Source · Select Committees · Women and Equalities Committee
Recommendation 4
4
Accepted
Paragraph: 43
It is unclear how the Equity and Equality guidance will be implemented and monitored.
Recommendation
It is unclear how the Equity and Equality guidance will be implemented and monitored. In response to this report, NHS England should set out their approach for assessing and monitoring the strategies of local maternity services. The Government should also provide clear timescales for the roll-out of the maternal morbidity indicator.
Government Response Summary
NHS England has reviewed local maternity systems' equity and equality action plans and will require all LMNSs to publish their plans by 31 March 2024, while also monitoring relevant data and providing regional and national support.
Paragraph Reference:
43
Government Response
Accepted
HM Government
Accepted
20. The Equity & Equality Guidance for LMNS asked local maternity systems to publish equity and equality action plans. Every LMNS has produced a plan which has been reviewed by NHS England. The review identified good practice and what further support is needed to improve equity and equality. All LMNS’ will publish their equity and equality action plan by 31 March 2024, as set out in the Delivery Plan. 21. ICS are responsible for assuring implementation of LMNS equity and equality action plans, in line with the recommendations of the Hewitt Review5 and NHS England’s operating framework6. 22. As set out in the Delivery Plan, NHS England will: • provide regional and national support for the implementation of LMNS equity and equality action plans; • monitor at national level: Ȥ CQC maternity survey data by ethnicity and deprivation Ȥ data about maternal mortality, stillbirths, neonatal mortality, brain injury (during or soon after birth) and preterm birth by ethnicity and deprivation 23. In examining these data, the NHS recognises that the social determinants of health, the conditions in which people are born, grow, live, work and age and inequities in power, money and resources are a significant driver of health inequalities. This emphasises the importance of the role played by the Maternity Disparities Taskforce in bringing together experts from across the health system, government departments and the voluntary sector to address health inequalities (as described in paragraph 8). 24. We recognise the importance of rolling out a maternal morbidity indicator and the Department of Health and Social Care is considering how this can be delivered. This includes exploring routes to commissioning research to develop and evaluate a composite maternal morbidity outcome indicator tailored to morbidity outcomes which would be impacted by maternal medicine network care. 25. This follows an earlier study by The National Institute for Healthcare Research, funded by the Department of Health and Social Care, to determine the feasibility of developing Maternal Morbidity Outcome Indicator in England using routinely available hospital data. The research considered the use of an indicator to measure severe pregnancy complications or ‘near misses’. Near misses are more common than maternal deaths and show disparities by ethnic group. The use of a measure based on ‘near misses’ helps the NHS to identify areas with good practice which other areas can learn from, as part of the NHS’ approach to encourage continuous quality improvement in maternity care. 26. NHS England have developed fourteen Maternal Medicine Networks across England, to ensure that all women with chronic and acute medical problems around pregnancy (e.g. diabetes or heart disease), have access to specialist management and care from physicians and obstetrics, tackling the biggest contributors to maternal mortality. 27. The Policy Research Unit for Maternal and Neonatal Health has been commissioned through the National Institute for Healthcare Research Policy Research Programme to research the numbers and proportions of women with a need for maternal medicine network care. This will enable the maternal medicine networks to plan their service provision and base need.