O71 - Australian maternity service provision: a comparative analysis of state and territory maternity care frameworks

Abstract

A maternity service capability framework provides direction for health services to assess the level of resources required for safe and effective service delivery. The way in which risk is considered, evaluated, and the way in which maternity services are operationalised to manage risk is largely determined by these frameworks. The current national strategy for maternity services, known as ‘the plan’, should be used throughout Australia’s states and territories underpinned by a framework. A scoping review was undertaken to identify and compare publicly accessible Australian state and territory maternity service frameworks. The broad search question used was “how do current Australian state and territory maternity service capability frameworks compare?” A comparative content analysis was undertaken. A total of n=40 documents were sourced, but many were additional clinical policy, guideline documents, or professional body position papers associated with a framework. All states had publicly accessible frameworks, however, the Northern Territory and the Australian Capital Territory did not. Variation exists between standalone maternity service frameworks and comprehensive clinical frameworks. Several jurisdictions align policy and ministerial directives in their frameworks outlining service delivery and guidance relating to maternal and/or neonatal transfer. Language referring to assessment of maternity services and service risk varied. Australian maternity service frameworks showed similarities and differences which were demonstrated in priority areas across jurisdictions. Consistency in structure, language, and a clear communication strategy embedded into each maternity service framework may improve the functioning of Australian maternity services at each level of the healthcare system. This analysis of Australian maternity service frameworks highlights opportunities where jurisdictional governance documents can be strengthened and unified in the absence of an agreed national maternity service framework.