Citation: BJOG: An International Journal of Obstetrics and Gynaecology. 2013, 120, 419-420
Author: Adams T.; Cooper J.; Rowlands D.; Bricker L.
Abstract: Objective Maternity services are to be commissioned by clinical commissioning groups in England and their equivalent in the devolved nations. Maternity is no longer to be commissioned by the national commissioning board and as such each clinical commissioning group will need metrics by which services can be measured. We present a series of evidence-based metrics for use in maternity care delivered to women who are considering a pregnancy or who are booking their pregnancy delivered derived from nationally available guidance. The metrics are achievable and are a suitable proxy for quality. They also reflect current national priorities and support the King's Fund Ten priorities for commissioners. The metrics were developed by the NHS Northwest's Birth and Newborn Clinical Pathway Group. A group of experts taken from all parts of maternity services, from commissioners, local authorities, primary care, departments of obstetrics and gynaecology, midwifery and hospital management so can be said to be truly multi-disciplinary. Methods Priority themes for health were identified by the group across areas relevant to maternity services focussing on preconception care and antenatal care. A literature search was performed for guidance that dealt with these priority themes across the different areas. The search extended from national organisations such as NICE to patient organisations such as Diabetes UK. From this search, standards of good care were derived together with over 20 suggested metrics. These were discussed in each area by the group, before being reduced to 10 achievable and clinically relevant standards across the two areas. Metrics to measure achievement against the standards were then derived directly by the group. Measuring overall performance in the two areas was supported by the development of one 'supermetric' for each area. Metrics cover all sspects of care including the place and timing of care and are not all secondary care based. Example of preconception care standard: women with epilepsy planning a pregnancy should take 5 mg folic acid daily. Example of antenatal care standard: pregnant women and their families should understand the importance of good food hygiene, particularly with reference to pregnancy.
