Maternity safety is an important issue for all members of our Clinical Negligence Scheme for Trusts (CNST). Obstetric incidents can be catastrophic and life-changing, with related claims representing the scheme’s biggest area of spend. Of the clinical negligence claims notified to us in 2017/18, obstetrics claims represented ten percent (1,067) of clinical claims by number, but accounted for 48% of the total value of new claims, £2,166.3 billion of the total £4,513.2 million. 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.
For a second year we have joined forces with the national maternity safety champions, Matthew Jolly and Jacqueline Dunkley-Bent, to support the delivery of safer maternity care through an incentive element to the contribution to the CNST, rewarding trusts meeting ten safety actions designed to improve the delivery of best practice in maternity and neonatal services. In the second year the scheme will further incentivise the ten maternity safety actions from the previous year with some further refinement.
The ten actions [and the refinements for year two] have been agreed with the national maternity safety champions in partnership with the Collaborative Advisory Group. The Collaborative Advisory Group 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, and the Care Quality Commission.
Provision for the maternity incentive scheme has been built into our CNST maternity pricing for 2019/20. As in year one, 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 the ten-out-of-ten threshold 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 actions they have not achieved. Such a payment would be at a much lower level than the 10% contribution to the incentive fund.
The full details of the scheme, including the conditions, ten safety actions, supporting technical guidance, frequently asked questions, Board declaration form and action plan details are available to review.
The ten maternity safety actions are summarised here:
Safety action 1: Are you using the National Perinatal Mortality Review Tool to review perinatal deaths to the required standard?
Safety action 2: Are you submitting data to the Maternity Services Data Set to the required standard?
Safety action 3: Can you demonstrate that you have transitional care services to support the Avoiding Term Admissions Into Neonatal units Programme?
Safety action 4: Can you demonstrate an effective system of medical workforce planning to the required standard?
Safety action 5: Can you demonstrate an effective system of midwifery workforce planning to the required standard?
Safety action 6: Can you demonstrate compliance with all four elements of the Saving Babies’ Lives care bundle?
Safety action 7: Can you demonstrate that you have a patient feedback mechanism for maternity services and that you regularly act on feedback?
Safety action 8: Can you evidence that 90% of each maternity unit staff group have attended an ‘in-house’ multi-professional maternity emergencies training session within the last training year?
Safety action 9: Can you demonstrate that the trust safety champions (obstetrician and midwife) are meeting bimonthly with Board level champions to escalate locally identified issues?
Safety action 10: Have you reported 100% of qualifying 2018/19 incidents under NHS Resolution’s Early Notification scheme?
We issued a press release announcing the results of year one of the scheme with details of the results and some successes of year one.
We have archived details of year one of the maternity incentive scheme.
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