Antenatal Shared Care Services

Project Officer: Karen Wheeler

Main: 9799 0933

For RPA Women and Babies and The Canterbury Hospital ANSC program enquiries, contact Karen Wheeler

GP Liaison Midwife: Clare Jordan
Phone: 0425 230 662  
Hours:  Mon-Thurs : 7.30-5.30pm For urgent clinical enquiries, page O&G Registrar at RPA or TCH.

The GP Liaison Midwife assists with the co-ordination of the ANSC program by:
• Conducting ANSC orientation sessions for new GPs joining the program
• Supports GPs in accessing maternity hospital services and answering telephone enquires
• Provides the interface for feedback and improved communication between the hospital and GPs
• Liaises with CSGPN to ensure policies, procedures and clinical practice guidelines ratified by the Maternity Services Advisory Committee are distributed to ANSC GPs
• Assists CSGPN in the co-ordination of the CPD education program and by maintaining the ANSC data entry of GPs.

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Quick link reference list
Orientation to ANSC Program
Hospital Referral Postcodes
Hospital Booking Process
Hospital Clinics and Services
Preconception Planning
ANSC Protocol
Group B Streptococcus
Genetic Counselling
Pregnancy Assessment
Risk Management
Postpartum Assessment and Management
Referral Forms
Patient Information
Online education
Translated Information
Useful Website Links

For copies of the ANSC GP Resource Manual v6 (2011), please contact Karen Wheeler on 9799 0933

Program overview

Antenatal Shared Care (ANSC) is an option of care provided collaboratively by the GP and the hospital-based maternity services. It is offered to all pregnant women assessed as suitable throughout the Sydney Local Health District (SLHD).
The program aims to:

• provide pregnant women with flexibility, choice and continuity of care
• caters for the preferences and needs of women from culturally and diverse backgrounds
• enhances the skills of GPs caring for women during pregnancy
• promote communication between GPs and the participating hospitals

The ANSC program is a joint initiative of:

• Sydney Local Health District (SLHD) maternity facilities located at Royal Prince Alfred (RPA) Women and Babies and The Canterbury Hospital
• Central Sydney GP Network (CSGPN)

The program is offered at other maternity facilites across Sydney. For further information regarding the program, contact the local hospital or GP Network in your particular area.

Orientation to the Antenatal Shared Care Program

• Becoming an ANSC Recognised GP
• Maintaining Recognition as an ANSC GP provider
• ANSC Program Requirements Overview
• Sydney Local Health District (SLHD) ANSC Program: Application Form (2011)

Hospital Referral Postcodes

There is a restricted access by residential postcode for women with low risk pregnancy to book for delivery at RPA Women and Babies and The Canterbury Hospitals. The postcode access areas for each facility are listed below:

• Canterbury Hospital Maternity Unit Postcode referral
• RPA Women and Babies Postcode referral

Women requiring complex or specialised care who live outside the suburbs covered by RPA Antenatal Clinic may be referred to RPA by their doctor. A letter of request is to be sent to the Director of O&G at RPA Women and Babies.

RPA Women and Babies Booking Process

RPA First Antenatal Clinic Visit
A woman is required to book either on-line or by fax ( 9515 3454) after completing the First Antenatal Visit Booking Form.The form can also be accessed via the RPA Women and Babies website under the tab “Information for Pregnant Women”.

Access to Medical Director and Best Practice templates of the RPA Women and Babies First Antenatal Visit Booking Form

Antenatal Clinic Booking Follow up
Hospital staff will contact the woman via mail ( ~2 weeks) with further information and an appointment date.

Delivery Booking Process
All women need to book their bed for delivery after 20 weeks gestation (usually soon after the obstetric review visit). The woman will need to take her yellow card and registration form to the RPA Medical Centre Suite 210, Level 2, cnr Carillon Ave and Missenden Rd.

The Booking Office is open from 7.30am till 5.00pm Monday - Friday

Canterbury Hospital Maternity Booking Process

For appointment bookings contact the Antenatal Clinic ph 9787 0250 ( Mon-Fri 9.00am - 4.30pm)

• Canterbury Hospital Maternity Referral Form (Feb 2011)

Hospital Clinics and Services

RPA Women and Babies

• Key Phone Contacts: RPA Women and Babies, The Canterbury Hospital (July 2011)
• RPA Women and Babies Hospital Clinics and Services - includes High Risk Clinics and referral criteria (May 2011)
• Referral Flowchart- RPAH Medical Obstetric Clinic (June 2011)
• Referral Flowchart- RPAH Hypertensive Disorders of Pregnancy (June 2011)
• Referral Fowchart- RPAH Young parents (June 2011)
• Referral Flowchart - RPAH O&G Ultrasound Department (July 2011)

Fetal Medicine Department RPA Women and Babies
The Fetal Medicine Department has introduced a paging system to assist GPs in contacting the Fetal Medicine Department for urgent matters.

