NHS England has launched an NHS-wide conversation on improving maternity and neonatal care, inviting staff from across the system to have their say on improving services and making change. Responses received will be used to inform the National Maternity and Neonatal Taskforce’s action plan, with each trust that participates to receive their own targeted report on what needs to happen locally.
Your Voice – Building a Better Future for Maternity and Neonatal Care is introduced in the wake of a number of national inquiries and reviews of maternity and neonatal services. NHS England commits to keeping responses anonymous to allow staff to be candid in their responses. It asks three key questions: How can we change nationally? How can your organisation change? How can you influence change?
Cheshire and Merseyside ICB shared encouragement for staff to take part, commenting: “What happened at the Countess of Chester Hospital was shocking, unacceptable and extremely serious and it is important that lessons are learnt so that such events cannot be allowed to occur again in the future. We need staff who work in and alongside these services across Cheshire and Merseyside to be involved in driving solutions, and that’s why we want to encourage as many staff as possible to take part in this conversation.”
“The reviews are clear,” NHS England states. “Now it’s time to put them into action. Staff who know maternity and neonatal care best need to help shape how we deliver the future together.”
Upon registration, questions ask for agreement or disagreement with statements such as: “I feel able to influence positive change in maternity and neonatal services”. Two further questions offer the opportunity for free text submissions, looking to find out respondents’ biggest hopes and fears for the Your Voice initiative.
Staff are encouraged to first read and reflect on the Independent National Maternity and Neonatal Investigation, taking time to discuss with their colleagues and teams. The investigation conducted reviews of maternity and neonatal services in 12 NHS trusts, aiming to identify systemic issues and to develop a series of national recommendations. It also incorporates the lived experiences of 450 families, 10,500 responses to a public call for evidence, feedback from more than 9,000 staff, and engagement with advocacy groups, national stakeholders, and NHS leaders.
The final report from the investigation pointed to challenges with fragmented digital systems, continued reliance on paper, and prolonged underinvestment in digital infrastructure, putting forward suggestions for capital investment, an updated modern service framework, AI, and data.
Duncan Burton, CNO for England, spoke of the potential for the conversation to improve understandings of where barriers and opportunities exist, and what kind of support is needed to “make meaningful improvements for women, babies, families and our staff”.
Professor Ngozi Edi-Osagie, the national clinical director for neonatal care, highlighted: “You know the service best. That’s why we genuinely want to hear your views on what changes you think could make a real difference. No idea is too small if it has the potential to give newborn babies a better start and help make neonatal services safer and more equitable.”
Wider trend: Digital in maternity and neonatal care
A national assurance assessment of maternity and neonatal care and services in Wales has made a series of findings and recommendations around the role of digital and data, noting in particular the requirement for better real-time data availability and coordination, and further investments in digital and infrastructure. For quality of care and service user outcomes, key findings included variability in data availability across health boards, with all health boards reporting a need for increased national focus, support, and oversight.
A £7 million unified technology fund programme has offered investment in core systems for clinical teams, according to Croydon Health Services. This enabled an upgrade to maternity EPR, allowing the service to meet national standards such as the Maternity Early Warning Scores in supporting early detection of illness, sending and receiving of referrals digitally, and sending consistent discharge summaries to GPs and other community services. The introduction of the latest version of the national Maternity Services Data Set has improved information availability for staff, as well as strengthening compliance from 30 to 90 percent, the trust adds.
Barking, Havering and Redbridge University Hospitals NHS Trust has highlighted a “pressing requirement for a maternity EPR”, following the publication of the Amos report earlier this year. Investment for the new system would be on top of £5.5 million already spent in the department over the last two years, the trust shares, which has helped make improvements including additional midwives, doctors, and support staff in maternity triage; and 24 hour flow coordinators. Work is also underway on the ten-point plan of urgent actions set out by NHS England following the Amos investigation and the Ockenden maternity review, BHRUT assures, to check requirements are met for the service.
