Day 1 - 2019 CNO Summit

1. www.england.nhs.uk 1
Chief Nursing Officer for England’s
Summit
13 March 2019
Sarah-Jane Marsh
Chair, Maternity Transformation Programme Board
NHS England and Chief Executive, Birmingham Women’s and
Children’s

2. www.england.nhs.uk
Better Births/The Long Term Plan and
Safer maternity care
Professor Jacqueline Dunkley-Bent
Head of Maternity Children & Young People
#BetterBirths
Twitter @dunkleybent

3. National Maternity Ambition
To reduce the rate of stillbirths,
neonatal and maternal deaths, and
brain injuries occurring during or
soon after birth by 50% by 2025; and
20% by 2020
Reduce PTB from 8% to 6%
Maternity Transformation
Programme
A cross-system programme set up to
implement the vision set out in the
National Maternity Review – NHS
Long term plan

4. www.england.nhs.uk
The importance of safety in maternity - facts
• 700,000 babies born in UK 2016
Conclusion:
We need to make
care safer
1123
babies met
Each Baby
Counts
criteria
11% (124)
intrapartum
stillbirth
76%
(854)
Severe
brain
Injury
13%
(145)
Early
NND
2014-2016
9.8 women per
1000 died during or
up to 6 weeks post
partum
MBRRACE 2018
71% of babies might
have had a different
outcome with
different care

5. www.england.nhs.uk
Maternity
(Source: NHS Resolution Annual report and accounts 2017/18)

6. www.england.nhs.uk
2019/20 Maternity
Safety Priorities
Workstream 2:
National ambition
Better Births
recommendations
Programme
delivery:
SBL CB CNST 10
PMRT MNHSC
Atain HSIB
EBC-L&S etc
Relationship
building
Using
Champions
proactively at all
levels.
Training and
learning:
1) Training the
workforce
2) From reviews and
investigation
3) Mandatory training
4) Pre-registration
Workforce
1. Training
2. Support when things
go wrong
3. Communication and
relationship building
Culture
User
involvement
Single
reporting
portal

7. www.england.nhs.uk
The journey to a national maternity safety ambition
2010
2016
–
Better
Births
2010 - NHS
Mandate &
Outcomes
Framework
2015 –
Kirkup
Report
2015 –
National
Ambition
2016 – Safer
Maternity
Care Action
Plan
2014 –
Five Year
Forward
View
2017 –
Progress and
next steps
2019 -
Long
term
Plan

8. –
Postnatal physiotherapy
• What: Women have access to
multidisciplinary pelvic health
clinics and pathways
• How: LTP funding for additional
midwives / midwifery time and
physiotherapists to further support
high quality care for women
experiencing physical
complications
• Why: incontinence/ prolapse/pain
• When: Full rollout 2023/24
Continuity of Carer
• What: Continuity of carer for
most women by 2021 - targeted
to those who will benefit most
• How: LTP funding for additional
midwives / midwifery time and
training
• Why: Maternal mortality: Black
women x5, Asian women x2,
most deprived x3,- Stillbirth rate
increasing for Black babies -
121% ↑, Neonatal mortality: Black
babies 50% ↑, Asian 66%↑,
deprived areas x2

9. Long term plan
Infant feeding
• What: All maternity providers who do not
already deliver an evidence based infant
feeding programme will be supported to do so
• How: support providers to adopt and deliver
an evidence based programme
• Why: UK breastfeeding rates at 6-8 weeks
compare unfavourably with other countries in
Europe & in London, 84% of children were
breastfed at 6-8 weeks from October to
December 2017. The average rate in the North
East was 32%
• When: Rollout to commence from 2019/20
improving mental health
• What: Women who experience mental health
difficulties from maternity experience will
receive integrated maternity reproductive
health and psychological therapy.
• How: LTP funding for funding for specialist
mental health midwives and perinatal
psychologists - integrated models of care
between maternity, reproductive health and
psychological therapy
• Why: Mental health problems in pregnancy
and the first year after birth are experienced by
up to 27% of women in the UK - support for
tokophobia and PTSD
• When: -Rollout from 2021 onwards