Sands works to improve care for families, not only when their baby dies, but to prevent babies dying in the first place. We have been working collaboratively with health professionals, researchers and policy makers, to raise awareness that some baby deaths in the NHS are potentially avoidable. Our one-day Stillbirth Summit in 2012 brought almost 50 experts across the UK together to develop a programme of work, directly linked to the strategy in our Preventing Babies' Deaths report.
As a result the Scottish government set a target to reduce deaths in 2012. In November 2015 the Secretary of State for Health, Jeremy Hunt, also announced an ambition to reduce stillbirths and neonatal deaths in England by 20% by 2020 and 50% by 2030. In October 2016 he launched the Safer Maternity Care action plan, which sets out the improvements to maternity services that are expected by 2020 and that will “make a difference in each and every maternity and neonatal service across the country. In November 2017, the national ambition was extended to include reducing the national rate of pre-term births fro 8 to 6% and the national ambition was brought forward to 2025.to achieve the ambition was brought forward to 2025.
- We are a member of the Stakeholder Council for NHS England's Maternity Transformation Programme
- We are advisors to NHS England's Saving Babies' Lives Care Bundle, a package of care to reduce stillbirths
- We are represented on Scotland's Stillbirth Group
- We are advisors to Welsh work on preventing stillbirths and improving care
- We work with the Northern Ireland Maternal and Infant Steering Group (NIMI)
- Our UK wide public health work can also be seen in the Our Chance campaign and our own Safer Pregnancy website
- We are part of the new Perinatal Mortality Review Tool collaboration which sets out a standardised and robust processes for reviewing every death ensuring parents are engaged in the process.
Saving Babies’ Lives Care Bundle
The NHS England Saving Babies’ Lives Care Bundle version two brings together four important areas of care which could help reduce stillbirth and early neonatal death rates. Sands helped to develop the Bundle, along with midwives and obstetricians. The four parts are looking at:
- Stopping smoking during pregnancy
- Better and ongoing training around CTG interpretation (the CTG is the trace showing the baby’s heart rate during labour)
- Measuring baby’s growth during pregnancy and the use of different growth charts depending on the mother’s characteristics
- Making pregnant women aware of the importance of their baby’s movements
- We helped NHS England develop the Care Bundle from the very beginning
- Our 'Safer Pregnancy' public health messages are included in the Care Bundle's second iteration
- We were advisors on the SPiRE study, which evaluated the success of the first iteration of the Care Bundle and showed a 20% fall in stillbirth rates in participating Trusts, as well as an impact on NHS resourcing.
NHS England Maternity Transformation Programme
NHS England has committed to delivering the recommendations in Better Births through the Maternity Transformation Programme. The Better Births report from the independent review of maternity services was published in February 2016. It sets out a vision for maternity services across England to become safer, more personalised, kinder, professional and more family friendly. The Maternity Transformation Stakeholder Council oversees the programme, representing the views of users
- We’re a member of the Maternity Transformation Stakeholder Council
The Scottish Stillbirth Working Group was begun in 2011 is chaired by Dr Sarah Stock and brings together clinicians, public health experts and Sands. The Group is now part of the Scottish Patient Safety Programme – Maternity and Children’s Quality Improvement Collaborative (MCQIC) which was begun in 2013. The focus of the work is on monitoring a baby's growth in utero, improving awareness about babies' movements in the womb, among health professionals and parents and monitoring the baby's heart trace adequately during labour. Scotland has achieved a 22.5% fall in stillbirths since 2014. It's now aiming to reduce the rate by up to 35% by 2019.
Scotland has also supported novel research studies, such as AFFIRM our-work/research/studies-we-fund/affirm-can-promoting-awareness-babys-movements-pregnancy-help.
- Scottish Stillbirth Working Group:
- Set up following Sands’ pressure via our Saving Babies’ Lives report and our parliamentary petition
- Sands is a member and makes sure parents’ views are heard
- An important presence at the annual Scottish stillbirth conferences
As part of the work to improve safety in maternity, Health Improvement Scotland (HIS) has also been piloting work in standardising review when a baby dies so that lessons can be learned and parents involved in the process of review. The learning from that work is contributing to work around a pathway for engaging parents in the review of their baby's death with the roll out of the new, national Perinatal Mortality Review Tool (PMRT). Sands is chairing the multi-disciplinary 'parents engagement' subgroup within the PMRT for developing the pathway and resources with other parent representative, Claire Storey from the International Stillbirth Alliance.
The Health and Social Care Committee of the National Assembly for Wales held a stillbirth inquiry in 2012. This set out recommendations that are being promoted by the Welsh Stillbirth Working Group. This Group, chaired by Prof Jean White, Chief Nursing Officer, brought together clinicians, public health experts and Sands. It liaises directly with all the Welsh Health Boards. The Group’s work programme is here.
- We continue to raise the parent voice in work in Wales through our Welsh network co-ordinator and through head office representation
The Northern Ireland Maternal and Infant Steering Group (NIMI) looks at all baby deaths from miscarriages to infant deaths at one year. It includes clinicians, baby charities and health officials.
- Sands NI Co-ordinator sits on the NIMI group, contributing parents’ views