The Maternity and Neonatal Safety Improvement Programme (known as MatNeoSIP), was renamed following the launch of the NHS Patient Safety Strategy in July 2019. It was previously known as the Maternal and Neonatal Health Safety Collaborative.
It aims to:
• Improve the safety and outcomes of maternity and neonatal care of all women, babies and families in England, reducing unwarranted variations in care and experience of care
• Help reduce maternal and neonatal deaths, stillbirths and brain injuries that occur during or soon after birth by 50% by 2025 – a national target set out in Better Births
Led by NHS England and Improvement, the National MatNeoSIP’s mission is to create and embed the conditions for all staff to improve the safety and outcomes of maternal and neonatal care by reducing unwarranted variation and provide a high quality healthcare experience for all women, babies and families across England. Read more about the National MatNeo SIP.
About the Maternity and Neonatal Patient Safety Network
In Wessex the focus of work is a Local Learning System (Improvement forum), which has been set up to enable our maternity systems, units and clinicians to collaborate and work together to improve services and reduce avoidable harm to mothers and babies.
The aim of the Local Learning System is to:
- Support individuals and teams to develop Quality Improvement skills through undertaking supported projects in their maternity units
- Provide an opportunity to share ideas, success & challenges about quality improvement projects
- Reduce variation and where possible to increase standardisation of care
- Support individuals and teams to develop Quality Improvement skills through undertaking supported projects in their maternity units
- Provide an opportunity to share ideas, success & challenges about quality improvement projects
- Support system level improvement and sharing of resources to reduce duplication
- Provide a regional forum to profile Quality Improvement and patient safety in Local Maternity Systems in Wessex, and through this align thinking and support collaboration across the region
- Share information with other maternity networks to improve communication and understanding.
The MatNeo Patient Safety Network offers a unique opportunity for those working to improve maternal and neonatal care across the local maternity systems to interact and collaborate, and a forum for local improvement to thrive.
Who are we working with
Locally, we are working in partnership with our regional Trusts, Local Maternity and Neonatal Systems (LMS), and other partners such as Public Health, Maternity clinical networks, Neonatal Operational Delivery Networks and voluntary sector. Due to our geography we extend both to the South West and South East to include Dorset (Dorchester and University Hospitals Dorset) and Southampton, Hampshire (Winchester and Basingstoke), Isle of White and Portsmouth as well as Salisbury.
Key ambitions
The National MatNeoSIP aims to:
- contribute to the national target of increasing the proportion of smoke-free pregnancies to 94% or greater by March 2023
- to support the spread and adoption of the preterm perinatal optimisation care pathway across England by 95% or greater by March 2025
- improve the early recognition and management of deterioration of women and babies
- to support the development of a national pathway approach for the effective management of maternal and neonatal deterioration using the PIER framework across all settings by March 2024
- to work with key stakeholders to support the development of a national maternal early warning score (MEWS) by March 2021 and spread to all providers by March 2024
- to support the spread and adoption of the neonatal early warning ‘trigger and track’ score (NEWTT) to all maternity and neonatal services by March 2023
We will support these objectives locally by focusing on:
• Optimisation and stabilisation of the preterm infant through
- birth in the right place;
- antenatal administration of magnesium sulphate;
- antenatal corticosteroids;
- intravenous antibiotics;
- delayed cord clamping;
- thermoregulation and
- early breast milk.
Optimisation of the preterm infant is being supported by a care bundle from the British Association of Perinatal Medicine (BAPM) which locally is known as PREM 7. The seven elements above making this a whole bundle. There are toolkits available to support QI work
on the BAPM website or please contact us.
• Early recognition and management of deterioration of women and babies through:
- testing MEWS at a system level
- examining the current MatNeo Prevent, Identify, Escalate and Respond (PIER) pathway
- supporting the adoption and spread of the neonatal early warning ‘trigger and track’ score (NEWTT2)
Following the launch of the NEWTT2 tool by BAPM in January 2023, we will be supporting the roll-out of the new framework across the units in our region. BAPM have released all the resources to support this delivery, plus the relevant contacts, and these can be viewed on the NEWTT2 page on their website.
We will continue to build on past experiences and successes such as PReCePT (Prevention of Cerebral Palsy in PreTerm Labour) which is now included in the BAPM pathway.
Local Work/Resources to Help with Quality Improvement in Maternity
There are a number of examples of local improvement projects that have already had an impact on maternity care that are detailed below and can be found either via links below or in the resources section to the right of this page.
Wessex Case Study: Preterm Optimisation Pathway for Neonates Born Less Than 34 Weeks Gestation- Early Breast Milk
The Maternity and Neonatal Safety Improvement Programme seeks to improve safety of neonatal care by reducing unwarranted variation in neonatal care settings through the optimisation and stabilisation of the preterm infant. One aspect of this programme of care is the administration of early breast milk to babies born less than 34 weeks gestation. You can read more about how we supported this work and helped to implement it across our region and what the results were in our case study.
