Maternity Services Monthly Statistics, Final November 2023, Provisional December 2023, experimental statistics

In 2016, the Maternity Transformation Programme, led by NHS England, published 'Better Births' which set out the following vision:

'...for maternity services in England to become safer, more personalised, kind, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centered on their individual needs and circumstances.'

The programme covers a number of specific policy areas for review, some of which are detailed below on this page.

Further information about the Maternity Transformation Programme is available here:

https://www.england.nhs.uk/mat-transformation/

On 21 September 2022, NHS England communicated to Trusts that there will no longer be a target date for maternity services to deliver Midwifery Continuity of Carer, and this will remain in place until maternity services in England can demonstrate sufficient staffing levels to do so.

This does not affect the requirement for maternity services to continue to report accurate care activity data as per normal to the Maternity Services Dataset. Therefore, if maternity services continue to offer Midwifery Continuity of Carer pathways to women, this should continue to be recorded for women who are placed on these. Conversely, if women are not being placed on Midwifery Continuity of Carer pathways because the pathway is not in place or has been suspended, this should also be recorded.

The overarching aim is to ensure safer care for women based on a relationship of mutual trust and respect between women and their midwives.

The provision of care by a known midwife throughout the pregnancy, labour, birth and postnatal period can be associated with improved health outcomes for the mother and baby, and also greater satisfaction levels.

When a Continuity of Carer pathway has been agreed, this should be recorded and submitted via the MSDS.

Data by organisation on the following can be found in the measures file available for download:

• Number of women placed on a Continuity of Carer pathway by 29 weeks gestation
  • Plus two new data quality tests, both of which providers must score more than 5% for to have their data included in the figures for women placed on a Continuity of Carer pathway.
• Number of women in ongoing receipt of Continuity of Carer
  • Plus four new data quality tests, all of which providers must score more than 5% for to have their data included in the figures for women in ongoing receipt of Continuity of Carer.

Filtered data looking at the breakdown of women by ethnicity and by their home’s index of multiple deprivation, has been published alongside the two main metrics.

Statistics on Continuity of Carer have been published to provide data submitters and users with insight into the quality and completeness of their data. Due to variations in data quality and completeness, these statistics may not accurately reflect the true number of women placed on a Continuity of Carer pathway at this early stage of development.

The Saving Babies’ Lives Care Bundle provides detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England, and is contributing towards the aim of the national safety ambition to reduce stillbirth, maternal mortality, neonatal mortality and serious brain injury by 50% by 2025, as well as a reduction in preterm birth rate, from 8% to 6%.

The Care Bundle version two brought together five elements of care based on evidence and best practice:

• Reducing smoking in pregnancy
• Risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction (FGR)
• Raising awareness of reduced fetal movement (RFM)
• Effective fetal monitoring during labour
• Reducing preterm birth

Some elements of the Care Bundle version two are captured by MSDS as part of routine care in maternity services.

More information can be found at: https://www.england.nhs.uk/publication/saving-babies-lives-version-two-a-care-bundle-for-reducing-perinatal-mortality/

The Care Bundle version three was published 31 May 2023 and includes the existing five elements of care from version 2 along with a new sixth element on Management of pre-existing diabetes. The indicators within the five existing elements have undergone multiple changes between version two and version three - including where indicators have been removed, altered, or added as new. In time, where possible using MSDS, relevant version three indicators will be reported as part of this statistical series and will supersede those published for version two.

The Care Bundle version two had five elements, and where possible using MSDS many of their supporting process and outcome indicators are reported as part of this statistical series.

The Care Bundle version three has six elements which are supported by a series of process and outcome indicators, the five elements from version two and a new sixth one on the management of pre-existing diabetes. Where possible using MSDS these indicators will be reported as part of this statistical series, and will supersede those currently produced for version two. They will be released in small batches as soon as they are developed.

To deliver safer care with better outcomes for all women and every baby it is directed that support should be provided to every woman to enable her to develop a personalised care and support plan to focus on her antenatal care, her birth care, and her postpartum care.

This three-stage care plan should be developed by the woman with her midwife, and other health professionals as appropriate, and set out her decisions about her care, reflect her wider health needs and be kept up to date as her pregnancy progresses.

Unbiased information should be made available to all women and genuine choices offered, to help them make their decisions and develop their three stage personalised care and support plan. They should be able to choose the provider of this care, have access to their own NHS Personal Maternity Care Budget, and be enabled to have personalised conversations about what matters to them. Care should be centred on the woman, her baby, and her family, and based around her needs and decisions.

Where a Personalised Care and Support Plan has been agreed, this should be recorded and submitted via the MSDS, including information about which type of care plan it is.