Harnessing digital technology in maternity services

Following the National Maternity Review, the Maternity Transformation Programme was set up as an NHS programme with nine workstreams aiming to make wide-ranging improvements. The Maternity Transformation Programme seeks to achieve the vision set out in Better Births by bringing organisations together to lead and implement the change. 

NHS Digital's 'Harnessing Digital Technology’ workstream sits within the Maternity Transformation Programme.

The Harnessing Digital Technology workstream provides the digital elements of the Better Births vision. Better Births recommends that to improve quality of care, learning and productivity, the NHS needs to make it much easier for health professionals to collect and share data with each other and with their patients. The new model of care requires a significant change in the use and access of information to support continuity of care throughout the ante-natal, intrapartum and post-natal period.

The Secretary of State refers to safety as the golden thread running through the Maternity Transformation Programme. Making better use of data, improving women's experiences of care, and ensuring the maternity workforce has regular training will all make a significant contribution to safer maternity services.

During 2018/19 we are focused on delivering four main projects: interoperable maternity records, women’s digital care records, digital maturity and a digital toolset to help offer trusted and reliable sources of maternity information for women.

Interoperable maternity records

The first phase of this project is to create a professionally agreed standard for maternity records. This will enable all maternity clinical systems to consistently capture information and ‘speak the same language’.

The second phase is ensuring the information can be shared securely so that everyone involved in the woman’s maternity care, including women themselves, will have access to a standardised set of paperless, digital maternity records.

The third phase is interoperability development, which will allow maternity record information sharing between local maternity systems, professionals and with women. This will ensure the electronic maternity records are accessible at the point of care. It will support continuity of care and safer care for women and their babies. Electronic maternity records that can be shared will reduce the amount of paper used across the service.

Women’s Digital Care Record

In January 2018, Simon Stevens (NHS England Chief Executive) undertook an in-depth review of what is required to provide women with access to their electronic maternity record. This supports the need to give women better understanding and control of their care, and an opportunity to contribute.

A new priority and expectation was given for NHS Digital and NHS England to implement electronic personal records for women, as an example that can be adopted more widely.

An electronic personal health record (ePHR) is a digital platform that enables people to take greater control of their health and care by accessing a range of information. For example, an ePHR could include:

• health records
• appointments
• prescriptions
• test results

ePHRs enable people to add information and share it with others involved in their care. For example, women may choose to:

• talk to care professionals through secure messaging
• share regular information about their health, such as updates to disease activity scores
• capture and share images or videos, record appointments, capture birth plan information and receive information relevant to the stage of their pregnancy
• complete pre-consultation questionnaires to help care providers understand women’s recent history and make the best use of time in appointments

ePHR outcomes

We aim to provide as many women as possible with the choice to access their electronic maternity record and benefit from the improvements it brings.

The benefits for women include:

• access to their personal maternity record online, giving them greater visibility, control and understanding of their health and related information
• access to trusted information about pregnancy with increased ownership and a better, safer maternity experience
• fewer barriers between the health care professionals and the woman - it also has the potential to include critical reminders around screening, immunisations and appointments during pregnancy
• a reduced risk of missing important clinical information

The benefits for healthcare professionals include:

• a reduced administrative burden
• an better relationship with women with fewer, but more focused, queries
• interaction via more convenient and efficient channels
• safer, better care and better value

The benefits for provider organisations include:

• reducing the cost to organisations of capturing and sharing information
• improving data quality
• service improvements and greater efficiency by supporting new ways of working and new models of care

Maternity Digital Maturity Assessment (DMA)

NHS Digital is working with maternity services to help them achieve their digital transformation ambitions. The Digital Maturity Assessment ran from April to June 2018, and was completed by 100% of maternity providers within each local maternity system (LMS) in England. 

Please visit the Maternity DMA project page for further details. Project outputs include:

• a Maternity DMA national report, available on the NHS England web page 
• 44 LMS digital maturity reports
• a Maternity DMA collaboration platform

The analysis and findings from the Maternity DMA will provide insights for future areas of work and will be a valuable asset for local and national initiatives.

A digital toolset

We aim to improve personalisation and choice for women by offering access to unbiased, evidence based and locally specific information. This includes information about people’s circumstances, choices available and their own personal care plans.

We are working with the NHS.UK team to update the content, structure, presentation and site navigation of the NHS.UK maternity pages following feedback from pregnant women.

A number of crucial improvements have been made:

1. New sign-posting links allowing users to get straight to the content they want. 
2. Important information highlights on pages to make it clearer for pregnant women when they need to seek help. 
3. Links to other useful and NHS approved apps within the NHS Health Apps Library.
4. New pregnancy week by week content available regarding development of the baby, changes to the woman’s body and what women should start thinking about at each stage of pregnancy.

The programme aims to: 

• maximise the quality time spent between women and healthcare professionals
• improve communication between women and maternity services
• increase the choice and personalisation of care for women and their families
• improve safety for women and babies
• improve women's experience of care

All 44 of the local maternity systems (LMSs) from across England are invited to provide representation at the LMS Digital Leaders Forum. This group has an important role in supporting our projects and contributing requirements from professional stakeholders across the country.

The Digital Midwives Expert Reference Group gathers expert advice from midwives and clinicians. The group meets four times a year to discuss the digital challenges and successes they experience, providing valuable input into the work of the Digital Maternity Programme.