PREM7 - South East Clinical Delivery and Networks
As mentioned, we partner with other Maternity programmes as part of the South East Maternity Regional Team network to deliver PREM7 to maternity and neonatal services across Wessex and the South East NHS region. You can view more of the work that goes on across the South East
on their website.
Wessex Healthier Together - Antenatal Care pathways
We have worked with Wessex Healthier together to deliver a set of standardised pathways to be used across Wessex for antenatal care and we developed a pack that has been delivered to maternity units and primary care staff for standard use. You can view the pathways pack
on the Wessex Healthier Together website here and you can view a poster detailing our involvement in the resources tab to the right of the page.
Wessex Patient Safety Collaborative Quality Improvement Hub
This site holds a wealth of information and signposts to further resources about Quality improvement, which are useful to anyone working on projects around safety, quality and Patient experience. It's well worth a look
here.
UHS Maternity - PERIPrem Plus Optimal cord management (OCM) & Birth Day Cuddles (BDC) poster
Our partners at UHS have developed a poster detailing the work they have done for pre-term babies, particularly by increasing the rates of OCM and BDC in their units. Their poster recently won the QI award in the UHS Always Improving conference and you can
view the poster here or download from the resources tab on the right hand side of the page.
To meet our aims we are keen to network and share with teams and individuals, so please do contact Rebecca Savage or Alison Scannell, our Maternity and Neonatal Patient Safety Programme Managers, on the contact details below if you would like to find out more or share your work.
National Resources
As our work is part of a National Programme we have found a number of resources that may be of interest and help you deliver local projects:
NHS Improvement: Maternal and Neonatal Health Safety improvement programme:
Maternity Transformation Programme
Born out of the Better Births Report, The Maternity Transformation programme seeks to achieve the vision set out in the report, which you can
view here.
For further information on the programme and resources to support your work, check out a
resource pack here.
Saving Babies Lives: Care Bundle Version 2
Launched in March 2019 to bring together learning from Version 1 and outline how to reduce perinatal mortality. There are 5 areas of focus:
- Smoking in Pregnancy
- Risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction (FGR)
- Raising awareness of reduced fetal movement (RFM)
- Effective fetal monitoring during labour
- Reducing preterm birth
Find out more from the
Saving Babies Lives Care Bundle Version 2 report. Please note, we awaiting the release of Saving Babies Lives: Care Bundle Version 3 and will release details when they are available.
ATAIN: (Avoiding Term Admissions Into Neonatal Units)
There is overwhelming evidence that separation of mother and baby so soon after birth interrupts the normal bonding process, which can have a profound and lasting effect on maternal mental health, breastfeeding and long-term morbidity for mother and child.
This makes preventing separation, except for compelling medical reason, an essential practice in maternity services and an ethical responsibility for healthcare professionals.
The focus is on four areas of significant potential harm to babies:
- Respiratory conditions
- Hypoglycaemia
- Jaundice
- Asphyxia (perinatal hypoxia-ischaemia)
Want to know more about ATAIN? E-Learning for health have developed
a module covering the 4 areas that the programme seeks to address in order to reduce separation of mother and term babies.
NHSE: National Maternity Early Warning Score (MEWS) podcasts
Three podcasts introducing the new Maternity Early Warning Score (MEWS) are available from the national patient safety team.
- The first discusses the development of the MEWS tool and is available here.
- The second focuses on the benefits of implementing the new tool and is available here.
- The third provides an overview of the feedback from the testing phases of the MEWS tool and is available here.
The Ockenden Report
This report, released in the House of Commons on 30th March 2022, details the findings, conclusions and essential actions from the independent review of maternity services at The Shrewsbury and Telford Hospital NHS Trust. You can read
the full report here.
Reading the signals: Maternity and neonatal services in East Kent – the Report of the Independent Investigation
This report, released in the House of Commons on 19th October 2022 and headed up by Dr Bill Kirkup CBE, details the investigations in maternity services in two East Kent hospitals and outlines recommendations and actions in order to dramatically improve services. You can read
the full report here.
NHS Digital: Maternity Services Monthly Statistics
These are the Official Statistics about NHS-funded maternity services in England, from the Maternity Services Data Set (MSDS), released monthly. Including activity at booking and pregnancy outcomes. You can view
on the NHS Digital website.
FutureNHS: Perinatal Culture and Leadership Programme Blog
Our Optimisation 'Coaching for Culture' programme has provided the opportunity for our SHIP (Southampton, Hampshire, Isle of Wight & Portsmouth) colleagues to access training on improving our workplace culture.
Other useful links
Royal College of Physicians and Surgeons of Glasgow: Three P’s in a POD - Preventing Maternal Deaths:
