1. Maternity Survey 2018: Trust webinar
1 March 2018

2. Agenda Survey overview What’s new for 2018 Questionnaire
Covering letters
Submitting PDFs and hard copies
Instruction manuals
Sample declaration form
Sampling and submission process
Section 251 requirements
Timetable
Q&A

3. Survey Overview

4. Survey overview
Survey methodology and questionnaire largely unchanged from 2017.
Trusts will draw a sample of eligible women who had a live birth during February 2018 [and January for smaller trusts].
We will also collect antenatal and postnatal attribution data to identify whether women are referring to your trust when answering the antenatal and postnatal sections of the questionnaire.

5. What’s new for 2018?

6. Questionnaire
Consultation with NHSE and CQC, analysis of results, and cognitive testing with new mothers resulted in the following changes:
1 new question added
1 question removed
Some existing questions amended
Notes and instructions in purple
Full details in Survey Development Report.
Questionnaire will be published after Ethics approval granted.
Reminders for in-house trusts:
Questionnaire to be printed in colour.
Free text comments to be recorded in full.

7. Covering letters
Changes to format and wording in line with Mental Health pilot.
Covering letters will be published after Ethics approval granted.
Reminders for in-house trusts:
Covering letters to be printed in colour.
Now a requirement to print 2nd letter with trust letterhead and signatory.

8. Submitting PDFs and hard copies (in-house trusts only)
Strongly recommend sending us PDFs of q’re and covering letters before you start printing.
Still require hard copies prior to start of fieldwork.
Hard copies must be printed exactly as they will be sent out to women.
Deadline for PDFs: 6 April.
Deadline for hard copies: 13 April.

9. Instruction manuals
Underwent redevelopment based on consultations with CQC and NHS trusts.
Now being rolled out across the patient survey programme.
Three manuals for the Maternity Survey:
Survey handbook
Sampling instructions
Attribution instructions
Generic instructions can be found on the website.
We would welcome any feedback about the new manuals.

10. Sample declaration form
Comment boxes added for trusts to explain any N/As.
Additional comment box added for trusts to explain any changes in sample profile since 2017.
Additional checklist item: total number of births before exclusions.
Form will be published on our website before the sample drawing period begins.

11. Sampling and submission process

12. Sampling and submission overview (trusts using a contractor)
Trust compiles sample of eligible women.
Trust conducts internal and DBS checks for deaths of women/babies. Trust removes any deceased.
Trust submits sample declaration form to contractor. Contractor checks the form.
Once sample declaration form is approved, trust submits a single sample and mailing file to contractor’s FTP.
Contractor checks the file and responds to trust with any queries.
Contractor creates separate sample and mailing files.
Contractor submits declaration form and sample file (not mailing file) to Coordination Centre.
Coordination Centre checks sample and sends queries / approval to contractor.
Once sample approved by Coordination Centre, contractor sends out mailing packs for trust.
Trust submits antenatal and postnatal data directly to Coordination Centre’s FTP.

13. Sampling and submission overview (in-house trusts)
Trust compiles sample of eligible women.
Trust conducts internal and DBS checks for deaths of women/babies. Trust removes any deceased.
Trust creates separate sample and mailing files.
Trust submits sample declaration form to Coordination Centre. Coordination Centre checks the form.
Once sample declaration form is approved, trust submits sample file only to Coordination Centre’s FTP.
Coordination Centre checks sample and sends queries / approval to trust.
Once sample approved by Coordination Centre, trust sends out mailing packs.
Trust submits antenatal and postnatal data directly to Coordination Centre’s FTP.

14. Drawing the sample
Sample should include all eligible women aged 16+ who had a live birth in February 2018.
All eligible February births should be included – no maximum sample size.
If there are <300 eligible February births, trusts should sample backwards into January until they reach January 1st or until they reach 350 (then cap at 300 after trust and DBS deceased checks).
Please follow the instructions carefully and check all inclusion and exclusion criteria to prevent sampling errors.
Full details in Sampling Instructions.

