HQIP: Listening to marginalised voices in maternity, helping to reduce health inequalities (22 May 2025)

Summary

There is a well-established link between social determinants and poor maternal outcomes. National audits such as MBRRACE-UK, the National Maternity and Perinatal Audit (NMPA), and others have highlighted persistent inequalities in access, experience, and outcomes across maternity care in England. These findings underscore the importance of capturing the voices of those most affected by systemic disadvantage.

Content

Commissioned by NHS England and delivered by the Health Quality Improvement Partnership (HQIP) in 2024, this qualitative insight project set out to inform the development of an inclusive Patient-Reported Experience Measure (PREM) for maternity care. It focused on capturing the experiences of groups underrepresented in existing feedback mechanisms – particularly those facing socio-economic, cultural, or health-related disadvantage.

The project combined a literature review, targeted outreach, and co-design with maternity charities to ensure engagement was inclusive and meaningful.

The approach uncovered fresh insights, guided the prioritisation of participant groups and informed the design of engagement activities. Thematic analysis of participant insights and accompanying recommendations have supported the maternity PREM and contributed to broader efforts to reduce inequalities in maternity care.

This case study outlines:

• The need for this work to deliberately reach those most affected by systemic disadvantage.
• The multi-stage, inclusive methodology used to capture diverse perspectives across the maternity care pathway.
• The impact the project had.