Gaps in Maternity Care Data

Abstract

The monitoring of maternal-newborn health and health services in the UK is important for identifying trends over time that could cause concern or require action to protect patients at national, regional or individual Trust level. Accountability at international level can also raise flags for patient safety tracking national progress towards international goals2, as recently seen in the highlighting of continued rise and inequalities in maternal mortality in the USA3.

Monitoring has been particularly important during the COVID-19 pandemic, as ongoing policy-making has needed to become very responsive to changing circumstances as successive waves and different strains of COVID-19 have unrolled. Monitoring our core maternity system, whether during a pandemic or not, should be comprehensive, fully include all Trusts, and be based on current agreed policy tenets. Comparing maternity provision and outcomes between different Trusts can be fraught with difficulty, as each Trust has its own characteristics and different caseloads, but its only by monitoring and comparing Trusts with care that we can identify good performers, share best practice, and draw lessons for policy and practice.

In England, individual Trusts are responsible for collecting, cleaning and using data for their own management given their own particular characteristics. But quality of data, data collection and expertise in analysis varies from Trust to Trust, causing problems for nationwide data systems that inform overall or regional strategies and policy development. During COVID-19, data collection and monitoring has become even more challenged, while at the same time more urgent, with a growing public understanding of health statistics and policy responses in real time.

The ASPIRE study investigated the use of quantitative data for monitoring maternity services throughout the pandemic. Available data were examined across the COVID-19 pandemic starting from one year before its onset in English Trusts. The study focussed on seven Trusts, but data from all English Trusts have been assessed in order to see each case study Trust in the context of nationwide variations. This policy brief presents findings on the data available to monitor maternity
services, the quality of that data and identifies the strengths and shortcomings of the data for responsive policy-making in a pandemic. Recommendations from the study are pandemic-specific, as well as more wide reaching and universal, using COVID-19 as an example of a crisis.