Maternity Dashboard South West Maternity and Children’s Strategic Clinical Network 27th November 2014 Ann Remmers, Clinical Director

Transformational Elements Network Priority Outcome Ambition Transformational Elements Reduction in perinatal morbidity and mortality (Domain 1) Improved maternal outcomes and experience (Domains 3 and 4). Improving maternal & perinatal outcomes and experience in the South West. Developing a South West maternity dashboard to identify unwarranted variation in outcomes (September 2014). Development of an agreed model of care to prevent and treat major post-partum haemorrhage, reduce stillbirth rates, pre-term birth and admission of term babies to NICU (2015-16).

National Priority NHS Mandate 2013-15 - Reducing infant mortality, neonatal mortality and stillbirths - Women’s experience of maternity services Reducing stillbirth rates is a priority of the National Clinical Director for Maternity and Women’s Health, Dr Catherine Calderwood

Background Network requested example dashboards from acute trusts across the South West via South West HoMS 16 dashboards were submitted (inc. Dorset and Channel Islands) Showed wide variation not only in the range of indicators measured but also in the criteria for an indicator. e.g. for 1 indicator there were 12 different criteria being used

Progress so far Maternity Working group worked on establishing Maternity dashboard – includes 32 indicators Detailed Technical Appendix has been produced to provide support and guidance to those supplying the data In the first round of data collection, 13 out of 14 Acute Trusts submitted data Data collection started in October

Dashboard Indicators Total number of babies born Instrumental birth rate PPH ≥1500 ml rate Apgar at 5 min < 7 at term or over Smoking at birth rate Number of live births Caesarean section rate Rate of women requiring level 3 care NICU admission at term or over ( on hold) Obesity rates Number of birth episodes Elective CS rate Preterm birth rate <37 weeks Stillbirth rate Rate of births resulting from under 18 conceptions Birth episode rate by place of birth Emergency CS rate Preterm birth rate <34 weeks Early booking rate for analysis by provider /CCG Rate of birth resulting from conceptions in women aged 40 or over Midwife to birth ratio Robson group 1 rate Preterm birth rate <27 weeks Early booking rate for analysis by provider or by CCG Female genital mutilation rate Induction of labour rate 3rd & 4th degree tear rate in unassisted births Low birth weight rate at term or over in live born babies Breastfeeding rate on transfer to health visitor (at 10-14 days) (on hold) Spontaneous birth rate in assisted births Low birth weight rate at term or over in stillborn babies Breastfeeding rate at 6-8 weeks (on hold)

Questions? Moving forward Agree presentation of data with the working group Work on setting thresholds Use of the dashboard to identify and monitor improvement work within maternity services as a part of the Network work programme, e.g. reducing stillbirths, low birth weight babies, management post-partum haemorrhage Questions?

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