Maternity improvement resource

What we look for

Well-led

Shared direction and culture

• Does the maternity service have a dedicated vision and strategy developed with stakeholders and staff focused on sustainability of services and aligned to local plans within the wider health economy?
• Describe your access to the board for raising concerns, celebrating success and routine reporting.
• How do you encourage check and challenge in the service?

Capable, compassionate and inclusive leaders

• Describe how the service is led:
  • Is the service led by an operations director, midwifery director and clinical director for obstetrics, gynaecology and neonatology?
• How do leaders maintain visibility in the clinical areas?
• Are the job plans clear and accurate about describing duties, responsibilities, accountabilities and objectives for medical staff, with enough time allocated to required duties and to attend meetings and training?
• How do staff and the board hear about staff vacancy rates, sickness rates, other leave impacting the team, for medical and all grades of midwifery staff?
• Describe the strategy for succession planning and development of future leaders in the service.

Freedom to speak up

• How can you evidence changes made as a result of staff giving feedback or speaking up?
• How are staff encouraged to speak up freely?

Workforce equality, diversity and inclusion

• Describe how you review and improve the culture of the service.
• Are there any actions in the service following the trust staff survey results? This could include people with protected characteristics or bullying and harassment?
• How reflective of the population is your workforce and what steps are taken to address any shortfalls?

Governance, management and sustainability

• Describe the governance structure, including:
  • regular meetings and attendance against quoracy, minutes and actions
  • risk registers and maternity red flag responses
  • Maternity Incentive Scheme outcomes.
• Describe how relevant information escalated to the trust quality and safety committee.
• How are you assured policies and procedures are up to date and in line with Royal Colleges and NICE guidelines?
• What are the arrangements for an audit programme and to check improvements over time?
• How do leaders report maternity service staffing to the board (this includes the use of bank, agency and locums; planned versus actual for labour ward, postnatal, antenatal, antenatal clinical, triage, maternity assessment/maternity day unit and community staffing; specialist and supernumerary roles)?  
• How are clinical records managed and what are the arrangements for data protection as well as for information sharing throughout the maternity pathway, from antenatal to postnatal care?

Partnerships and communities

• How do leaders engage with Maternity and Neonatal Voices Partnership (MNVP), staff and women?
• How has the MNVP shaped the service?

Learning, improvement and innovation

• Describe your approach to continuous quality improvement for maternity services.
• What recent improvements have there been to the service?

The importance of people's experience

• Do you receive patient stories at board from those with direct experience of the maternity service?