions
26 Entire agreement
These terms and conditions form the entire agreement between the Maternity Facility and the Practitioner.
27 Term
(1) This agreement is continuous, subject to an annual sighting of the practitioner's annual practising certificate and indemnity protection.
(2) The practitioner may terminate this access agreement by giving written notice to the facilities.