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Improving Scotland’s maternity care

11 March, 2014

Improving Scotland’s maternity care

A multidisciplinary approach in which maternity, neonatal and paediatric services are working together is underway in Scotland. Emma Riches from Healthcare Improvement 
Scotland explains more.

Midwives magazine: Issue 2 :: 2014 A multidisciplinary approach in which maternity, neonatal and paediatric services are working together is underway in Scotland. Emma Riches from Healthcare Improvement Scotland explains more.


An initiative is underway in Scotland to improve the nation’s maternity care. It has specific targets to meet by 2015, such as bringing about a drop in the number of stillbirths.

The project – the Maternity and Children’s Quality Improvement Collaborative – was launched in March 2013 as a three-year programme in which maternity, neonatal and paediatric services worked together to improve outcomes and reduce inequalities.

The initiative comes from the Scottish Patient Safety Programme (SPSP), which was set up by Healthcare Improvement Scotland, a national health body set up to improve the quality of health care for people across Scotland, and puts patient safety at the heart of its work. The SPSP, which was established in 2008, had a remit to build sustainable infrastructure for quality improvement in NHS Scotland. Since it began, it has delivered a programme that encompasses acute adult and paediatric care, and more recently mental health and primary care. Now it is the turn of maternity services.

The collaborative has a series of key improvement targets to meet in the next couple of years. It must reduce harm in women, babies and children by 30%, decrease the number of stillbirths and neonatal deaths by 15% and achieve a 30% drop in severe postpartum haemorrhages. It also needs to increase the percentage of women satisfied with their care to greater than 95%. Interventions to address smoking in pregnant women are also a key component of the programme.

The programme is composed of six two-day learning sessions with action periods in between. Every NHS board in Scotland sends multidisciplinary clinical teams from the three disciplines to the learning sessions and will report on outcome and balancing measures. SPSP provides direct support to boards by providing networking opportunities, monthly WebEx meetings, support visits and regular telephone and email communication.

The improvement aims are delivered using robust improvement science methodologies within the existing SPSP framework of a ‘cause-and-effect’ driver diagram. A change package identifies and establishes recommended interventions that have been proven to bring about improvements in patient care collectively.

The work programme is built around four drivers for change, shared by all the maternity, paediatric and neonatal services. These are: person-centred care; leadership and culture; teamwork, communication and collaboration; and safe, effective and reliable care.

To see whether the changes have been effective, data must be collected. A measurement package has been developed to link process and outcome measures.

Maternity champions are in place to help make it all happen. They work in each NHS board and have relevant training and education to encourage engagement and develop local champions. They also act as a link between local and national initiatives. The community of maternity champions provides a forum to share ideas, resources and solutions across Scotland. Maternity champions receive ongoing support from the SPSP team.

The support for the collaborative has been overwhelming. The programme provides a stronger voice among multidisciplinary groups, and offers an opportunity to improve health outcomes for the benefit of the women, children and families of Scotland.

► For more information, visit: www.scottishpatientsafetyprogramme.scot.nhs.uk


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