Contact RPA Hospital on ph 9515 6111 Pager # 81668

The paging system is to be used to access urgent ultrasound bookings, urgent ultrasound reports, second opinions or if advice is required from a Fetal Medicine Specialist. The service will operate between Monday and Friday from 7.00am-3.30pm. If the pager is not answered please contact the Department on 9515 6042.

Gynaecology Referral RPA Women and Babies
The RPA Women and Babies Gynaecology Referral Form is required for referral to all Specialist Women’s Clinics. Appointment requests are by fax only ( 9515 3454). It is mandatory that a telephone contact is available so the woman can be contacted for an appointment time and date. The staff will make two(2) attempts only to contact the woman and she can be expected to be contacted within three (3) business days of the hospital receiving the completed information.

The Canterbury Hospital

• The Canterbury Hospital Antenatal Clinics Service Profile (April 2011)
• The Canterbury Hospital :Options of Care

Preconception Planning

• Preconception checklist
• Preconception planning for women with pre-existing Diabetes :Type 1 or 2 (July 2011)

Antenatal Shared Care Protocol

• Sydney Local Health District (SLHD) ANSC Protocol (July 2011)
• Guide to protocol use
• RPA Women and Babies Birth Centre Protocol (Sept 2010)

Group B Streptococcus (GBS) Information

• In October 2010, RPA Women and Babies changed the timing of the vaginal GBS screen from 28 weeks to 36 weeks according to RANZCOG guidelines. This is a vaginal/anal swab. This is reflected in the Sydney Local Health District (SLHD) ANSC Protocol (July 2011)
• RANZCOG guidelines for Screening and Treatment for GBS in Pregnancy (as per RANZCOG website 2011)
• Swab collection for GBS :Diagram illustrating the procedure for genital swab collection (as per RANZCOG website 2011)
• GBS and Pregnancy - Patient Information (Oct 2010)
To ensure that GBS results are available at following hospital visit, please note the Pathology Provider on the woman’s Antenatal “yellow card” Record

Genetics Counselling
The Fetal Medicine Unit at RPA Women and Babies offers Nuchal Translucency Screening with biochemistry to all pregnant women booking at RPA and Canterbury Hospitals. Shared care GPs who have attended the introductory information session through the Central Sydney GP Network on “options of prenatal screening/testing” can refer women directly to the Fetal Medicine Unit at RPA Women and Babies on 9515 6042 or 9515 8258.

GPs who have not attended this session have the option of referring women to the genetic counselling clinics at RPA Hospital on 9515 7101 and Canterbury Hospital on 9787 0183.

This resource booklet is used by Sydney Local Health District (SLHD) Genetic Services when discussing options for prenatal screening and testing. Copies of the ” Prenatal Testing” booklet are available from CSGPN. Additional information on a range of genetic matters can be accessed from The Centre for Genetics Education and the National Health and Medical Research Council - NHMRC.

Translated material regarding genetics, prenatal testing and pregnancy can be located at the NSW Health: Multicultural Health Communication Service

Pregnancy Assessment

• RPAH Emergency Dept : Hyperemesis: Clinical Practice Reference (2010)
• RPAH Emergency Dept : Nausea and Vomiting in Pregnancy Reference (2010)
• Guide to monitoring fetal movements
• Ministry of Health NSW : Decreased fetal movements in the third trimester : Guidelines (Oct 2011)
• Referral Flowchart - RPAH O&G Ultrasound Department (July 2011)
• Referral Flowchart - Thalassaemia screening
• Screening for Anaemia and Iron Deficiency
• Referral Flowchart - Antenatal Thyroid Clinic (May 2011)

Early Pregnancy Assessment Service

• EPAS Overview (2010)
• Referral flowchart – EPAS (Oct 2011)
• RPA Women and Babies Early Pregnancy Assessment Service (EPAS) Patient Brochure
• Guidelines for Medical Management of Miscarriage (Feb 2011)
• Patient Information: Options for Management of Miscarriage (Apr 2011)
• Patient Information: Medical Management of Miscarriage (Apr 2011)
• Patient Information: Expectant Management of Miscarriage (Apr 2011)
• Patient Information: Surgical Management of Miscarriage (Apr 2011)

Perinatal Mental Health

• Referral flowchart -Perinatal Mental Health
• Psychosocial Referral Form (June 2011):to ensure referral is received phone PMH 9515 5873 or GP Liaison Midwife 0425 230 662
• Edinburgh Depression Scale - Assessment of Perinatal Depressive Illness
• ATAPS overview – Perinatal Depression Stream
• Perinatal Mental Health Referral Contacts

Risk Management

• Varicella in pregnancy (2011)
• Antenatal Management Guidelines for Hepatitis B (2011)

Gestational Diabetes Management

• Screening and Diagnosis of Gestational Diabetes (July 2011)
• Management of GDM (July 2011)
• Glucose Tolerance Test Instructions and Diet Preparation (July 2011)
• GDM Recipe Website:Dietitian reviewed (July 2011)

Postpartum Assessment and Management

• Six week post-partum check
• SLHD Breastfeeding Guidelines - (Jan 2010)
• Inner West Breastfeeding Groups (Nov 2011)

