Smoking status at time of delivery guidance

Sub-Integrated Care Boards (sub-ICBs) are mandated to submit data on smoking status at time of delivery (SATOD) at quarterly intervals via the NHS Digital’s Strategic Data Collection (SDCS) system.

Read the supporting guidance on how to submit data through the Strategic Data Collection Service (SDCS).

The quarterly intervals used for submitting this data are based on the financial year. The submission deadlines are for each quarter.

The exact mechanism for collecting and sharing SATOD data is up to local decision makers to agree. However, it is recommended that the requirement for sub-ICBs to collect and share this data is written into all relevant contractual agreements held with the sub-ICB, and that processes at ward level support staff to routinely assess SATOD, and support efficient and accurate data recording. sub-ICBs may also wish to establish quality assurance measures for validating the accuracy of recorded data.

The following data items should be submitted for each quarter in the financial year of the birth registration:

• number of maternities
• number of women known to be smokers at the time of delivery
• number of women known to be non-smokers at the time of delivery
• number of women whose smoking status was not known at the time of delivery

These are defined as follows

• the number of maternities is defined as the number of pregnant women who give birth (during the quarter) to one or more live or stillborn babies of at least 24 weeks gestation, where the baby is delivered by either a midwife or doctor at home or in an NHS hospital (including GP units). This count should be the number of pregnant women, not the number of babies (deliveries), i.e. twins are counted as one maternity. It does not include maternities that occur in psychiatric hospitals or private beds / hospitals.
• women known to be smokers at the time of delivery are defined as pregnant women who self-reported that they were smokers. This includes any cigarettes or tobacco at all, but excludes non-combustible nicotine products, such as e-cigarettes or other nicotine containing products. If a woman intends to give up smoking after the delivery, but was a smoker up until the delivery date they are included in this count.
• women known to be non-smokers at the time of delivery are defined as pregnant women who self-reported that they were non-smokers (no cigarettes or tobacco at all).  This count does not include women whose smoking status is not known (which is collected separately), or those who intend to give up smoking after delivery.
• women whose smoking status was not known at the time of delivery are defined as those whose smoking status was not determined for whatever reason.

This is a sub-ICB return. Sub-ICBs should submit all maternities where the baby is delivered by either a midwife or doctor at home or in an NHS hospital (including GP units). A prospective mother should be assigned to a sub-ICB based on the postcode of their GP.

For the return each sub-ICB is required to submit four figures at the end of each quarter:

• number of maternities
• number of women known to be smokers at the time of delivery
• number of women known to be non-smokers at the time of delivery
• number of women whose smoking status was not known at the time of delivery

All four numbers must be submitted as integers. The following validation will be undertaken by SDCS system on each quarter’s submission:

Number of women known to be smokers at the time of delivery +

Number of women known to be non-smokers at the time of delivery +

Number of women whose smoking status was not known at the time of delivery =

Number of maternities

The SDCS will not accept a submission that fails this validation. In this situation the sub-ICB will be prompted to amend and re-submit their data until their submission passes this validation.

A second set of validations will also be undertaken by SDCS. These validations are breachable.  The current data return will be validated against the following criteria

• number of maternities is +/-15% of an average of the previous 4 quarters
• number of women known to be smokers at the time of delivery is +/-15% of an average of the previous 4 quarters
• number of women known to be non-smokers at the time of delivery is +/-15% of an average of the previous 4 quarters
• number of women whose smoking status was not known is above or equal to 5% of number of maternities entered this quarter

The data will either need to be amended, or confirmed as correct by selecting a breach reason from the drop down menu and providing, further information in the ‘Comments’ box. Please ensure any breach reasons give a full explanation of why the data is not within the tolerance.  If we do not feel the breach reason provides a satisfactory explanation, we may contact you for further details.

Please be aware that NHS Digital publish the breach reasons.  Therefore only submit reasons you are prepared to put into the public domain and take care not to identify any individuals.

This data is presented in the DQ tables of the SATOD publication in order to  maximise the usefulness of the data whilst also encouraging improvements in data quality by highlighting any areas that may have issues.

From 1 April 2017 the definition of the indicator for the proportion of women smoking at the time of delivery has changed to exclude those maternities with an unknown smoking status from the denominator.  This will have minimal impact for sub-ICBs with good data quality (i.e. few unknowns) but will have a much larger impact for sub-ICBs with a lot of unknowns who will see their indicator value increase quite noticeably. 

NHS Digital will monitor the data quality of your SATOD data and will be escalating any sub-ICBs with poor data quality to the NHS Digital Data Quality Assurance Steering Group which contains representation from NHS England. Read the terms of reference. 

We will escalate sub-ICBs who have had more than 10% of maternities with an unknown smoking status in the last three quarters.  We will look to tighten these criteria as data quality improves with an aim of having all sub-ICBs with less than 5% unknowns each quarter.

During the quarter 4 submission period, there will be an opportunity to re-submit data for previous quarters within that financial year. So at that time a sub-ICB will submit it’s quarter 4 data, but also be able to re-submit quarter 1, 2 or 3 data. If you want to make revisions please contact the data collections team first so they can re-open the quarter(s) for revision

For queries relating to the content and definitions for this collection:

Contact Centre
Email: [email protected]

For queries on the technical aspects of the form, including submission:
 

Data Collections Team
Email: [email protected]