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Maternity Dashboard

South West Maternity and Children’s Strategic

Clinical Network

27th November 2014Ann Remmers, Clinical

Director

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Outcome Ambition Transformational Elements

Reduction in perinatal morbidity and mortality (Domain 1)Improved maternal outcomes and experience (Domains 3 and 4).

Improving maternal & perinatal outcomes and experience in the South West.

Developing a South West maternity dashboard to identify unwarranted variation in outcomes (September 2014).Development of an agreed model of care to prevent and treat major post-partum haemorrhage, reduce stillbirth rates, pre-term birth and admission of term babies to NICU (2015-16).

Network Priority

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• NHS Mandate 2013-15

- Reducing infant mortality, neonatal mortality and stillbirths

- Women’s experience of maternity services

• Reducing stillbirth rates is a priority of the National Clinical Director for Maternity and Women’s Health, Dr Catherine Calderwood

National Priority

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• Network requested example dashboards from acute trusts across the South West via South West HoMS

• 16 dashboards were submitted (inc. Dorset and Channel Islands)

• Showed wide variation not only in the range of indicators measured but also in the criteria for an indicator. e.g. for 1 indicator there were 12 different criteria being used

Background

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• Maternity Working group worked on establishing Maternity dashboard – includes 32 indicators

• Detailed Technical Appendix has been produced to provide support and guidance to those supplying the data

• In the first round of data collection, 13 out of 14 Acute Trusts submitted data

• Data collection started in October

Progress so far

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Dashboard Indicators

Total number of babies born

Instrumental birth rate

PPH ≥1500 ml rate

Apgar at 5 min < 7 at term or over

Smoking at birth rate

Number of live births

Caesarean section rate

Rate of women requiring level 3 care

NICU admission at term or over( on hold)

Obesity rates

Number of birth episodes

Elective CS rate Preterm birth rate <37 weeks

Stillbirth rate Rate of births resulting from under 18 conceptions

Birth episode rate by place of birth

Emergency CS rate

Preterm birth rate <34 weeks

Early booking rate for analysis by provider /CCG

Rate of birth resulting from conceptions in women aged 40 or over

Midwife to birth ratio

Robson group 1 rate

Preterm birth rate <27 weeks

Early booking rate for analysis by provider or by CCG

Female genital mutilation rate

Induction of labour rate

3rd & 4th degree tear ratein unassisted births

Low birth weight rate at term or over in live born babies

Breastfeeding rate on transfer to health visitor (at 10-14 days) (on hold)

Spontaneous birth rate

3rd & 4th degree tear ratein assisted births

Low birth weight rate at term or over in stillborn babies

Breastfeeding rate at 6-8 weeks(on hold)

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• Agree presentation of data with the working group• Work on setting thresholds• Use of the dashboard to identify and monitor

improvement work within maternity services as a part of the Network work programme, e.g. reducing stillbirths, low birth weight babies, management post-partum haemorrhage

Questions?

Moving forward