When babies are born prematurely (before 37 weeks of pregnancy), survival rates are lower and there is a higher-chance of the baby having a long-term illness (1). ‘Optimisation and stabilisation of the preterm infant’ – making sure vital signs are stable and helping the infant to thrive – aims to give babies who are born prematurely the best chance of survival and quality of life. It is one of two clinical workstreams within the Maternity & Neonatal Safety Improvement Programme (MatNeoSIP).
The primary aim of the MatNeoSIP is to reduce preterm births, stillbirths, neonatal deaths, brain injuries and unwarranted variation in maternity and neonatal care. The programme works with all maternity and neonatal providers in the East of England on a range of key improvement workstreams.
More than 53,000 babies are born prematurely each year in the UK and complications arising from premature birth are the leading cause of neonatal death (death in the first few weeks after birth) (1). The programme aims to contribute to the national ambition, set out in Safer Maternity Care action plan, to reduce the national rate of preterm births from 8% to 6% by 2030.
The optimisation and stabilisation of the preterm infant workstream supports the adoption and spread of nine evidence-based interventions, outlined by the British Association of Perinatal Medicine, to improve health outcomes for mothers and preterm babies. These include but are not limited to:
Ensure antenatal corticosteroids are offered to women in threatened preterm labour – to accelerate the lung development of the baby.
Health Innovation East’s East of England Patient Safety Collaborative (PSC) has been supporting maternity and neonatal improvement since 2018, with Tendai Nzirawa, maternity clinical improvement lead, leading the workstream since 2019.
The PSC supports the delivery of the ‘Regional Preterm Birth Forum’, bringing together local maternity and neonatal systems (LMNS’s). The forum facilitates collaboration and the sharing of best-practice, alongside promoting relevant research and data-sharing efforts.
At these forums, the PSC shares key data captured by trusts on Badgernet (an electronic maternity notes system) which is then analysed and presented in the MatNeo dashboard. Utilising measurement for improvement principles, clinical expertise and national intelligence, Tendai highlights specific interventions or trusts demonstrating significant progress, alongside interventions or trusts requiring targeted support. In doing this, Health Innovation East champions and enables best-practice to thrive, whilst simultaneously identifying and flagging to teams’ areas that – without immediate quality improvement (QI) – will be less likely to meet national ambitions and targets.
Suffolk and North East Essex (SNEE) Maternity and Neonatal Services have developed an online resource to inform, educate and empower expectant parents to actively shape their own birth experience.
A section of the website designated for preterm labour and birth touches on several of the nine interventions in this workstream. Providing this information helps to empower women to make informed choices and self-advocate.
SNEE Maternity and Neonatal Service preterm birth webpages are just one way the workstream data has been used to shaped through service-level improvement efforts, and as a Patient Safety Collaborative, we are uniquely placed to provide bespoke QI support to NHS staff. Alongside focusing on priorities pertinent to specific perinatal teams, we also ensure to link in with national priorities. Some examples of national priority areas (in addition to those within the Maternity and Neonatal Safety Improvement Programme) include but are not limited to: The NHS Resolution Maternity Incentive Scheme, Better Birth’s, and Saving Babies Lives Care Bundle.
Our work involves engaging with local healthcare providers and supporting them to identify inefficiencies within their practice. By utilising Plan-Do-Study-Act (PDSA) cycles to test changes, we promote evidenced-based practices and support the spread, adoption and sustainability of successful interventions; notably, those where measurement for improvement data demonstrate a reduction in harm, and enhanced outcomes with regards to patient safety.
The National Patient Safety Improvement Programmes – maternity and neonatal – report that;
Between April 2020 and December 2024 in the East of England:
Between April 2020 and December 2024 the national optimisation pathway’s impact includes:
(1) https://www.tommys.org/pregnancy-information/premature-birth/premature-birth-statistics