Maternity Services Monthly Statistics - May 2021, 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 centred 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. 

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.

Where 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
• Number of women in receipt of Continuity of Carer

As of the December 2020 publication, filtered data looking at placement of black and Asian women, and women from the most deprived decile of areas, has been published alongside the main metrics.

A numerator and denominator will be shown for all providers, but only providers that score 5% or more will be included in the national-level rate, as a basic test for data quality. Data Quality assessment criteria will be developed further in coming months

The Care Bundle provides detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. It brings together this information in five elements of care based on evidence and best practice. It is part of an aim, reiterated in the NHS Long Term Plan, 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 five elements are:

• 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

More information can be found from NHS England.  

The Care Bundle’s five elements are supported by a series of process and outcome indicators. Where possible using MSDS, these indicators will be reported as part of this statistical series and will be released as soon as they are developed. The first set of indicators were published in the April 2021 (January 2021 data) release.

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 personalised care plans to focus on her antenatal care, her birth care, and her postpartum care.

These care plans 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 personalised care plans. 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 Plan has been agreed, this should be recorded and submitted via the MSDS, including information about which type of care plan it is.

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

• Number of women with an Antenatal Personalised Care Plan in place by 17 weeks gestation
• Number of women with a Birth Personalised Care Plan in place by 35 weeks gestation
• Number of women with a Postpartum Personalised Care Plan in place by 37 weeks gestation
• Number of women who had an Antenatal Personalised Care Plan in place by 17 weeks gestation, a Birth Personalised Care Plan in place by 35 weeks gestation and a Postpartum Personalised Care Plan in place by 37 weeks gestation

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

A numerator and denominator and rate will be shown for all providers, but figures for the higher geography breakdowns (e.g., National, regional, …) will be calculated only using those providers with a rate of 5% or more for the metric. For the breakdowns by ethnicity and deprivation, this will be calculated based on the rate of the overall fourth measure and not the rate for the specific ethnic group or deprivation breakdown.

Data Quality assessment criteria will be developed further in coming months, and due to variations in data quality and completeness these statistics may not accurately reflect the true number of women placed on each of the Personalised Care Plans at this early stage of development.