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Advice to obstetricians and gynaecologists, GP obstetricians

14 March 2020

Dear Colleagues,

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) acknowledges the risk posed to the community, health workers, all patients and pregnant patients, in particular, due to the COVID-19 pandemic. The RANZCOG Board, President and CEO want to ensure that we maintain open lines of communication with our members, staff, clinicians in obstetrics and gynaecology and your patients. We understand that this situation will potentially impact you professionally, emotionally and financially.
 
RANZCOG needs to respond to this situation as a large organisation and also as a medical college and health leader. Our health system cannot afford to have a significant proportion of our workforce infected, unwell or isolated, or transmitting disease to patients. That is why every hospital has cancelled meetings, travel has been curtailed, large conferences cancelled or postponed. RANZCOG’s response has been proactive but also aligns with that taken by other Colleges and medical institutions. The risk to the community is too great to take chances and, as this situation is unprecedented, there are no guidelines.
 
The College recognises the role of government, health departments and health administrators in coordinating a national response. In addition to all sensible hygiene precautions, we would like to bring to your attention some of the following considerations:

Public and private hospital rostering
 
  • Consider cancelling all elective surgery and consultations.
  • Consider reducing “active” staff and, where possible, create “teams” so that if one team is incapacitated due to illness or isolation, another “well” team can step in. This approach should apply to medical, nursing, midwifery and ancillary staff. Logically, think in terms of a two week rotation.
  • Screening through targeted questions and temperature measurement. Social distancing between patients and staff.
  • Reduce, postpone and/or increase the interval between antenatal visits. Limit routine antenatal visits to less than 15 minutes. Consider telehealth consultations, either as a replacement, or in addition, to routine visits. Close access to hospitals and maternity units to visitors (excluding partners). Consider early discharge from hospital.
  • Contact all retired staff and those on leave as potential back-up workforce. Prepare and disseminate a disaster management plan in case of sudden escalation.
NB: All Cat 1 obstetric and gynaecological cases, e.g. emergency gynaecology and gynaecological oncology services will, by necessity, need to continue and may need additional support.

Private Practitioners
 
The same principles apply. Additionally, consider:
 
  • Developing a private rostering system for attendance of births, antenatal and postnatal visits.
  • Develop an emergency locum plan in case of illness or isolation.
  • The Federal Government has introduced the option of telehealth consultation (refer: MBS Online)

Trainees
 
All medical staff owe a duty of care to our patients. That said, the College acknowledges that all trainees will be concerned about the impact of this crisis on their personal health, their families and their training requirements.
 
The Board has appointed a task force to review all training requirements, including, but not limited to, time in training, compulsory workshops and assessments, examinations and surgical numbers and we will communicate our detailed outline over the next week. Trainees should be reassured that the impact of COVID-19 will be considered “exceptional circumstances” and no trainee will be unfairly disadvantaged or penalised as a result of illness, isolation, cancellation of services or rostering requirements.
 
The College is also aware that this unprecedented crisis may lead to requests by jurisdictions for doctors to work longer hours, staff other areas of the health and the hospital system, and to perform duties not usually within their current job description. We encourage you to work cooperatively with administrators and officials, within reasonable limits.

Trainees experiencing specific difficulties should contact the Member Support and Wellbeing Team at the College, Carly Moorfield, Senior Coordinator, Trainee Liaison via [email protected] and Clare Wells, Wellbeing Coordinator via [email protected]
 
If you would like to speak to someone outside the College for support, please visit Converge International (specialists in psychology, mental health and wellbeing) on 1300 687 327 (Australia), 0800 666 367 (New Zealand) or from other countries on +613 8620 5300.
 
The RANZCOG Board, President and CEO are in contact every day and meeting, via teleconference, as required, every few days. We encourage you to forward any enquiries to [email protected] or [email protected]

Dr Vijay Roach                             Ms Vase Jovanoska    
President                                     CEO                  



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The Royal Australian and New Zealand College of Obstetricians and Gynaecologists


+61 3 9417 1699
+61 3 9419 0672
[email protected]

College House, 254-260 Albert Street East Melbourne, Victoria 3002, Australia.

RANZCOG acknowledges and pays respect to the Traditional Custodians of the lands, waters and communities across Australia, on which our members live and work, and to their Elders, past, present and future. RANZCOG recognises the special status of Māori as tangata whenua in Aotearoa New Zealand and is committed to meeting its obligations as Te Tiriti o Waitangi partners.