Gestational Diabetes Postnatal Follow-up

• GDM- postnatal information for GPs (July 2011)

Perinatal Mental Health

• Perinatal Mental Health Referral Contacts
• Edinburgh Depression Scale - Assessment of Perinatal Depressive Illness
• ATAPS overview – Perinatal Depression Stream

Immunisation

Visit CSGPN Immunisation page for further information and news regarding Childhood Immunisation.
• NSW Immunisation Schedule ( Sept 2011)

Referral Forms

• RPA Women and Babies First Antenatal Visit Booking Form
• RPA Women and Babies Gynaecology Referral Form
• RPAH O&G Physiotherapy Referral Form (Oct 2011)
• RPAH Antenatal Thyroid Clinic Referral Form (Sept 2011)
• RPAH Hepatitis C Referral Form (Aug 2011)
• RPAH Hepatitis B referral Form (Sept 2011)
• Psychosocial Referral Form (June 2011) : to ensure referral is received ph PMH 9515 5873 or GP Liaison Midwife 0425 230 662
• Canterbury Hospital Maternity Referral Form (Feb 2011)
• Tresillian Referral Form

Best Practice and Medical Director Forms

• Refer to Templates for Best Practice and Medical Director Forms

EMERGENCY medical help during your pregnancy:

If you are greater than 20 weeks pregnant : RPA Labour Ward 9515 8420; TCH 9787 0000 ask for Birthing Unit

If you are less than 20 weeks pregnant :

- Non- urgent: Your GP for follow-up
- Urgent : RPA Emergency : 9515 6111 or TCH Emergency Dept 9787 0000

Patient Information

• ANSC Patient Information Brochure: colour version (August 2011)
• ANSC Patient Information Brochure : B&W version (August 2011)
• GBS and Pregnancy - Patient Information (2010)
• NSW Health: Napthalene Factsheet
• Baby’s Movement: one way of checking on your baby (August 2011)
• Vitamin D information for pregnant women and new mothers (August 2011)

Parent Education Classes

• RPAH Parent Education Classes (May 2011)
• Canterbury Hospital Parent Education Classes (May 2011)

RPA Women and Babies/The Canterbury Hospital

• RPA Women and Babies: First Antenatal Visit Booking Form
• The Canterbury Hospital : Options of Care
• Canterbury Hospital Maternity Unit Postcode referral
• RPA Women and Babies Postcode referral

Early Pregnancy Assessment Service

• RPA Women and Babies Early Pregnancy Assessment Service (EPAS) Patient Brochure
• Patient Information: Options for Management of Miscarriage (Apr 2011)
• Patient Information: Medical Management of Miscarriage (Apr 2011)
• Patient Information: Expectant Management of Miscarriage (Apr2011)
• Patient Information: Surgical Management of Miscarriage (Apr 2011)

Gestational Diabetes

• Website for Gestational Diabetes Mellitus Recipes:Dietitian reviewed

Postnatal Contacts

• Early Childhood Centres Contacts
• Inner West Breastfeeding Groups (Nov 2011)

Online Education Options

• ‘Beyond babyblues: Detecting and managing perinatal mental health disorders in primary care
• RACGP GP Learning
• Online GPCE Primary Care
• Frontier Health Events
• Think GPed
• Australian Doctor
• Medicine Today

Translated Information

Translated material regarding pregnancy related issues can be located at NSW Health: Multicultural Health Communication Sevice. Information available include Maternity Care Options, Planning a Pregnancy, Caring for a Baby at Home and Depression during Pregnancy and Early Parenthood.

Sydney Local Health District (SLHD) ANSC Protocol
• Arabic (Oct 2011)
• Bengali (Oct 2011)
• Chinese (Oct 2011)
• Khmer (Oct 2011)
• Korean (Oct 2011)
• Vietnamese (Oct 2011)

Preparation for GTT (various languages)

• Vietnamese
• Arabic
• Bengali
• Korean
• Urdu

Vitamin D information for pregnant women and new mothers

• Arabic
• Chinese
• Farsi
• Hindi

Useful Website Links

• RANZCOG:Royal Australian and New Zealand College of Obsetricians and Gynaecologists
• ADIPS:Australian Diabetes in Pregnancy Society
• GDM Recipes:Gestational Diabetes Mellitus Recipes:Dietitian reviewed
• beyondblue: :Information on antenatal and postnatal depression
• Gidget Foundation: Raising awareness of perinatal anxiety and depression
• PANDA: Post and Antenatal Depression Association Inc
• St John of God Hospital: Mental Health Services: Mother and baby unit
• Centre for Genetic Education: NSW Health : Centre for Genetics Education
• Mothersafe: Counselling service regarding medications and/or exposures during pregnancy and breastfeeding
• Sids and Kids: Breavement support, education and advocacy for families who have experienced the unexpected loss of a baby or child
• NSW Multicultural Health: Multicultural Health Communication Service: resources available by topic and language
• ASHM:Comprehensive directory of health services relating to HIV, viral hepatitis and related areas