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Obstetric incidents can be catastrophic and life-changing, with related claims representing the Clinical Negligence Scheme for Trusts’ (CNST) biggest area of spend. Of the clinical negligence claims notified to us in 2020/21, obstetrics claims represented 11 per cent (1,190) of clinical claims by number, but accounted for 59 per cent of the total value of new claims; almost £4.2 billion.
The Maternity Safety Strategy set out the Department of Health and Social Care’s ambition to reward those who have taken action to improve maternity safety. We are very happy to support this work through the Maternity Incentive Scheme.
Maternity Incentive Scheme: Year three
We are pleased to announce MIS year 3 results which are now available below. The results can be filtered by Trust’s name, region and/or compliance status. Should you have any queries, please contact firstname.lastname@example.org
Maternity Incentive Scheme: Year four
The scheme supports the delivery of safer maternity care through an incentive element to trust contributions to the CNST. The scheme, developed in partnership with the national maternity safety champions, Dr Matthew Jolly and Professor Jacqueline Dunkley-Bent OBE, rewards trusts that meet 10 safety actions designed to improve the delivery of best practice in maternity and neonatal services.
In the fourth year, the scheme further incentivises the 10 maternity safety actions from the previous year with some further refinement.
Year four of the scheme began on 9 August 2021. Following the relaunch of the fourth year, NHS Resolution and the Collaborative Advisory Group (CAG) have continued to monitor the Trusts’ position in relation to Covid-19, staffing and acuity and the challenges faced by Trusts in achieving the scheme’s safety actions.
Due to the Covid-19 pandemic, in December 2021, a decision was made by the scheme’s CAG to pause the reporting for year 4 of the scheme. Trusts were asked to continue to apply the principles of the scheme and to continue to report to MBRRACE-UK, NHS Digital and HSIB.
The scheme’s CAG reconvened on 28 February 2022 and a decision was made to relaunch the scheme on 6 May 2022.
The timeframes and submission deadline for MIS year 4 have been extended and new requirements included in light of Ockenden Report. The scheme’s conditions have also been reviewed and strengthened.
The 10 safety actions
The ten safety actions for year four have been agreed with the national maternity safety champions in partnership with the Collaborative Advisory Group (CAG). The CAG was established by NHS Resolution to bring together other arm’s length bodies and the Royal Colleges to support the delivery of the CNST maternity incentive scheme and has also advised NHS Resolution on the refined safety actions. Members of the group include: the Department of Health and Social Care, NHS Digital, NHS England, NHS Improvement, Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE), Royal College of Anaesthetists, the Care Quality Commission (CQC) and the Healthcare Safety Investigation Branch (HSIB).
How the scheme works
Provision for the maternity incentive scheme has been built into our CNST maternity pricing for 2022/23. As in year three, the scheme incentivises ten maternity safety actions. Trusts that can demonstrate they have achieved all of the ten safety actions will recover the element of their contribution to the CNST maternity incentive fund and will also receive a share of any unallocated funds.
Trusts that do not meet all ten safety actions will not recover their contribution to the CNST maternity incentive fund, but may be eligible for a small discretionary payment from the scheme to help them to make progress against any actions they have not achieved. Such a payment would be at a much lower level their original 10 per cent contribution.
All participating trusts are required to provide clinical and financial contacts to receive and send communications relating to the maternity incentive scheme.
How the scheme is managed
Whilst the maternity incentive scheme is a self-certified scheme, with all scheme submissions requiring sign-off by trust Boards following conversations with trust commissioners, all submissions also undergo an external verification process and are sense-checked by the Care Quality Commission (CQC).
We have carried out an interim evaluation of the maternity incentive scheme, incorporating feedback from NHS trust maternity services and identifying key outcomes from the scheme to date.
You can find more information on the results of year one and year two of the maternity incentive scheme below.
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