The government has set a target of halving the rates of stillbirths, neonatal and maternal deaths, and brain injuries associated with delivery, by 2025.

There have been a range of initiatives to support this aim, including NHS Resolution’s incentive scheme under which NHS trusts with maternity units who meet 10 criteria or safety actions, agreed by the national maternity champions are eligible for a 10%+ rebate of their CNST maternity contributions.

The terms for the third year of the scheme have now been released, which seek to build upon the achievements of the first two years, and were among topics discussed at the excellent ‘Sharing best practice for safer births’ conference on 5 December 2019. The criteria appear similar on first reading, although continue to develop and be refined and so care is needed.

The 10 criteria are as follows:

  1. Are you using the National Perinatal Mortality Review Tool to review perinatal deaths to the required standard?

  2. Are you submitting data to the Maternity Services Data Set to the required standard?

  3. Can you demonstrate that you have transitional care services to support the recommendations made in the Avoiding Term Admissions Into Neonatal units Programme (ATAIN)?

  4. Can you demonstrate an effective system of clinical workforce planning to the required standard?

  5. Can you demonstrate an effective system of midwifery workforce planning to the required standard?

  6. Can you demonstrate compliance with all five elements of the Saving Babies’ Lives care bundle version 2?

  7. Can you demonstrate that you have a mechanism for gathering service user feedback, and that you work with service users through your Maternity Voices Partnership to coproduce local maternity services?

  8. Can you evidence that at least 90% of each maternity unit staff group have attended an ‘in-house’ multi-professional maternity emergencies training session within the last training year?

  9. Can you demonstrate that the trust safety champions (obstetrician and midwife) are meeting bi-monthly with board level champions to escalate locally identified issues?

  10. Have you reported 100% of qualifying 2019/20 incidents under NHS Resolution’s Early Notification scheme?

For those tasked with preparing submissions, it is important to read the detail of the underlying required standards, as there are a variety of changes to tighten criteria, developments to reflect progress in the tools expected to be used and, importantly, to widen the scope of staff covered to include neonatology.

The national results from year two are due to be published, although all trusts should have received their individual notifications, as well as any payments triggered.

The conditions for year three of the scheme reiterate that trusts meeting all criteria ‘will’ recover the 10% incentive, plus ‘a share of any unallocated funds’. However those who do not meet all criteria ‘will not recover’ the 10%, ‘but may’ receive a discretionary payment ‘at a much lower level’ to help make progress against missed actions.

The benefit in terms of patient safety and the financial incentivisation mean it is extremely important that trusts with maternity units immediately determine with whom the responsibility for ensuring compliance will rest, and start to develop action plans for hitting the specified targets. The experience gained in years one and two should assist, although care needs to be taken to identify developments in the standards to be met.

The key dates to diarise now are:-

  • Closing deadline for submitting board declaration forms – Thursday 17 September 2020 at 12 noon

  • Notification of results – end-October 2020

  • Payments for awards processed – end-December 2020

The closing deadline is notably a month later than in previous years, avoiding submission over the summer. There is however emphasis that this is a hard deadline, with late submissions or corrections not accepted.

Should trust boards not be able to certify that all criteria are met, then action plans for those missed should again be submitted at the same time, which will be considered for discretionary support.

The submission should be signed by the chief executive, as should any action plan required.

While evidence is not required to be submitted with declarations, some criteria are subject to external verification against MBRRACE-UK, NHS Digital and NNRD data. Submissions will also be ‘sense checked’ with the CQC.