The National Maternity and Perinatal Audit (NMPA) is a large evaluation of NHS maternity and neonatal services in Britain.
Launched in 2016, the NMPA uses timely, high quality data to evaluate a range of care processes and outcomes. It aims to identify good practice and areas for improvement in the care of women and babies looked after by NHS maternity services.
The report, published today, has found that:
Services
- Smoking cessation and weight management support is available at 72% and 45% of trusts and health boards respectively – no improvement since 2017.
- A higher number of Trusts and health boards participate in a perinatal mental health network – this has increased from 70% to 93% in England, from 43% to 79% in Scotland, and from 71% to 86% in Wales.
- Access to community perinatal mental health teams increased from 72% to 91% of Trusts and boards, and to specialist perinatal mental health midwives from 72% to 91% of 151 Trusts and boards. Availability of psychiatrist clinics increased from 37% to 58% of maternity sites with an obstetric unit.
- Eighty three percent of maternity sites with a neonatal unit provided transitional care – keeping mothers and babies together and avoiding unnecessary neonatal unit admission – and this has risen from 64% in 2017.
- Maternity sites with a dedicated multidisciplinary cardiac clinic increased from 18% to 25%, with a greater geographical spread in England and Scotland than in 2017.
- Access to electronic maternity records improved for community midwives, with 66% of Trusts and boards reporting access at any location and 90% at midwives’ community bases. But still only 19% reported that women could access their own electronic record, and the number of GPs with access decreased from 29% to 21%.
Staffing
- While 87% of obstetric units reported gaps in their obstetric middle grade rotas, compared to 89% in 2017, the number that required locum cover remained the same at 83%.
- Eighty five percent of sites reported that at least 95% of women had one-to-one midwifery care in established labour, compared to 84% in 2017. But only half (51%) of maternity sites reported that all women received one-to-one care in established labour, compared to 54% in 2017.
The Royal College of Obstetricians and Gynaecologists (RCOG) who deliver the audit say that more work needs to be done to ensure services are safe and personalised for women and their families.
In response to the publication of the report, Professor Russell Viner, RCPCH President, said:
The expansion of perinatal mental health support is particularly welcome news. A mother’s mental health can have an enormous impact on her children, particularly during the early years, and so it is right to expand provision so that more pregnant women can consult mental health professionals and specialist midwives.
It is disappointing to see the lack of improvement in the availability of smoking cessation and weight management programmes, and simply not good enough that only one in five Trusts gave women access to their own electronic maternity records.
Good maternal health is vital for children’s wellbeing, and so all women must be appropriately supported throughout pregnancy, birth, and postnatally. Support services have been put under immense pressure in light of recent public health funding cuts, and so we urge an immediate moratorium on any further cuts so that pregnant women and their children can access the treatment and support they deserve.