Maternity Disparities Taskforce meets to improve pre-pregnancy care and maternity outcomes

Alison Morton, iHV’s CEO, attended yesterday’s meeting of the Maternity Disparities Taskforce. It was co-chaired by Health Minister Maria Caulfield who set out her ambition to ensure all women receive the same high standard of maternity care, regardless of their race.

The purpose of the taskforce – which is composed of mothers and clinicians – is to tackle disparities for mothers and babies, and reduce maternal and neonatal deaths. This will be done through improving access to care before, during and after pregnancy for women from ethnic minorities and those living in the most deprived areas.

The discussions, led by the Minister and the taskforce’s co-chair, NHS chief midwifery officer Professor Jacqueline Dunkley-Bent, focused on pre-pregnancy care and developing guidance to support Black women and women in deprived areas with healthcare before pregnancy begins, to give women and their babies the best possible start for life.

Alison Morton, iHV CEO, said:

“It was sobering to attend the rapidly reinstated Maternity Disparities Taskforce yesterday and to hear, yet again, about the stark inequities in pregnancy outcomes that need to be addressed. These affect black and brown women and the poorest disproportionately. The challenge from Professor Jacqui Dunkley-Bent, our Chief Midwifery Officer in England, to the Minister and all of us present was that we need to listen, hear and above all, act. How many more rafts of inquiries and reports on inequalities do we need?

“As always, the solution is that we need a ‘whole system’ response, yet the landscape of policies that might make a difference are still being developed in silos. I was able to speak about the vital contribution that health visitors can make to tackling these inequalities – we know what is needed, it is well evidenced in our universal and targeted work in preconception and perinatal health. But it won’t happen unless the ‘elephant in the room’ of workforce capacity is not addressed.”

Minister for Women’s Health Strategy Maria Caulfield said:

“Regardless of race or background, everyone should receive the highest quality maternity care.

“All stages of a woman’s life, from before she is pregnant to after delivery, are crucial to the health and wellbeing of both mother and baby.

“Today we met with mothers and healthcare experts to ensure women from ethnic minorities and those from deprived areas have access the right care and support for their journey into parenthood – and are listened to throughout this experience.

“We are considering the outcomes of the taskforce, and I will be monitoring progress closely to ensure real change can be made.”

The next taskforce will next convene in Summer 2023.

For further information:

https://publications.parliament.uk/pa/cm5803/cmselect/cmwomeq/94/report.html

https://www.gov.uk/government/news/new-taskforce-to-level-up-maternity-care-and-tackle-disparities

https://www.england.nhs.uk/publication/equity-and-equality-guidance-for-local-maternity-systems/

Leading health organisations have called for upgrades to England’s NHS maternity service buildings to improve care for women and conditions for staff in a letter to Health Minister Nadine Dorries today.

Women’s maternity care was significantly impacted during the pandemic, made worse by old, poorly designed buildings, according to the One Voice coalition of health organisations and the Society of Radiographers.  Many women were unable to have their partners with them because the layout of maternity facilities prevented social distancing, and would have put women, their partners and other service users at risk of catching the virus.  One Voice is calling for better design and use of space, such as having single rooms and dedicated areas for maternity clinics and scans.

Alison Morton, Acting Executive Director at the Institute of Health Visiting, commented:

“As a member of the One Voice coalition of health partners, we support this call from our maternity colleagues for upgrades to England’s NHS maternity service buildings. The government’s recent White Paper on health and social care has highlighted once again that positive outcomes are fundamentally delivered “in a place”. By improving the quality and safety of the environments in which we work, through sustained investment in “place”, we can make a big difference to the outcomes and experiences of care that we provide to families, as well as the health and wellbeing of the workforce.”

The Petitions Committee has scheduled a debate on the impact of Coronavirus on maternity and parental leave – taking place this afternoon (Monday 5 October) from 4:30pm and Catherine McKinnell MP, Chair of the Committee, will open the debate.

The debate will be available to watch online here.

Following the Prime Minister’s appearance in front of the Liaison Committee last week, where the Chair asked him about the Government’s response to the maternity report, the Committee has written to the Prime Minister to ask him to read the report and respond before the debate.

You can read the letter here: https://committees.parliament.uk/publications/2698/documents/26693/default/

Watch the Chair question the Prime Minister at the Liaison Committee session here: https://youtu.be/mv8SXHGIgWQ?t=1815

The Committee has also written again to Paul Scully MP, Minister for Small Business, Consumers and Labour Markets, to ask for an update on his department’s plans for meeting with representatives of the baby group sector. In the letter, the Committee highlights how the new restrictions on meetings of more than six people have caused further confusion to this sector, and requests urgent clarification.

You can read the letter here: https://committees.parliament.uk/publications/2699/documents/26695/default/

The Institute of Health Visiting (iHV) was delighted to be invited to attend a virtual round table meeting about supporting new and expectant mothers with The Duchess of Cambridge this week to highlight the essential work and support that health visitors provide to new mothers.

The Duchess of Cambridge spoke with leading sector experts about the challenges and impact that COVID-19 is having on new and expectant mothers and their families ahead of the UK’s Maternal Mental Health Awareness Week (4-10 May).

