NHS Maternity Statistics, England - 2020-21

The MSDS is a patient-level data set that captures key information at each stage of the maternity service care pathway in NHS-funded maternity services, such as those maternity services provided by GP practices and hospitals. The data collected includes mother’s demographics, booking appointments, admissions and re-admissions, screening tests, labour and delivery along with baby’s demographics, diagnoses and screening tests. This information has been reported to NHS Digital on a monthly basis since April 2015.

The MSDS has been developed to help achieve better outcomes of care for mothers, babies and children. As a 'secondary uses' data set, it re-uses clinical and operational data for purposes other than direct patient care. It provides comparative, mother and child-centric data that will be used to improve clinical quality and reduce health inequalities.

In April 2019 the MSDS transitioned to a new version of the dataset. MSDS v2.0 is an update to the previous data set that introduced a new structure and content, including clinical terminology, in order to meet current clinical practice and incorporate new requirements. It is designed to meet requirements that resulted from the National Maternity Review, which led to the publication of the Better Births report in February 2016. Due to the change in MSDS, data from this year and 2019-20 are not directly comparable to earlier years of MSDS data.

Statistics published in this report using maternity data from MSDS are classified as Experimental Statistics, these are new official statistics undergoing evaluation. They are published to involve users and stakeholders in their development and to build in quality at an early stage.
Further information on the MSDS and MSDS v2.0 is available at:
https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/maternity-services-data-set

This comes from the HES data warehouse containing details of all admissions, outpatient appointments and accident and emergency (A&E) attendances at National Health Service (NHS) hospitals in England. It includes private patients treated in NHS hospitals, patients who were resident outside of England and care delivered by treatment centres (including those in the independent sector) funded by the NHS.

HES datasets are the data source for a wide range of healthcare analyses for the NHS, Government and many other organisations and individuals. HES is sourced from the Secondary Uses Service (SUS) database, which is collected from hospitals’ patient administration systems on a monthly basis at record level.

Records in the HES Admitted Patient Care (APC) database, which form the basis of this Hospital Maternity Activity publication, are called ‘hospital episodes’, and each hospital episode relates to a period of care for a patient under a single consultant within one hospital provider. A stay in hospital from admission to discharge is called a ‘spell’ and can be made up of one or more episodes of care. This publication releases some high level analyses of HES data relating to deliveries in NHS hospitals, and looks at specific types of hospital episodes called ‘finished delivery episodes’ and ‘finished birth episodes’.

Statistics published in this report using maternity data from HES are classified as Official Statistics reflecting its status as an established data source.
Each record in HES includes a wide range of information including details of the patient (age, gender, geographic details), when they were treated and what they were treated for.

Summary tables

These tables contain the underlying data presented in this report. It is a joint document between HES and MSDS providing a collective and coherent message between the two datasets. 

Maternity Statistics Tables (HES)

This publication includes detailed tables at national level (HES Data):

• Time series
• Method of onset of labour
• Method of delivery
• Age of mother
• Deprivation
• Ethnicity
• Delivery complications
• Birth complications

Each of these tables is further broken down by additional dimensions such as gestation length, duration of hospital stay and birth status.

Provider level analysis (HES)

In addition to national aggregations of activity a provider-level analysis is supplied; this allows users to select hospital providers and compare activity with peer organisations, regions or the England total. One of the purposes of the provider-level analysis is to contribute to the improvement of both the quality and coverage of the data submitted to HES.

CSV data (MSDS)

A CSV file containing the aggregate underlying data for all submitters and by provider.

Metadata

The table descriptions that accompany this publication are given in the documents entitled ‘NHS Maternity Activity, 2020-21 – HES Metadata’ and ‘NHS Maternity Activity, 2020-21 – MSDS Metadata’; this includes descriptions of the tables included in the report, as well as providing useful links to other relevant webpages and documents.

Data Quality Review and Exploratory Analysis of Neonatal Critical Care Minimum Data Set (NCCMDS), Maternity Services Data Set (MSDS)

Published alongside the report this supplementary analysis has been produced by NHS Digital and contains Management Information produced using the NCCMDS and MSDS data collected by NHS Digital against activity published in NHS Reference Costs. This analysis seeks to assist users of the data in understanding the data quality of reported neonatal critical care data in both the NCCMDS and MSDS highlighting issues around coverage coherence and completeness of this data looking at the provider and all submitters geographies in order to assist how such data maybe used to support future user needs.

The Office for National Statistics (ONS) also collects information on births and maternities (maternities are equivalent to deliveries in HES). Most of the information, for both live births and stillbirths, is supplied to registrars by one or both parents. It is legal requirement in England and Wales to register the identity of a new baby within 42 days of the birth.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages

As it is a legal requirement to register all births, the ONS is the official source of delivery and birth information and should be used in preference to HES and MSDS maternity data held by NHS Digital.

NHS Digital maternity data has the following advantages:

• detailed information on the hospital care that a mother and baby received before, during and after the delivery, such as the method of delivery and the type of anaesthetic received;
• clinical information about the mother and baby – diagnosis, investigation and treatment details;
• the organisation where the baby was delivered.
• Investigating links between previous medical or socio demographic factors of the mother at the beginning of the pregnancy to outcomes at the end of the pregnancy (MSDS).

NHS Digital produces a quarterly report on women's smoking status at the time of delivery in England which can be found here:

https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england

The National Maternity and Perinatal Audit (NMPA) is a large-scale audit of the NHS maternity services across England, Scotland and Wales. Published data from the NMPA can be accessed via their website:

http://www.maternityaudit.org.uk/pages/home