Maternity improvement resource

What we look for 

Safe

Learning culture

• How are protected characteristics recorded and analysed for all incidents?
• Is there a commitment to improving safety for those with equality characteristics at all levels in the organisation?
• Have staff completed cultural awareness training that is tailored to the service’s local population?

Safe systems pathways and transitions

• Are you aware of national evidence about safety risks for particular groups of women, for example women from ethnic minority backgrounds and women with mental health needs?
  • Can you give examples of action that has been taken as a result, to increase safety for particular groups of women?

Involving people to manage risks

• How are risk assessments developed to support the care of women and babies with protected characteristics?

Effective

Assessing needs

• Are care plans personalised to include individual needs and choices for care and treatment, including pain relief?
• Are personalised care and support plans (PCSPs) available in a range of languages and formats, including hard copy for those experiencing digital exclusion?
• How have you addressed NHS England’s Core20PLUS5 approach’s aims to ensure continuity of carer from Black, Asian and ethnic minority communities and from the most deprived groups?

Monitoring and improving outcomes

• In what ways has the maternity service taken action to reduce inequality in negative outcomes for people?
• How do staff record health inequalities data in incident reviews?
  • How is data interrogated and trends monitored?

Delivery evidence-based care and treatment

• How do different outcomes for women and babies get included in training such as PROMPT, skills and drills?
• How has the antenatal care offer been tailored to address health inequalities that impact the local population?

Consent to care and treatment

• How do you ensure women receive information about care and treatment being offered or recommended in a way they can understand before giving consent?
• Are interpretation services always offered, even where a family member would be able to translate?

Responsive

Care provision, integration and continuity

• What are the diverse health and social care needs of your community?
• How is antenatal care for women with complex social factors being delivered, in line with NICE guidelines.
• How are services delivered for those more at risk of poor care in maternity services?
• How do managers ensure staff support, signpost and refer women and families with additional healthcare needs to specialist and community services? These could include:
  • people with a learning disability
  • people whose preferred or known language is not English
  • people with sensory loss for hearing or sight
  • people who have mobility issues
  • people with mental health needs and risks associated with safeguarding.

Providing information

• Is information about pregnancy and antenatal services available in different formats and distributed to community settings?
• How do you ensure that individual communication needs are fully recorded and shared with staff throughout the maternity pathway?
• Where interpreting services are used, are length of appointments adjusted to allow for extra time?

Involving and listening to people

• How do you engage women from ethnic minority groups and other equality groups in co-production of equality and equity interventions?

Equity in access

• How is the impact of equality and equity initiatives or interventions measured?
• If services are provided digitally, how does the service mitigate against digital exclusion that some women face?

Well-led

Shared direction and culture

• How does the maternity service's vision and strategy encompass the needs of those with protected characteristics?
• How are you assured staff at all levels have a detailed knowledge of equality, diversity and human rights?

Workforce equality, diversity and inclusion

• What action has been taken to improve the experience of staff with protected equality characteristics or those from excluded or marginalised groups?
  • How have these interventions been monitored to evaluate their impact?

Governance management and sustainability

• What data is recorded about protected characteristics?
• Is health inequality on the maternity service’s risk register?
  • How is this escalated to the board?

Partnerships and communities

• How does the maternity and neonatal voices partnership (MNVP) work together with the trust to engage with women who represent the local population?
• How has the trust involved the MNVP in the maternity service’s actions to promote equity for women from ethnic minority groups and women from socially deprived areas? This may include:
  • increasing support of at-risk pregnant women
  • reaching out and reassuring pregnant women from ethnic minority backgrounds with tailored communications
  • recording the ethnicity of every woman, as well as other risk factors.