• Top line L-R: Jessica Read, Deputy Chief Midwifery Officer for England, Julia McGinley, Head of Parent Support, Netmums (an inclusive online parenting community), Katie Massie-Taylor, Co-founder of Mush (an online community and app for mums)
• Second line L-R: Dr Edward Morris, President, The Royal College of Obstetrics and Gynaecology (RCOG), Dr Alain Gregoire, Chair of the Maternal Mental Health Alliance, Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting

On this call, the group discussed key concerns that new and expectant parents had during this time, including apprehension about going into hospital and for community appointments, isolation, reduced support systems and increased anxiety. They also discussed a potential silver lining of lockdown being the increased presence of supportive partners, and new families being able to spend more time together with their newborns. The experts also spoke about the importance of community and emotional support for mothers which has been made more difficult by social distancing.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“We want to get the message to families that the health visiting service is open, and we encourage all parents who would value some support to use their health visiting service when they need to.  Many areas now have advice lines that are manned throughout the day, in some cases into the evening.  If a health visitor isn’t immediately available a message can be left and one will ring back.”

Health visitors, alongside GPs, are the only health professionals who routinely see and support all families from pregnancy to when the youngest child goes to school.

The Duchess praised the resources developed by key institutions who are providing advice at this time saying:

“As organisations you’re playing such a vital role giving key information. You’re hugely trusted by the public and therefore the information you provide is a lifeline to a lot of people.”

The iHV has an area on their website for families which includes a section on Parenting through COVID-19. It can be found here: https://iHV.org.uk/ParentingCOVID19

The Institute of Health Visiting team would like to say thank you to every single health visitor and member of a health visiting team across the UK – we know that they are all going the extra mile to support the children and families in their areas. They are all heroes, our heroes.


More information about The Duchess’ meetings and round table call:

The Duchess took part in a call with midwives from Kingston Hospital last week and on Wednesday held a roundtable call with representatives from the sector including:

  • Dr Alain Gregoire, Chair of the Maternal Mental Health Alliance UK
  • Dr Eddie Morris, President, The Royal College of Obstetrics and Gynaecology (RCOG)
  • Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting
  • Jessica Read, Deputy Chief Midwifery Officer
  • Katie Massie-Taylor, Co-founder of Mush Mums (an online community and app for mums)
  • Julia McGinley, Head of Parent Support, Netmums (an inclusive online parenting community)

 

NHS Digital has today released new SATOD data for Quarter 3 2016/17. The full data can be accessed here.

Key points from the data are:

  • The percentage of women recorded as smokers at the time of delivery has risen slightly in the third quarter of 2016/17 to 10.6%.
  • This is the same rate recorded for quarter three last year and for 2015/16 overall (10.6%). It is slightly higher than the rate recorded for quarter 2 2016/17 (10.4%), although the difference is not statistically significant.
  • There were large geographical differences. Between CCGs this ranged from 2% in NHS Richmond to 26.6% in NHS Blackpool. Amongst all NHS England Regions, this varied from 16.1% in  Cumbria & North East  to 5.1% in London. This is a similar pattern to previous years.
  • The quality of this data remains a cause for concern, with 2% of maternities having an unknown smoking status (compared to 1.4% in 2013/14, although this is an improvement on the 2015/16 rate of 3.1%.

To note: From April 2017 the number of maternities with an unknown smoking status will be excluded from the baseline calculations; if this was applied to the current data the overall rate would increase to 10.9%.  To aid this transition and highlight the difference this may make to rates at a local level, NHS Digital is publishing both figures during 2016/17, which can be accessed via the excel spreadsheet.

NHS England has put together a survey to help better understand the information that women want when making a decision about their maternity care.

They would like information from women who are pregnant or have had a child in the last two years. This will help to improve maternity information and care for women.

NHS England wants to find out what information is important to women, before deciding where to go for care before, during and after birth. They want to know when women want this information, and what format(s) would be most useful to them. This will be an excellent tool to inform how they shape information for women going forward to support them in making choices.

The survey should take about 15 minutes to complete.

They would really appreciate help from health visitors in cascading this survey to women – in particular, if you have links  with harder to reach groups, then that would be really appreciated.

Survey closes 31 March 2017.

Many thanks for your contributions to shaping this survey.

The Secretary of State has announced £8m funding available for Maternity Safety Training.

All Trusts are being encouraged to apply with a minimum of £40k to be allocated to every Trust.  Bids will go to the nominated Regional Leads who are undertaking the shortlisting process; this will be followed by a panel review to determine the level of award to each Trust (this can be up to £80k).

The deadline to submit bids is 5pm Friday 18 November 2016.

The National Maternity Review Report, published today, sets out to improve maternity services across the country for women, their babies and families.

Dr Cheryll Adams, Executive Director of the iHV, said:

“We welcome the report and the improvements it will bring to maternity services.  We are particularly pleased at the attention given to  the need for closer working and improved training, communication and transitions between the team around the mother including with health visitors and for enhanced postnatal care. Where community midwives have been able to be based in children’s centres with health visitors, they find together these professionals can be very responsive to mothers’ needs so it is helpful to see this model being endorsed.”

The National Maternity Review report finds that despite the increases in the number of births and the increasing complexity of cases, the quality and outcomes of maternity services have improved significantly over the last decade.

  • The stillbirth and neonatal mortality rate in England fell by over 20% in the ten years from 2003 to 2013.
  • Maternal mortality in the UK has reduced from 14 deaths per 100,000 maternities in 2003/05 to 9 deaths per 100,000 maternities in 2011/13.
  • The conception rate for women aged under 18 in England, a key indicator of the life chances of our future generations, reduced by almost half, between 1998 and 2013.

However, the review also found meaningful differences across the country, and further opportunities to improve the safety of care and reduce still births.

Prevention and public health have an important role to play, as smoking is still the single biggest identifiable risk factor for poor birth outcomes. Obesity among women of reproductive age is increasingly linked to risk of complications during pregnancy and health problems of the child.

The framework highlights seven key priorities to drive improvement and ensure women and babies receive excellent care wherever they live.