Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps he is taking to improve the UK's patient safety OECD ranking for patient safety incidents involving multiple pregnancies; and if he will make a statement.

The Organisation for Economic Co-operation and Development rankings on patient safety are informed by the Health Care Quality Indicators which currently do not compare or rank nations specifically by patient safety incidents involving multiple pregnancies. There are five indicators which are used to rank countries for patient safety:

1. retained surgical device or fragment
2. post-operative wound dehiscence
3. post-operative pulmonary embolism or deep vein thrombosis
4. post-operative sepsis
5. obstetric trauma

Women should receive excellent maternity care that focuses on the best outcomes for women and their babies and on women’s experience of care.

There must be a relentless focus on safe care, right first time. This means creating a culture within the National Health Service that is open. A culture that reports errors, analyses what went wrong, and puts those lessons into practice as quickly as possible.

A safety culture is open and fair, shares information openly and freely, delivers fair treatment for staff when an incident happens, and encourages people to speak up about mistakes.

The Department commissioned the National Institute of Care and Excellence (NICE) to produce clinical guidelines and quality standards for the management of twin and triplet pregnancies in the antenatal period. NICE have also produced a pathway to support professionals to care for women with multiple pregnancies who suffer from complications.

NHS England has developed a Maternity Safety Thermometer – which is available to all trusts and allows maternity teams to take a temperature check on harm and records the proportion of mothers who have experienced harm free care, but also records the number of harm(s) associated with maternity care. It supports improvements in patient care and patient experience, prompts immediate actions by healthcare staff and integrates measurement for improvement into daily routines.

The Maternity Safety Thermometer was tested in a pilot phase from June 2013 until October 2014 and is now fully released and available to any organisation wanting to use it.

NHS England is undertaking a major review of the commissioning of NHS maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.

Recent advances in maternity care, changes in the demographics of women having babies, and preferences of where they want to give birth will form a key focus. Firstly, the review will evaluate the United Kingdom and international evidence and make recommendations on safe and efficient models of maternity services. Secondly it will ensure that the NHS supports and enables women to make safe and appropriate choices of maternity care for them and their babies. Thirdly it will support NHS staff including midwives to provide responsive care.

The terms of reference for the review were published on the 3 March. They can be found online at:

http://www.england.nhs.uk/wpcontent/uploads/2015/03/maternity-rev-tor.pdf

This review, which is expected to report in by the end of the year, will be led by an external chair, supported by a diverse panel.