NHS Maternity Statistics, England, 2023-24

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 discharges, screening tests, labour and delivery information along with baby’s demographics, birthweight, diagnoses and screening tests. This information has been reported to NHS England (NHS Digital prior to the 2023 merger with NHS England), 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 MSDS version change, data from 2019-20 onwards are not directly comparable to earlier years of MSDS data.

Statistics published in the Summary tables using data from MSDS are now classified as Official Statistics. This follows on from the statistics published in the Maternity Services Monthly Statistics now being badged as Official Statistics earlier this year.  The rationale for this change is explained in the Relevance section of the Data Quality Statement of the Maternity Services Monthly Statistics publication.  It is the case that the existing measures presented within the Summary tables (with underlying data in the main MSDS csv file) of this annual publication are also now well established and consistently produced using high quality data representative of maternity services in England. Therefore, it is considered that the MSDS information within this publication are no longer badged as Experimental Statistics but Official Statistics. The Official Statistics status indicates that the published statistics have public value, are high quality, and are produced by people and organisations that are trustworthy.  Experimental Statistics are now labelled as Official Statistics in Development following some recent changes to the National Statistics Code of Practice. For more information see the UK Code of Practice for Statistics.

In this publication, this leaves the CQIM Breastfeeding at 6 to 8 weeks measure as Official Statistics in Development as well as the newly developed Smoking at Time of Delivery (SATOD) measure, as data completeness is yet to improve for these measures. We shall review whether any further new measures need to be specifically labelled as Official Statistics in development, where the data quality or completeness is yet to be sufficiently improved.  Please the Relevance section of the Data Quality Statement of this annual report regarding the badging of the MSDS measures. 

Further information about the MSDS and MSDS v2.0 is available.

This comes from the HES data warehouse containing details of all admissions and outpatient appointments 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’.

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.

Statistics published in this report using maternity data from HES are classified as Official Statistics reflecting its status as an established data source.

The NHS England website contains more background information about HES.

The HES publications focus on headline information about hospital activity. Each annual publication includes a series of national tables and also provider-level breakdowns for some main areas.

All data items included in the published tables are explained in footnotes, and NHS England publishes data dictionaries for HES describing the format and possible values for all HES data items.

This data is also readily accessible via an online interrogation service (for NHS users) or via our bespoke extract service.

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 file containing provider-level and region-level analysis is supplied. 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, by region and by provider.

Breastfeeding CSV data (MSDS)

A CSV file containing the aggregate underlying data for all submitters and by provider, for the CQIMBreastfeeding6to8Weeks measure which records the percentage of babies fully or partially breastfed between 6 and 8 weeks old. This measure uses both the Maternity Services Dataset (MSDS) and Community Services Dataset (CSDS). Due to variations in data quality and completeness these statistics may not accurately reflect the true number of babies breastfeeding between 6 and 8 weeks old, at this early stage of measure development. The official statistics for breastfeeding prevalence at 6 to 8 weeks after birth are produced quarterly and annually by the Office for Health Improvement and Disparities (OHID), as part of the Child and maternal health statistics. 

Smoking at Time of Delivery (MSDS) Excel and CSV file

For the first time information on Smoking at Time of Delivery (SATOD) has been presented using annual data from the MSDS. This includes national data broken down by maternal age, ethnicity and deprivation. From 2025/2026, MSDS will become the official source of SATOD information and will replace the historic SATOD data which is to become retired. We are currently undergoing dual collection and reporting on a quarterly basis for 2024/25 to help users compare information from the two sources. We are working with data submitters to help reconcile any discrepancies at a local level before any close down activities begin. A link to the dual reporting in the SATOD publication series can be found in the links below.

Metadata

The table descriptions that accompany this publication are given in the documents entitled ‘NHS Maternity Activity, 2023-24 – HES Metadata’ and ‘NHS Maternity Activity, 2023-24 – MSDS Metadata’; this includes descriptions of the tables included in the report, as well as providing useful links to other relevant webpages and documents. 

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. See Births, deaths and marriages data published by the ONS. 

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 England.

NHS England 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).

More information on the comparability between ONS, HES, and MSDS data can be found in the Data quality statement (MSDS) under Coherence and Comparability.

NHS England produces a quarterly report on women's smoking status at the time of delivery in England which can be found here: Statistics on Women's Smoking Status at Time of Delivery: England.

This uses data from the Smoking at Time of Delivery (SATOD) data collection submitted by commissioners. For the first quarter of 2024-25, comparative data using MSDS data was included in this report to see how data from both data sources align with a view to retiring the Smoking at Time of Delivery data collection at the end of the 2024-25 financial year. NHS England are working with data submitters to help reconcile any differences between the data from the two sources at local level.  During this period the SATOD data collection remains the primary source for the quarterly publication.

Some annual measures for SATOD have been included in this publication for the first time using MSDS. As SATOD is an aggregate data collection it cannot support this granular level of reporting as MSDS where we can look at trends by various demographic breakdowns.

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: National Maternity and Perinatal Audit.