AHSN Network: Promoting safe maternal and newborn care (16 September 2021)

Summary

For World Patient Safety Day, Natasha Swinscoe, Patient safety national lead for the AHSN Network and CEO, West of England AHSN, highlights the difference the AHSNs and Patient Safety Collaboratives have made in safe maternal and newborn care.

Content

PReCePT (prevention of cerebral palsy in preterm labour) offers magnesium sulphate to eligible women during preterm labour, reducing the risk of a pre-term baby developing cerebral palsy by 50%. This HSJ Patient Safety Award-winning intervention led to 850 additional mothers in preterm labour receiving magnesium sulphate in 2019/20, avoiding an estimated 30 cases of cerebral palsy. The learning from the spread of PReCePT to all maternity units in the West of England was adopted as national safety improvement programme, leading to increased uptake across England.

PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) is a new perinatal care bundle improving outcomes for premature babies across the West of England and South West AHSN regions. The bundle consists of a number of interventions that can have a significant impact on brain injury and mortality rates amongst babies born prematurely. The project has been co-produced with parent partners, with specific resources developed to ensure parents are the agents of their premature baby’s care.

‘Place of birth’. The Oxford AHSN Maternity Network brought together stakeholders from across the region, so that more extremely premature babies are born in a Level 3 unit that can provide more specialist care. This required a significant shift in working practices from making decisions based on availability of beds and staff, to focus on the risks for the mother and baby. The initiative has led to an increase in eligible babies born in a Level 3 unit from 50% to around 75-80%, and it is estimated that the lives of four more extremely premature babies are being saved every year, a 5% increase. 

Unlike mainstream emergency medicine, there is currently no standardised triage system within maternity for unscheduled appointments. The Birmingham Symptom-specific Obstetric Triage System (BSOTS) was co-produced in 2013 by midwives and obstetricians from Birmingham Women’s and Children’s NHS Foundation Trust and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC). BSOTS is now in 25 maternity units across the UK and approximately 33,000 women have been assessed sooner.

MatNeo Safety Improvement Programme contributes to two key national ambitions: to reduce the rates of maternal and neonatal deaths, stillbirths and brain injuries that occur during or soon after birth by 50% by 2025 (as set out in Better Births), and to reduce the national rate of preterm births from 8% to 6% (as set out in Safer Maternity Care).