15. Potential sampling errors
Excluding home births.
Not including all eligible February births.
Sampling >300 women from Jan+Feb.
Sampling by discharge date rather than delivery date.
Including women who delivered at another trust.
Excluding births from one of the trust’s sites.
Inappropriate use of site codes.
Missing or incorrect CCG codes.
Formatting postcode sector incorrectly.
Full details available in Sampling Errors Report.

16. Deceased checks
It is essential that multiple deceased checks are conducted throughout the survey period.
Includes women AND babies.
Five stages of checks:
Initial trust check
DBS check prior to submitting sample
Trust check prior to 1st mailing
Trust check prior to 2nd mailing (DBS also recommended)
Trust check prior to 3rd mailing (DBS also recommended)
Trusts using a contractor: advise your contractor immediately if any women or their babies die after submitting your sample.
In-house trusts: record deaths with the appropriate outcome code in the sample file.

17. Sample declaration form
Excel sheet with a series of checklist items
Must be electronically signed by the person drawing the sample and the Caldicott Guardian.
to contractor (or Coordination Centre for in- house trusts) before submitting sample file.
Must be sent from of Caldicott Guardian, or from of sample drawer with Caldicott Guardian copied in.
Form must be approved before sample file is submitted.

18. Submitting your sample
Trusts using a contractor: submit sample and mailing data to contractor’s FTP as a single file.
In-house trusts: submit sample data only to Coordination Centre’s FTP.
All files must be password-protected.
Do not submit any files via .

19. Antenatal/postnatal data
Trusts are asked to submit antenatal and postnatal (attribution data).
This information identifies whether each woman in your sample received their antenatal and/or postnatal care from your trust.
Tells us whether we can attribute women’s responses on antenatal and postnatal questions to your trust.
Compiled after sample is drawn, using electronic records (or postcode sector information if electronic records not available).
Submitted in a separate file directly to the Coordination Centre.
Full details in the Attribution Instructions.

20. Section 251 requirements

21. What is Section 251?
Allows the common law duty of confidentiality to be put aside in order to enable the processing of patient identifiable information without consent.
Provides a legal basis for trusts to provide names and addresses to contractors.
Any deviation from the methodology outlined in the survey instruction manuals may render the approval invalid and CQC will be obliged to take action.

22. Approval pending Section 251 approval for the survey is still pending.
Sample data cannot be transferred outside of the trust until Section 251 approval has been granted.

23. Recording dissent
Information about how to opt out must be available to all service users.
Opt-outs must be logged in a consistent manner.
Patients who have indicated dissent must be excluded from the sample.
Trusts should have displayed a dissent poster and distributed an information leaflet to year old mothers during the sampling month(s). If your trust did not do this, written confirmation must be gained from the Caldicott Guardian to transfer patient data.

24. Submission of sample files
Sample declaration form must be approved before any files are submitted.
Trusts using a contractor: submit a single file containing both sample and mailing information to contractor’s FTP. They will provide instructions on how to do this.
In-house trusts: submit only the sample data to the Coordination Centre’s FTP.
All trusts must password protect their files.
The Coordination Centre must not receive any mailing data.

25. Potential S251 breaches
Trusts sending data directly to the Coordination Centre (except attribution data).
Coordination Centre receiving mailing data.
Trusts sending combined sample and mailing file to contractor via rather than FTP.
Trusts not password-protecting files.
Generic document on Data protection and confidentiality available on our website.

26. Timetable

27. Timetable Trusts draw sample: 12 March – 13 April
Coordination Centre sample checking: 2 – 27 April
(In-house trusts only) PDF copies of q’re and covering letters due: 6 April
(In-house trusts only) Hard copies of q’re and covering letters due: 13 April
Fieldwork: 23 April – 24 August
(In-house trusts only) Weekly monitoring: 3 May – 23 August
Antenatal and postnatal data due: 29 June
(In-house trusts only) Final data due: 31 August

28. Questions?

29. Thank you for your time
A copy of these slides will be available on the NHS Surveys website here.
Coordination Centre contact details: