Maternity Services Data Set uplift requirements (v2.0 to v2.5)

Requirement

Align items and national codes with current standards.

Detail

Alignment work to be carried out includes:

• alignment of items and structures with updates to the Digital Maternity Record Standard
• alignment of items and national codes to the latest version of the NHS Data Model and Dictionary
• consideration of MSDS v2.0 Data Dictionary items that could be replaced with SNOMED CT codes
• removal of Read2 and CTV3 coding schemes (deprecated)
• replace year-specific Multiple Deprivation Index to a version-agnostic input item (derivation will be updated accordingly)

Requirement

Capture detail on key policy areas and initiatives (NHS England and DHSC) implemented or to be implemented since the previous MSDS uplift in 2018.

Detail

Key policy areas identified are:

• 'About me' standards
• bereavement and loss
• care of women under 18
• care of women living in more diverse circumstances
• complex social factors (for example NICE CG110)
• continuity of carer
• Core20PLUS5
• equality and diversity maternity policy, including ethnic category 2021 codes
• maternity incentive scheme
• maternal medicine referrals
• multiple births
• pelvic floor health
• perinatal mental health (potentially through linkage)
• personalised care and support plans
• postnatal GP activity (potentially through linkage)
• ending rough sleeping for good strategy (DHSC)
• saving babies lives care bundle version 3
• smoking cessation
• three year delivery plan for maternity and neonatal services
• unplanned pregnancies

Requirement

Capture and/or link MSDS to medical prescribing data relating to pregnancy.

Detail

For example, linkage to Electronic Prescribing and Medicines Administration (EPMA) data.

Requirement

Reevaluate the scope of pregnancies and births included in MSDS, for example privately funded maternity care, and freebirths (without NHS or medical intervention).

Requirement

Consider collection of further items requested by organisations outside of NHS England for research purposes or data linkage.

Detail

Organisations/collections that have contacted us:

• National Maternity and Perinatal Audit (NMPA)
• Medicines and Healthcare Products Regulatory Agency (MHRA)

Requirement

Update input fields to reflect new and updated clinical practice and/or assessment tools.

Detail

Updates identified:

• balloon catheter induction
• consanguinity codes
• critical safety surveillance
• fetal medicine codes
• Generalised Anxiety Disorder 2-Item (GAD2)
• intrapartum consent tool
• MEWS
• NEWTT-2
• Perinatal Grief Scale (PGS)
• virtual/remote contacts (including pre-antenatal booking)

Requirement

Update items, codes, groups and group relationships to fix inconsistencies and gaps in the MSDS v2.0 design.

Detail

Suggestions for inconsistencies and gaps that should be addressed include:

• consider transfers between providers throughout the maternity episode, and how these affect national metrics (for example CQIMs)
• enable simple identification of "lead" trust, where a patient has received maternity care in multiple settings
• address data quality issues with discharge reason, allowing for identification of current pregnancies, and pregnancies ended without a baby record
• reason for late or no booking (for example. overseas, private, presented in labour with no prior contact)
• consider option to record non-disclosure of "previous" items (caesareans, live births, still births) for CQIM
• remove redundant code on OFFER STATUS (DATA ULTRASOUND SCAN) "04 - Not Offered"

Requirement

Consider linkage to other data sets  (NHS England owned as well as others) to reduce duplication for providers in collecting, compiling and submitting data, as well as to provide research and insight opportunities from newly linked data.

Detail

Suggested data sets to be investigated are:

• newborn hearing screening database (Smart for Hearing)
• Newborn Physical Examination Result (NIPE) database, NIPE Smart
• Electronic Prescribing and Medicines Administration (EPMA) Data
• Commissioning Data Set (CDS)
• National Congenital Anomalies and Rare Diseases Registration Service (NCARDS)
• Tobacco Dependence Programme Patient Level Data Collection

Requirement

Derive items where possible to reduce provider submission burden and provide consistency, and implement placeholder derivations from MSDS version 2.0 (May not require formal changes to the MSDS ISN).

Detail

Derivations identified:

• anaesthesia type in labour and delivery
• artificial rupture of membranes
• birth weight
• Body Mass Index (including at booking and band)
• episiotomy
• gestation length at birth
• org code (antenatal pathway lead commissioner)
• mapped information from ICD-10, OPCS-4, and SNOMED CT codes
• maternal critical incident type
• medical induction of labour method
• organisation identifiers (ODS codes)
• Oxytocin administered indicator
• postpartum maternal blood loss
• Robson group
• smoking status (at booking, delivery, and discharge)
• unique identifiers for Data Access Request Service (DARS) extracts