Local Maternity System

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LMS Guidelines 

The LMS Guidelines Group is developing a suite of guidelines/guidance to be used by colleagues at Hull University Teaching Hospitals NHS Trust, York & Scarborough Teaching Hospitals NHS Foundation Trust and Northern Lincolnshire and Goole NHS Foundation Trust. 

Guideline/Guidance Publication Date 
PMRT Guidance 

13 September 2021

PReCePT Guideline - Magnesium Sulphate Protocol

16 November 2020 

Frenotomy (Division of Tongue Tie) 

02 December 2020

It has been agreed that all HCV Trusts will use/refer to the Royal College of Obstetricians and Gynaecologists information on Group B Streptococcus (GBS) in pregnancy and newborn babies which can be found here

LMS Safety Alerts 

Safety Alert  Publication Date 
Herpes Simplex Virus 3 September 2021

Links to key national safety documents/websites

Ockenden Maternity Review 

Published on 10th December 2020 the Ockenden Maternity Review details the failures at Shrewsbury and Telford hospitals (SaTH) that led to the deaths and harming of mothers and babies from 2000-2019. These included a reluctance to conduct caesarean sections; a tendency to blame mothers for problems; a failure to handle complex cases; a lack of consultant oversight, and a lack of kindness and compassion. The review details a series of immediate actions and “must do” recommendations for all hospital trusts to improve maternity safety “at pace”. These include formal risk assessment at every antenatal contact, twice-daily consultant-led maternity ward rounds, women and family advocates on the board of every NHS trust, and the appointment of dedicated lead midwives and obstetricians.

Non-invasive Prenatal Training (NIPT)

Information on what midwives need to know ahead of the introduction of NIPT on 29 March 2021 is available from PHE here

Healthcare Safety Investigation Branch (HSIB)

HSIB conduct independent investigations of patient safety concerns in NHS-funded care across England. The safety recommendations it makes aim to improve healthcare systems and processes in order to reduce risk and improve safety. The maternity investigation programme is part of a national action plan to make maternity care safer. HSIB undertakes approximately 1,000 independent maternity safety investigations to identify common themes and influence systemic change.

The HSIB quarterly learning newsletter and linked summary spreadsheet were published in July 2021. 

Maternity and Neonatal Safety Improvement Programme

The Maternity and Neonatal Safety Improvement Programme (formerly known as the Maternal and Neonatal Health Safety Collaborative) supports improvement in the quality and safety of maternity and neonatal units across England.

Maternity Incentive Scheme - Year 3

NHS Resolution is an arm’s-length body of the Department of Health and Social Care.  It provides expertise to the NHS on resolving concerns and disputes fairly, sharing learning for improvement and preserving resources for patient care.

NHS Resolution is operating a third year of the Clinical Negligence Scheme for Trusts (CNST) maternity incentive scheme  to continue to support the delivery of safer maternity care. The maternity incentive scheme applies to all acute trusts that deliver maternity services and are members of the CNST. As in year two, members will contribute an additional 10% of the CNST maternity premium to the scheme creating the CNST maternity incentive fund. The scheme incentivises ten maternity safety actions. Trusts that can demonstrate they have achieved all of the ten safety actions will recover the element of their contribution relating to the CNST maternity incentive fund and will also receive a share of any unallocated funds.

Neonatal Critical Care Transformation Review

An action plan has been developed to implement the recommendations of the Neonatal Critical Care Transformation Review which sets out how the NHS will further improve neonatal care with the support of funding set out in the NHS Long Term Plan.

The National Neonatal Audit Programme 2020 Annual report on 2019 data is available here

Saving Babies' Lives Care Bundle Version Two (SBLCBv2) 

SBLCBv2 has been produced to help reduce perinatal mortality across England. It provides detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. The second version of the care bundle brings together five elements of care that are widely recognised as evidence-based and/or best practice, these are:

  • Reducing smoking in pregnancy
  • Risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction (FGR)
  • Raising awareness of reduced fetal movement (RFM)
  • Effective fetal monitoring during labour
  • Reducing preterm birth.

MBRRACE-UK Reports

Saving Lives, Improving Mothers’ Care , from the Maternal, Newborn and Infant Clinical Outcome Review Programme, delivered by MBRRACE-UK, details the lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2015-17. Learning from Standardised Reviews When Babies Die is the Perinatal Mortality Review Tool (PMRT) first annual report which was published in October 2019. 

Reports published on 14 January 2021 can be accessed here and include:

  • A Perinatal Confidential Enquiry: Stillbirths and neonatal deaths in twin pregnancies 
  • Saving Lives, Improving Mothers’ Care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016–18 

Nursing and Midwifery Council (NMC)

The NMC is the professional regulator for nurses and midwives in the UK, and nursing associates in England and it:

  1. Maintains the register of nurses and midwives who meet the requirements for registration in the UK, and nursing associates who meet the requirements for registration in England.
  2. Sets the requirements of the professional education that supports people to develop the knowledge, skills and behaviours required for entry to, or annotation on, the register.
  3. Shapes the practice of the professionals on the register by developing and promoting standards including its Code, and promotes lifelong learning through revalidation.
  4. Investigates and takes action, if needed, where serious concerns are raised about a nurse, midwife or nursing associate’s fitness to practise.
2019-07-03 (7)

Your baby is now officially an embryo and is about the size of a poppy seed.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/4-weeks-pregnant/ for more information.

2019-07-03 (4)

Your baby is now the size of a kidney bean and weighs 1g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/8-weeks-pregnant/ for more information.

2019-07-03 (6)

Welcome to the second trimester!

Your baby is about the size of a small lime and weighs approximately 14g.

You have hopefully seen your midwife for your 'booking in' appointment, if you have not yet seen a midwife please make an appointment quickly, so you can have all of your choices about screening tests explained and offered to you.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/12-weeks-pregnant/ for more information. You can also link to the 'Pregnancy Journey' area here.  

2019-07-03

Your baby is about the size of an avocado and weighs approximately 100g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/16-weeks-pregnant/ for more information.

2019-07-03 (2)

Your baby has grown in length and is now the length of a small banana and weighs approximately 300g. Around this time you will be offered your '20 week' scan, also known as the 'anatomy' or 'anomaly' scan.Click here for more information about screening. 

This is a also a good time to talk and sing to your bump as your baby can now hear sounds. This is great way for you and your partner/family to bond with your baby.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/20-weeks-pregnant/ for more information.

2019-07-03 (8)

Your baby has grown again to the approximate length of an ear of sweetcorn and weighs about 600g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/24-weeks-pregnant/ for more information.

2019-07-03 (1)

Welcome to the third trimester!

Your baby is now approximately the weight of an aubergine; about 1kg and approximately 37cm in length. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/28-weeks-pregnant/ for more information.

2019-07-03 (3)

Your baby now weighs approximately the same as a coconut; around 1.5kg. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/32-weeks-pregnant/ for more information.

2019-07-03 (5)

Your baby is now around the same size as a lettuce, approximately 47cm long and weighs around 2.6kg. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/36-weeks-pregnant/ for more information.

2019-07-03 (9)

Your baby is now the weight of a small watermelon which is approximately 3.3kg and around 50cm in length. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/40-weeks-pregnant/ for more information.