Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study
The Lancet 1 November 2021 DOI:https://doi.org/10.1016/S0140-6736(21)01595-6

• Analysis of data compiled by the National Maternity and Perinatal Audit (women with a singleton birth between 1 April 2015 and 31 March 2017) indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with fetal growth restriction in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile.

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study.
Lancet 1 November 2021

• This research quantifies the magnitude of socioeconomic and ethnic inequalities for adverse pregnancy outcomes at the population level in England. Using data from the National Maternity and Perinatal Audit. Results indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with FGR in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile

The Safety of Maternity Services in England

The safety of maternity services in England
Health and Social Care Committee 6 July 2021

• This report finds that improvements in the safety of maternity services have been too slow. It recommends urgent action to address staffing shortfalls in maternity services, with staffing numbers identified as the first and foremost essential building block in providing safe care. 
• An accompanying report the Committee commissioned from an expert panel to evaluate government progress on delivering four commitments on maternity services concludes that the government’s overall progress to achieve key commitments in maternity services ‘requires improvement’.

National Maternity and Perinatal Audit – NHS Maternity care for women with a Body Mass Index (BMI) of 30 or above

National Maternity and Perinatal Audit – NHS Maternity care for women with a Body Mass Index (BMI) of 30 or above
HQIP 13 May 2021

• This audit (April 21015 – March 2017) found that women with BMI of 30 or above have a higher risk of complications antenatally, intrapartum and postnatally than women with a BMI in the healthy range. Nevertheless, approximately one-third of these women have a pregnancy and birth without complication.

How to specify healthcare process improvements collaboratively using rapid, remote consensus-building

How to specify healthcare process improvements collaboratively using rapid, remote consensus-building: a framework and a case study of its application. 

BMC Med Res Methodol 21, 103 (2021). https://doi.org/10.1186/s12874-021-01288-9

• Researchers have developed an approach for engaging diverse stakeholders remotely in a consensus-building exercise to help specify improvements in a healthcare process. Using Thiscovery (https://www.thiscovery.org/about), an online research and development platform created and developed by THIS Institute at the University of Cambridge, they tested the approach in a case study that sought to specify process improvements for the management of obstetric emergencies during the COVID-19 pandemic.
• Read the THIS Institute blog 

National response to the First Ockenden Report

National Response to the First Ockenden Report
NHS England / NHS Improvement board paper 25 March 2021

• A description of the work in place since publication of the Ockenden report (11 December 2020) and the 7 “Immediate and Essential Actions” (IEAs) to improve care and safety in all maternity services.
• Progress is described in Annex A
• Line of sight from trust level response to the Ockenden Report is described in Annex B

Investigation into delays to intrapartum intervention once fetal compromise is suspected

Investigation into delays to intrapartum intervention once fetal compromise is suspected
Healthcare Safety Investigation Board 12 November 2020

• This review aimed to identify improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell. It was compiled after a review of 289 maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9 per cent of cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays.

Risk of complicated birth at term in nulliparous and multiparous women using routinely collected maternity data in England: cohort study

Risk of complicated birth at term in nulliparous and multiparous women using routinely collected maternity data in England: cohort study
BMJ 2020; 371:m3377 doi: https://doi.org/10.1136/bmj.m3377 (Published 01 October 2020)

• AIM: To determine the rate of complicated birth at term in women classified at low risk according to the NICE guideline for intrapartum care (no pre-existing medical conditions, important obstetric history, or complications during pregnancy) and to assess if the risk classification can be improved by considering parity and the number of risk factors.

Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation

Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation
BMJ Quality & Safety 25 September 2020. doi: 10.1136/bmjqs-2020-010988

• Following a multisite ethnography with staff across six maternity units and stakeholders [Cambridge, UK] the researchers identified seven features of safety in maternity units and summarised them into a framework, named For Us (For Unit Safety).

Babies in lockdown: listening to parents to build back better

Babies in lockdown: listening to parents to build back better

Best Beginnings 5 August 2020

• This report from Best Beginnings, together with Home-Start UK and the Parent-Infant Foundation, reveals the disproportionate impact of Covid-19 and subsequent measures on those pregnant, giving birth or at home with a baby or toddler. For generations, no other group of parents has had to navigate pregnancy, birth and beyond under such extraordinary circumstances. "The ramifications of the lockdown have been detrimental, and could cast a long shadow going forward for parents and babies alike."

Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review

Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review.
Health Serv Deliv Res 2020;8(14) March 2020

• A review of the available evidence suggests that the experiences of immigrant women in accessing and using maternity care services in the UK are mixed; however, women largely had poor experiences. 
• Contributing factors included a lack of language support, cultural insensitivity, discrimination and poor relationships between immigrant women and HCPs. Furthermore, a lack of knowledge of legal entitlements and guidelines on the provision of welfare support and maternity care to immigrants compounds this.

CQC Maternity services survey 2019

Maternity services survey 2019
CQC 28 January 2020

• Report of a survey which looked at the experiences of women receiving maternity services. (17,151 participants, response rate 36.5%). Includes results by NHS trust and an outliers report.

Maternity Digital Maturity Assessment

Maternity DMA Report – Digital Maturity Assessment of Maternity Services in England 2018
NHS England 13 November 2018

• The Digital Maturity Assessment (DMA) is a complete picture of the digital maternity landscape across England – a baseline for improvement at both a national and local level.
• It provides a baseline to help evidence the current state of digital maturity across England and to ensure that the required level of leadership, infrastructure and capabilities exist to enable the Better Births recommendations around digital technologies to be delivered.
• Chapters / Sections include:
• National analysis p17
• Data driven improvements in maternity services p59
• Business cases and business change: maternity digital hardware p65 
• Remote and assistive care (provider's use of remote, mobile and assistive technologies to support the provision of care.) p142
• Maternity Voices Partnership (including service user engagement) p32
• Social media in maternity services p189
• NHS Apps library p169

Effective co-production through local Maternity Voices Partnerships: A resource for commissioners

Effective co-production through local Maternity Voices Partnerships: A resource for commissioners
London Clinical Networks 13 June 2018

• This document brings together a range of information and resources and is designed to support commissioners to fulfil their statutory obligations to secure meaningful patient and public involvement in commissioning maternity services and to respond to the recommendations of the National Maternity Review report, Better Births.