Maternity Transformation in Nottinghamshire Sally Seeley Director of Quality and Personalisation, Nottingham City CCG Senior Responsible Officer for Nottinghamshire Local Maternity System & Board Chair

Better Births The National Maternity Review ‘Better Births’ (February 2016) vision for maternity services is: ‘for them to become safer, more personalised, kinder, 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 around their individual needs and circumstances. All staff to be supported to deliver care which is women centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries’.

Better Births Recommendations Personalised care Continuity of carer Safer care Better postnatal and perinatal mental health care Multi-professional working Working across boundaries Fairer payment system

Safety By 2020 /2021 all services will: Have reduced rates of stillbirth, neonatal death, maternal death and brain injury during birth by 20% and on track to make 50% reduction by 2030 Be investigating and learning from incidents and sharing this learning Be fully engaged in the development and implementation of the NHSI Maternity and Neonatal Health Safety Collaborative

Choice and Personalisation By 2020 /2021: All pregnant women have a personalised care plan All women are able to make choices about care during pregnancy, birth and postnatally Most women have continuity of the person caring for them during pregnancy, birth and postnatally More women are able to give birth in midwifery settings (home and maternity units)

Local Maternity Transformation Plans All areas need to develop a Local Maternity Transformation Plan This needs to show how the Local Maternity System will deliver the transformation required in Better Births by the end of 2020/21 – particularly in relation to Safety and Choice These need to be created, agreed and submitted by the end of September 2017

Nottinghamshire Local Maternity System  11,710 live births (ONS data July 2017) Nottingham City – 4,297 Nottinghamshire (excludes Bassetlaw) - 7413 6 Clinical Commissioning Groups (CCGs) 2 Local Authorities 2 providers of Maternity Services 1 provider of Perinatal Services 2 providers of Early Years Services Differences across Nottinghamshire

Maternity Indicators Performance Neonatal Mortality & Stillbirth (2014/15 data) Comparator rate for England is 7.1   Rate per 1000 births Mansfield & Ashfield 8.4 Newark & Sherwood 2.4 Nottingham City 12.4 Nottingham North & East 3.1 Nottingham West 9.1 Rushcliffe 2.9

Maternity Indicators Performance Womens Experiences of Maternity Services (2015 survey)   % Score Mansfield & Ashfield 83.9 Newark & Sherwood 82.5 Nottingham City 78.6 Nottingham North & East 82.2 Nottingham West 77.4 Rushcliffe

Maternity Indicators Performance Womens Choices in Maternity Services (2015 survey)   % Score Mansfield & Ashfield 68.4% Newark & Sherwood 61.2% Nottingham City 67.7% Nottingham North & East 62.8% Nottingham West 61.6% Rushcliffe 64.8%

Local Maternity System Partnership Board Established and meeting regularly Representation from areas involved in developing and delivering our Transformation Plan Clinicians from Provider organisations (obstetricians, neonatologists, heads of midwifery, early years and perinatal services and General Practice) Commissioners from CCGs and Local Authorities Regional networks (maternity /neonatal/ provider) Work streams identified

Governance Structure

Nottinghamshire Plan Work streams have Chairs and deputies Areas of responsibility / focus Information requirements to allow the plan to be created and submitted Work plan for further development / implementation Core group will focus on creating the plan which will be agreed with the LMS Partnership before submission

Engagement Engagement with service users, families, staff in maternity services and other key groups is taking place now Focus groups and workshops held with maternity staff to ask them What is working well? What do you want to change? What do you need to change? Web based survey closes on Friday (28/7/17) All engagement will inform the plan Early intelligence supports what we thought we knew

Links to Survey Women and Families https://consult.nottinghamshire.gov.uk/public-health/better-birth-improving-outcomes-women-and-families Clinical staff & stakeholders https://consult.nottinghamshire.gov.uk/public-health/better-birth-improving-outcomes-clinical-staff Open until Friday 28 July 2017    Links to Survey