Tommy’s, The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) have formed an alliance to launch The Tommy’s National Centre for Maternity Improvement which will be established from 1 September 2019.
- The three-year programme of work – which will involve the creation of a digital tool to personalise and improve maternity care for women – is in support of achieving the government’s objectives to reduce stillbirth and preterm birth
- The Centre will be led by Professor Tim Draycott and will involve expert obstetricians, midwives, data analysists and behavioural scientists from leading UK universities and clinical centres
- The programme is a collaboration between Tommy’s, RCOG, RCM, the NHS, universities and crucially, women and their families
- This alliance represents an ongoing commitment to improving care across the maternity system to make the UK the safest place in the world to give birth
The Tommy’s National Centre for Maternity Improvement is an alliance between parents, midwives, doctors, the NHS and academic experts to drive improvement in the maternity service with the aim of preventing 600 stillbirths and 12,000 preterm births nationally. These reductions will support government targets to make the UK the safest place in the world to give birth by halving stillbirth rates and reducing preterm birth from 8 per cent to 6 per cent by 2025.
In the UK, nearly 60,000 babies are born prematurely every year (before 37 weeks)[i]. Some do not survive, and those that do can face a lifetime of health issues. And, tragically, 2,700 babies per year in the UK are stillborn.[ii] In terms of stillbirth, the UK is outside of the top 20 safest high-income countries in which to give birth. There is clearly room for improvement[iii].
The Tommy’s National Centre for Maternity Improvement will build on existing research and initiatives, and focus on personalised, patient-centred care, to create a model of care that can be scaled up nationally. This will help reduce current geographical and socio-demographic inequalities in the quality of care experienced between providers, with a focus on improving outcomes in the poorest performing 80 per cent of UK regions to reach the level of the top 20 per cent.
The Centre will also develop a digital tool, that will be freely available to every woman and their healthcare providers, in the UK. Women will input their own data and be signposted to advice related to their care or lifestyle choices that can improve their chance of a healthy baby. Medical professionals will also contribute clinical data to a woman’s record, and these combined data will be used to personalise risk and choices with signposting to advice and more options. This will be achieved through five workstreams:
- Identification and implementation of interventions to mitigate and manage preterm birth
- Identification and implementation of interventions to mitigate and manage stillbirth
- Implementation and improvement science to inform development, implementation and evaluation of interventions to support practice change
- Practical implementation of interventions identified
- Data analysis for improvement
Professor Tim Draycott is the Clinical Director for The Tommy’s National Centre for Maternity Improvement and the team of midwives, clinicians, obstetricians, academics and experts. Tim is a senior practising clinician (North Bristol NHS Trust) and Improvement Scientist with world-leading experience of delivering improvements in maternity care. Tim will be supported by two Deputy Directors: Professor Jane Sandall, a midwife who will bring implementation science and collaborative cross-boundary leadership experience; and Professor Andrew Judge, a professor of translational statistics with expertise in medical statistics and in conducting epidemiological research using ‘big’ health registry data across multiple health conditions.
Multi-professional clinical leadership will be provided by consultant obstetricians Professor Basky Thilaganathan and Professor Dilly Anumba, midwife Cathy Winter, with support from clinicians and data scientists across the UK. Maria Viner, CEO of charity Mothers for Mothers and a member of the RCOG’s Women’s Network, will provide leadership and representation for the parents who will contribute to the centre’s work.
Jane Brewin, Chief Executive of Tommy’s said; “Currently, almost all women are assigned to low risk care in their first pregnancy, and obstetric history is used as an indicator of risk. So, it feels like you must lose a baby before being referred to high risk care and being pregnant for the first time carries a greater risk than women who have had a previous healthy baby.
“By identifying women at risk, we can ensure they receive the correct care and treatment throughout their pregnancy to improve their chances of a successful pregnancy. Our aim is to improve care for everyone in the UK, empowering women and healthcare providers alike to do the right thing the easy way. It shouldn’t matter where you live or who you are, everyone should be entitled to the best care for themselves and their baby.”
Professor Tim Draycott said; “The Tommy’s National Centre for Maternity Improvement will harness digital technology, national data and behavioural insights to reduce preterm birth and stillbirth across the UK. We aim to reduce the current unequal provision of care that can be too little too late for some women, and too much too soon for others, by developing digital platforms and practice-based tools to personalise care with women. These tools will also enable maternity professionals to provide tailored and evidence based care with women.
“We are excited by the potential synergies offered by working directly with Tommy’s and the Maternity Voices Partnership, drawing on their expertise and resources to reach all women and their families who will benefit from our Centre’s work.”
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said; “We recognise that there are no magic bullets in healthcare improvement but by harnessing data already collected by front-line maternity staff and using it to personalise care for women throughout their maternity journey, we are confident this innovative approach will lead to improvements and streamline the current care system to reduce preterm birth and stillbirth.
“What is unique about this Centre is that we are bringing together a multi-professional group of academics and clinicians who will be working with the RCM and RCOG, representing the entire UK maternity workforce. Together with a consortium of charities, a national Women’s voices partnership and a national network of partner NHS Trusts, we aim to leverage this crucial funding from Tommy’s to achieve our vision to make the UK the safest place in the world to give birth.”
Gill Walton, Chief Executive of the Royal College of Midwives, said; “This is an important and exciting initiative that will support efforts to reduce UK stillbirth rates. It will enable maternity services to identify women who may need additional support so that their care can be tailored appropriately. This project will make our maternity services safer and better.
“It is also important that the project has women as key partners in it. This means so that the initiatives coming out of this collaboration meet their needs.”
[i] England and Wales: 53,887 preterm births in 2017: https://www.ons.gov.uk/file?uri=/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/datasets/birthcharacteristicsinenglandandwales/2017/birthcharacteristicsworkbook2017.xls
Scotland: 3,351 preterm births in 2017: http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publications/2017-11-28/mat_bb_table8.xlsx
[ii] ONS (2018) Vital statistics in the UK: births, deaths and marriages – 2018 update, Office of National Statistics, London, England, https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigrati…