About Sands and Tommy’s Joint Policy Unit
In 2022, the charities Sands and Tommy’s came together to form a Joint Policy Unit. Together we are focussed on achieving policy change that will save more babies’ lives during pregnancy and the neonatal period and on tackling inequalities in loss, so that everyone can benefit from the best possible outcomes.
For more information about the Joint Policy Unit, please contact: Robert Wilson, Head of the Joint Policy Unit: robert.wilson@sands.org.uk
Towards the best: Future maternity safety ambitions to save more babies' lives
The National Maternity Safety Ambitions - which aim to halve the 2010 rates of stillbirths, neonatal and maternal deaths and brain injuries and reduce the rate of preterm births from 8% to 6% - expire in 2025.
The Sands & Tommy’s Joint Policy Unit is focused on saving babies’ lives. As we near the expiry date of the ambitions, we have considered what appropriate future ambitions for reducing perinatal mortality and preterm birth could look like. We propose that the deadline for future ambitions is 2035 to align with the 10 Year Plan for the NHS in England which will be published in 2025.
Download Future maternity safety ambitions to save more babies' lives
Counting miscarriages in the UK
Unlike stillbirths and neonatal deaths, the number of miscarriages which occur each year in the UK are not measured or reported. While there are no UK-wide data on miscarriage, some miscarriage-related data are collected across the four nations. However, data are often limited to the hospital setting and inconsistent records, definitions and digital systems makes collation challenging, even before integrating other areas of the health system, such as primary care.
Work is underway in each of the devolved nations to consider how to collect data on miscarriage going forward. This briefing note outlines what data are currently available in each nation, what improvement work is underway and what further action is required.
Saving babies' lives 2024
This is the second Saving Babies’ Lives Progress report published by the Joint Policy Unit. The report summarises the latest data and shares updates on work that the Joint Policy Unit has delivered over the past year.
Download the summary report
Download the full report
Download the infographic
Health is a devolved matter, with policies, funding and the healthcare system overseen by devolved governments in each of the four nations. The main report includes mortality data from across the UK but much of the data on the health system and the systemic issues they face are reported separately. In 2024, alongside the main report we explore data for each nation in tailored briefings, with a focus on recommendations for policy makers in each nation:
Download the Northern Ireland briefing
Download the Scotland Briefing
Download the Wales briefing
Information and advice given on contacting maternity triage in early labour
Previous reports have identified maternity triage as an area of concern into the safety of maternity services. Delays in admitting women and birthing people to hospital has prevented them from receiving appropriate care and has contributed to poor outcomes. Reports have also shown inconsistencies in advice when contacting triage, with women and birthing people’s concerns not being heard or addressed.
We reviewed 35 sources of information found on NHS Trust websites under their guidance for contacting triage in early labour to assess consistency in advice.
Our analysis found concerning levels of variation across topics and language encouraging women and birthing people to stay at home, without a clear evidence base. It is vital that services provide consistent guidance around contacting triage, as well as clear information about the care people are entitled to.
Read Joint Policy Unit's Ceilidh Al Amoodi's article explaining why this is an area of concern.
Saving babies’ lives 2023
Our inaugural report brought together data from different sources for the first time to show the extent of pregnancy loss and baby deaths across the UK.
Download the summary report
Download the full report*
Download the infographic
*The stillbirth rate and extended perinatal mortality rate for Wales was updated in August 2023. In the original publication in May 2023, the infant mortality rate for Wales was incorrectly entered as the stillbirth rate.
Investment in maternity and neonatal services
While long-term progress has been made in reducing rates of stillbirth and neonatal death, more recently this progress has stalled and we are not on track to meet government ambitions to halve stillbirths and neonatal deaths, and reduce preterm births, by 2025 (relative to 2010 levels).
We assessed recent commitments from the Government to increase funding for maternity and neonatal services in England, highlighting how these remain significantly below the level needed to support transformative improvements in these services.
Much more comprehensive investment is needed to support government ambitions to reduce rates of stillbirth and neonatal death, tackle inequalities and support improvements in the safety and quality of services.
Priorities for next Government
There is still a long way to go to make the UK the safest place in the world to have a baby. Despite increasing policy focus on maternity safety over recent years, the fundamental change required to ensure safe, equitable care for all is not happening. According to most recent data, progress to reduce rates of deaths is slowing or reversing and experiences of care are deteriorating.
This document sets out what we believe the next government must do to deliver safer maternity and neonatal services, so that fewer babies die and inequalities in loss are eliminated. What we are calling for:
- Renewing the national maternity safety ambitions: We are not on track to meet the current ambitions. The next government must commit to renew and enhance these ambitions, with a focus on making the UK the safest place in the world to have a baby.
- Eliminating inequalities in pregnancy and baby loss: There are stark and persistent inequalities in baby loss, particularly by ethnicity and deprivation. The next government must make a strong commitment to eliminating inequalities, underpinned by a comprehensive programme of research and improvement.
- Delivering a fully funded workforce: There are particularly acute staffing issues in maternity services which are impacting the delivery of safe care. The next government must ensure the commitments made in the Workforce Plan are backed by adequate funding and expand the wider maternity and neonatal workforce so that nobody is without the care they need.
- Putting in place a system that supports safe care: We are still not learning lessons when babies die. The next government must move from supporting individual services which are deemed to be outliers, towards a comprehensive national approach, which addresses the fundamental issues and puts in place the key elements of a safe system.
- Providing the best possible support throughout pregnancy and following loss: There are currently too many gaps in the support available throughout pregnancy and baby loss. Building on recent commitments, the next government must allocate funding to ensure services can provide the best possible support and care.
Report: Better board oversight needed to save babies’ lives
The safety and quality of maternity and neonatal services are the responsibility of the board in each NHS Trust. However, board oversight has been highlighted as an issue in successive inquiries and reviews.
We reviewed publicly available board papers and minutes for seven NHS Trusts in England to analyse whether the information presented to boards, the process for review, and actions taken enabled boards to deliver on this responsibility.
Our findings across these three areas raise questions about boards’ ability to have a full understanding of the performance of maternity and neonatal units under their direction under the current system.
What do you think needs to change to deliver safer maternity and neonatal services?
We are undertaking work to identify what is needed to make progress on key themes from previous reports and reviews into the safety of maternity and neonatal services. Reports and reviews into the safety of maternity and neonatal services across the UK consistently identify similar themes, which keep recurring despite steps to implement recommendations from past reports.
The Sands and Tommy's Joint Policy Unit reviewed 30 reports into maternity and neonatal services across the UK. For each of these reports we identified recommendations relevant to saving babies’ lives and tackling inequalities, and then grouped these into key themes. Read more in our policy briefing.
We have recently undertaken a call for evidence to identify what is needed to make progress on each of these key themes, and are analysing the responses.