Recommendation 14

HM Government Acknowledged

We strongly agree with the committee that collecting robust, consistent and equity-focused data on ethnicity and maternal morbidity is essential to enable health services to monitor and improve their service delivery, thus guiding improvements in maternal outcomes. NHS England has worked closely with stakeholders, including ICBs and trusts, voluntary sector partners and national bodies such as the Office for National Statistics, to develop an Ethnicity Recording Improvement Plan. The plan sets out 5 areas for action by ICBs and providers that are essential to drive improved ethnicity recording practice, accurate recording and robust analysis to understand inequalities between groups. This includes: • providing clinical administrative staff with resources and training to support direct yet culturally sensitive conversations with patients about ethnicity recording • regularly reviewing completion of ethnicity fields across different services and carrying out improvement work to drive up completion where necessary • working to optimise patient record systems and forms to ensure that recording ethnicity is the easiest thing to do and supported by a user-friendly interface • using the data collected to: • understand ethnic health inequalities across services • carry out targeted interventions to remove barriers to access, experience and outcomes To support implementation of the plan when it is published, NHS England will work with systems and providers to disseminate good practice resources and remove barriers to improvement that can be addressed nationally, such as outdated ethnicity codes and fragmented data sets that require repeated recording of ethnicity for the same patient across services. The plan contains example measures that can be monitored at ICB and provider level to track progress on improving the quality of ethnicity data. Alongside this, NHS England is working to embed monitoring of the completeness of ethnicity data into accountability mechanisms, with a focus on reducing the number of blank records, and inappropriate use of ‘not known’ and ‘not stated’ codes. NHS England is developing a Maternity and Neonatal Equity and Equality Dashboard to strengthen transparency and accountability in addressing health inequalities. The initial iteration, scheduled for launch in January 2026, will present 12 important metrics relating to disparities in outcomes and experiences. This will enable the identification of areas where Black and Asian women, and women from socioeconomically deprived backgrounds, experience the greatest inequities in care quality and health outcomes. By consolidating a range of inequality indicators into a single platform, the dashboard will support trusts in: • monitoring performance • assessing the impact of improvement initiatives • driving targeted action Data will be published with the shortest feasible time lag to promote a culture in which tackling inequalities is prioritised across maternity and neonatal services. Importantly, the dashboard will be publicly accessible, enhancing transparency and strengthening accountability to service users. Subsequent iterations will seek to incorporate less routinely collected data and develop more sophisticated metrics on patient experience and clinical outcomes, further supporting evidence-based improvement. Ethnicity coding data completeness in the Maternity Services Data Set has improved year on year: from 92% in 2021 (when data was first considered robust) to 96% in 2024. This is important as it helps the NHS better understand health outcomes and, from there, how effective action is to address inequalities. These improvements in data quality have been supported by safety action 2 of NHS Resolution’s Maternity Incentive Scheme, which supports data quality improvement. ’Not stated’, ‘missing’ and ‘not known’ are not valid records for the ethnicity coding data quality standard as they are only to be used in exceptional circumstances. As a result of the committee’s recommendations, a new system of surveillance for severe maternal morbidity is also being developed. PReventing Severe Maternal Morbidity and mortality (PRiSMM) is a new data-driven approach that is being developed to monitor pregnancy complications in real time using linked patient care records. This system will provide deeper insights into the causes and pathways of harm, enabling targeted interventions to reduce unequal risks and improve outcomes for all women and babies. Central to this effort is the development of a ‘Maternal Care Bundle’, which will standardise care across 5 core clinical areas and be implemented from April 2026. A supporting measurement strategy will track implementation and ensure the bundle is having the intended impact, particularly in reducing ethnic inequalities. The first data from this new surveillance system is expected in the first quarter of 2026. Additionally, NHS England is due to launch a Maternity and Neonatal Equity and Equality Dashboard i