Maternity and neonatal Services
What are our overall aims by 2028?
Safe, personalised, kind, professional and family friendly maternity and neonatal services are embedded across our system, through which every woman has access to; information to enable them to make decisions about their care, and support that puts them and their baby at the centre based around their individual needs and circumstances.
To provide assurance by the surveillance and triangulation of clinical outcomes that robust, quality maternity and neonatal services are in place to support women, babies, and families.
To continually drive service improvement and transformation to reduce health inequalities, and maternal and perinatal mortality and morbidity, listening to women, families and frontline staff to ensure that their voices are at the heart of service improvement.
What’s our starting point?
Through the Coventry and Warwickshire Local Maternity and Neonatal System (‘the LMNS’) system partners, including Local Authorities, Maternity Services, Health Visiting, and the Maternity and Neonatal Voices Partnership, are working collaboratively to deliver consistent care to women, babies and families wherever they live in Coventry and Warwickshire, improving health and wellbeing outcomes for women and babies, through safer, more equitable and more personalised services.
Fundamental to the LMNS is the delivery of the national Three Year Delivery Plan for Maternity and Neonatal Services which incorporates the asks of services and systems set out in key national reports including Better Births, the Saving Babies’ Lives Care Bundle v2, and the Ockenden and East Kent Reports. The Coventry and Warwickshire LMNS Delivery Plan reflects the Three Year Delivery Plan. Oversight of the delivery of the plan sits with the Coventry and Warwickshire LMNS Board.
Ensuring that maternity and neonatal services are designed and delivered in a way which seeks to achieve maximum equality of outcomes in women and babies’ mental and physical health and wellbeing is a key priority for our system. The LMNS Equity and Equality Plan 2022-2025 sets out the key actions that we will take as a system against an agreed set of priorities.
What are some of the key links to other parts of the plan?
Engaging and Involving People – through our Maternity and Neonatal Voices Partnership we are actively involving local families in the work of the LMNS to ensure that services are developed and transformed in a way that take into account and improves what matters most to women and families.
Personalised Care – improving the personalisation of maternity and services is a key priority within the LMNS Delivery Plan, this includes ensuring that women are aware of their choices along the whole maternity journey and feel empowered to make informed decisions for themselves, baby and their families.
Quality – improving the quality and safety of maternity and neonatal services is central to the work of the LMNS.
Digital, Data and Technology – transformation activity will seek to harness opportunities for digital innovation to enhance working practices, whether its communicating with women more effectively or managing workload.
Workforce – supporting our local workforce to develop their skills and capacity to provide high-quality care is another key priority in the LMNS Delivery Plan.
What will we be focusing on in the next 2 years?
Over the next two years the LMNS will be focusing on responding to the national Three Year Delivery Plan for Maternity and Neonatal Services, which will drive planning and delivery activity in relation to improvement actions identified across a range of national reports, including full implementation and embedding of the initial seven Immediate and Essential Actions (IEAs) in the Ockenden Report and the additional 15 IEAS, the East Kent Report and the Saving Babies’ Lives Care Bundle v2 and v3. This will be in addition to the delivery of the LMNS Equity and Equality Action Plan. Implementation and monitoring of activity will be delivered through the LMNS workstreams.
Digital and Personalisation – implementing digital tools and the What Good Looks Like Framework to enable the flow of information so that women can access their records, and interact with their digital plans and information, to support informed decision making, personalised care and support plans.
Quality and Safety – implementing the NHS-wide Patient Safety Incident Response Framework in 2023 for all incidents to support families with a compassionate response, and to ensure learning. Also developing Data Quality Improvement Plans to ensure that there is high quality data to inform the decisions of clinicians and leaders.
Neonatal – implementing the Saving Babies Lives Care Bundle v3, a package of interventions to reduce stillbirth, neonatal brain injury, neonatal death, and preterm birth. Plus fully implementing the Neonatal Critical Care Recommendations, including the implementation of a Phase 1 system wide Allied Health Professionals team.
Equity and Equality – implementing the LMNS Equity and Equality Strategy and aligned Action Plan to reduce inequalities in experience and outcomes. Including the implementation of ‘Continuity of Carer’ for those from ethnic minority groups and the most vulnerable and deprived areas.
Listening to Women and their Families – expanding the Maternity and Neonatal Voices Partnership to reflect the ethnic diversity of the local population, ensuring the development of information in accessible formats, and embedding co-production in all aspects of transformation.
Women with Complex Pregnancies – developing accessible information and appropriate pathways to ensure individuals with complex social needs, including alcohol/drug misuse, those from newly arrived communities, aged under 20 and suffering domestic abuse have effective services.
Health and Wellbeing – implementing action plans to support local Health and Wellbeing Strategies in the reduction of mortality and morbidity in women and their babies, including reducing smoking in pregnancy rates, implementing pelvic health services, developing an Infant Feeding Strategy and focusing on the prevention of diabetes in pregnancy.
Maternal and Perinatal Mental Health – rolling out of perinatal mental health services to improve the availability of this specialist care, including improved access and timely interventions. Investing in the availability of 7 day a week bereavement services for women and families who have experienced loss.
Workforce – implementing staff retention improvement plans, identifying and addressing local retention issues. Rolling out effective training, including cultural awareness, to maternity and neonatal staff to increase knowledge and skills, and reduce unwarranted variation in the improvement of outcomes.
Finance – continued quality service improvements and transformation require significant system investment. Funding is on an annual basis which presents recruitment challenges.
Technical – currently maternity services use bespoke systems with no interoperability with other digital systems. Change in digital systems needed to ensure Clinical Negligence Scheme for Trusts and Ockenden reporting compliance.
Culture – developing and sustaining a culture of safety, learning, and support which is key to improving the experience of care and outcomes for women and babies, and also supports staff to thrive.
Staffing – there continue to be national and local recruitment and retention challenges within maternity and health visiting.
Key Metrics and Deliverables
Listening to women and families with compassion which promotes safer care:
- Ensuring pregnant women and new mothers have access to pelvic health services by March 2024 to identify, prevent, and treat common pelvic floor problems.
- Investing to ensure the availability of bereavement services 7 days a week by the end of 2023/24 for women and families who experience loss.
- Full implementation of the initial Ockenden recommendations by October 2023.
- Development of local plans and metrics to support the delivery of the Three Year Delivery Plan for Maternity and Neonatal Services by September 2023.
Supporting our workforce to develop their skills and capacity to provide high-quality care:
- Ensure the right numbers of the right staff are available to provide the best care for women and babies through regular local workforce planning, including Trusts meeting staffing establishment levels and achieving fill rates by 2027/28 for midwifery.
Developing and sustaining a culture of safety:
- Throughout 2023, effectively implement the NHS-wide Patient Safety Incident Response Framework approach to support learning and a compassionate response to families following any incidents.
Meeting and improving standards and structures:
- All Trusts to full comply with the Saving Babies’ Lives Care Bundle v2, including the establishment of pre-term birth and uterine artery doppler across the system by October 2023.
- By 2025, implement the Saving Babies Lives Care Bundle v3.
- By 2025, implement the national maternity early warning score and updated newborn early warning trigger and track tools to improve the care of unwell mothers and babies, enabling timely escalation where needed.
- Make progress towards the national safety ambition to reduce stillbirth, neonatal mortality, maternal mortality, and serious intrapartum brain injury.
- Increase fill rates against funded establishment for maternity staff by 2025.