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‘Positive first year’ for new maternity safety incentive scheme

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A national scheme to help maternity services in England deliver better care to mothers and their babies has shown positive results in its first year, according to those behind it.

NHS Resolution’s maternity incentive scheme rewards trusts that meet 10 safety actions which are designed to improve the delivery of best practice in maternity and neonatal services.

The 10 actions were agreed by the national maternity safety champions, Matthew Jolly and Jacqueline Dunkley-Bent, in partnership with NHS Resolution’s collaborative advisory group (CAG).

As part of the refreshed safety strategy Safer Maternity Care, which was published in November 2017, NHS Resolution introduced the scheme to incentivise the delivery of safer maternity care.

To fund the new initiative, the body collected an extra 10% of funding from trusts in 2018-19 that it already took for its maternity care clinical negligence scheme.

Trusts that subsequently demonstrated compliance against all 10 safety actions could recover the additional 10% payment and also benefit from a share of any unallocated funds.

Those making progress but not meeting all of the actions could benefit from a lesser sum to help them achieve the remaining actions if they were able to demonstrate a “robust business case”.

In year one 75 trusts met all 10 actions and have received their 10% rebate and have been awarded a proportionate share of the remaining funds, said NHS Resolution.

jacqueline dunkley bent

jacqueline dunkley bent

Jacqueline Dunkley-Bent

Meanwhile, 57 trusts did not meet all 10 actions and have received some funding linked to robust action plans to enable them to meet the outstanding safety actions.

In addition, the body said the scheme saw “demonstrable impact in terms of delivering safety improvements”.

These included 100% registration with Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRACE-UK) to access national perinatal mortality review tool.

There was also significant improvement in quality of reporting to NHS Digital for March 2018 and 100% reporting to NHS Resolution’s early notification scheme.

The incentive scheme is going to be extended into a second year and details will be announced next month, according to NHS Resolution.

Dr Jolly, national clinical director for maternity and women’s health at NHS England, said: “The scheme has been hugely influential and led to improvements in services, with all participating trusts receiving varying levels of incentive funding to drive further improvements.”

Helen Vernon, chief executive at NHS Resolution, highlighted that maternity clinical negligence claims represented the biggest area of spend for NHS Resolution.

Of the claims in 2017-18, obstetrics represented 10% (1,067) of clinical claims by number, but accounted for 48% of the total value of new claims, £2,166.3m of the total £4,513.2m.

Ms Vernon said: “Trusts that improve their maternity safety will be in a better place to protect mothers and babies from harm, will save the NHS money, allow resources to be made available to deliver frontline care and will help drive continuous improvement.”

Denise Chaffer, director of safety and learning at NHS Resolution, said: “Obstetric incidents can be catastrophic and life-changing for families, and we need to all work together to do all we can to help prevent these occurring.

NHS England

Matthew Jolly

Matthew Jolly

“Our maternity incentive scheme draws together a number of actions agreed by senior clinicians to help drive improvements in maternity,” she said.

She added: “By meeting all 10 safety actions, we believe that this will help trusts to deliver safer maternity services and result in fewer cases of brain injuries or other harm that lead to negligence claims.”

NHS Resolution is an arms’-length body of the Department of Health and was formerly known as the NHS Litigation Authority. It changed its name in April 2017.

The organisation’s purpose is to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care.

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