1. 12 JUNE 2012 DUE DATA – IMPROVING MIDWIVES’ USE OF DATA AND ACCESS TO INFORMATION JULIE TINDALE-MIDWIFE Maternity Data Update on issues

2. Julie Tindale : Heart of England NHS Foundation Trust Biog: Clinical Midwife- Lead for Information and Communications for Women’s Health Governance Dept Member of CCIO Leaders Network Advisory Group Chair NN4B Closure Programme working Group Member of Maternity Dataset (MCDS) Implementation Group Member of National Nursing (and midwifery)Informatics Strategic Taskforce (NNIST) 4 years as National Clinical Lead for Midwifery – DH Informatics Directorate (DHID) and Connecting for Health (Feb 2008 to Apr 2012)

3. Due Data  Overview:  NN4B  MCDS (Maternity and CYPHS and CAMHS)  PbR and Metrics  Clinical Information Systems  Leadership- A Maternity CCIO-how do we progress? 12/06/2012 3 Julie Tindale : julie.tindale2@nhs.net

4. NHS Number for All Babies born in England Electronically Since October 2002 1. Contract ends June 2014 (was 2013) 2. The software is now very out of date 3. Previous expectation Trusts would all be PDS compliant now 4. INNS was a temporary solution only 1. Renegotiation of business contracts on-going with BT 2. Trusts are not all PDS compliant 3. Trusts expected to have a working clinical maternity information system Maternity Data: NN4B 12/06/2012 4 Julie Tindale : julie.tindale2@nhs.net

5. Maternity Data: NN4B http://www.connectingforhealth.nhs.uk/systemsandservices/nhsnumber http://www.connectingforhealth.nhs.uk/systemsandservices/nhsnumber System Providers are engaged with the CFH team Early adopters based in Manchester : Silverlink for Maternity and iSoft for Child Health systems Maternity services to provide a Clinical Lead as focus for communications / compliance Regular updates are circulated- when there is news/progress Website is updated with information Contact : for further information Paul.Arrowsmith@nhs.net Julie.tindale2@nhs.net 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 5

6. MDS CYPHS and CAMHS Maternity Units – including a Midwifery clinical lead! Units must be working with their Data management departments to ensure the correct definitions working Child Health units must be working with their Data management departments to ensure the correct definitions working Mental health systems also need to adjust definitions and consider data capture methods Maternity data: MCDS June 2013 http://www.ic.nhs.uk/maternityandchildren/maternity http://www.ic.nhs.uk/maternityandchildren/maternity 12/06/2012 6 Julie Tindale : julie.tindale2@nhs.net Approved by ISB

7. Maternity data: MCDS http://www.ic.nhs.uk/services/maternity-and-childrens-data-set/maternity- services-secondary-uses-data-set http://www.ic.nhs.uk/services/maternity-and-childrens-data-set/maternity- services-secondary-uses-data-set Key Areas  Routine Booking Appointment activities  Maternity Care Plans  Dating Scan  Antenatal Screening Tests  Structural Fetal Anomaly Screening  Labour & Delivery  Postnatal Demographics  Newborn Screening  Maternal and Neonatal Death 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 7

8. Maternity data: MCDS http://www.ic.nhs.uk/services/maternity-and-childrens-data-set/children-and-young- peoples-health-services-cyphs-secondary-uses-data-set http://www.ic.nhs.uk/services/maternity-and-childrens-data-set/children-and-young- peoples-health-services-cyphs-secondary-uses-data-set Children and Young People's Health Services (CYPHS) Secondary Uses Data Set Key areas Personal and demographic Social and personal circumstances Relationships and household Breastfeeding and nutrition Care event Screening activity Inpatient stays Observations of BMI 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 8

9. Maternity data: MCDS http://www.ic.nhs.uk/maternityandchildren/CAMHS http://www.ic.nhs.uk/maternityandchildren/CAMHS CAMHS key Areas Referrals to CAMH services Demographics Background and Family history Targeted needs Encounters Care planning and Interventions Outcome measures Inpatient stays Presenting problems and diagnoses 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 9

10. Maternity data: MCDS Benefits The Information will flow real time to a national data warehouse reducing burden on service delivery organisations Information will use same definitions- comparators will be more robust Babies/ Children records directly linked to Mother’s pregnancy record*  Outcomes directly linked with significant events in pregnancy and delivery Records for subsequent pregnancies and deliveries for the same mother will be linked Powerful for public health: Smoking history linked to outcome trends, Breastfeeding prevalence and persistence 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 10

11. Maternity data: PBR mailto:http://www.dh.gov.uk/health/2012/04/guidance-maternity-services / mailto:http://www.dh.gov.uk/health/2012/04/guidance-maternity-services / STANDARD INTERMEDIATE AND INTENSIVE Pathway payment system to be introduced in shadow from April 2012 Payment split into 3 modules antenatal care; birth spell to discharge; postnatal care Each module split into pathway levels by intensity of care needed; based on a woman’s characteristics and factors Estimation of onset of conditions during pregnancy to enhance pricing 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 11

12. Maternity Data :PbR http://www.dh.gov.uk/health/2012/04/guidance-maternity-services/ http://www.dh.gov.uk/health/2012/04/guidance-maternity-services/ 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 12 AntenatalBirthsPostnatal Standard £1,126 65.5% of casemix £243 64.2% of case Mix Intermediate £1,803 27.3% of case Mix £307 35.0% of Case Mix Intensive £3,000 7.1% of case Mix £825 0.8% of Case Mix With CC £2,434 28.6% of case mix Without CC £1,506 71.4% of case mix

13. Issues Solutions? 12/06/2012 Julie Tindale : julie.tindale2@nhs.net Finding an up-to-date system that has a support department that is able to ‘speak Maternity’ What does the best of breed maternity system look like? Sharing best practice Signposting to systems that work Local networks choosing shared or collaborative systems 13 Maternity Data :Clinical Information Systems

14. Access for service users Solutions? 12/06/2012 Julie Tindale : julie.tindale2@nhs.net Health Bill: No decision about me without me Information strategy: access to own medical records Data sharing & security Scheduling Learning Disability, Language difficulty and equality Access for laboratory and diagnostic results RedBook on line Pregnancy records on line Navigation of proliferation of on-line pregnancy and birth advice A Role for Information ‘Observatories’? 14 Maternity Data :Clinical Information Systems

15. Chief Clinical Information Officer for Maternity 12/06/2012 Julie Tindale : julie.tindale2@nhs.net 15 (Discussion) How to grow the future leaders for Information and Communications Informatics is not IT Information and Communications is key- Better Safer Care? Sharing for better safer services- Local and Regional Collaboration? Who speaks for front line midwives who are ‘drowning’ under weight of the Data requirements, old equipment, no equipment?