LMNS Guidelines 

The LMNS 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
Conflict of Clinical Opinion	17 October 2022 - updated 17 November 2022
Latent Phase of Labour	23 September 2021
Preterm Birth	20 September 2021
PMRT Guidance	13 September 2021
PReCePT Guideline - Magnesium Sulphate Protocol	19 June 2023
Frenotomy (Division of Tongue Tie)	02 December 2020

It has been agreed that all HNY 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 . 

LMNS Safety Alerts 

Safety Alert	Publication Date
Herpes Simplex Virus	3 September 2021

Links to key national and regional 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.

Published on 30th March 2022 the final report of the Ockenden Review details the findings, conclusions and essential actions from the independent review of maternity services at the SaTH. Based on a review of all family cases that formed part of this investigation, the final report outlines system-wide learnings; and immediate and essential actions to improve maternity care.

Maternity and neonatal services in East Kent: 'Reading the signals' report

On 13 February 2020 the Minister of State, DHSC, confirmed in Parliament that, following concerns raised about the quality and outcomes of maternity and neonatal care, NHS England and NHS Improvement (NHSEI) had commissioned Dr Bill Kirkup CBE to undertake an independent investigation into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust. 

The primary reason for this report is to set out the truth of what happened, so that maternity services in East Kent can begin to meet the standards expected nationally, for the sake of those to come. This report identifies 4 areas for action. The NHS could be much better at:

• identifying poorly performing units
• giving care with compassion and kindness
• teamworking with a common purpose
• responding to challenge with honesty

The full report can be accessed here . 

Maternity Incentive Scheme - Year 5 (published on 31 May 2023)

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 fifth year of the Clinical Negligence Scheme for Trusts (CNST) Maternity Incentive Scheme (MIS)  to continue to support the delivery of safer maternity care. 

The MIS supports the delivery of safer maternity care through an incentive element to Trust contributions to the CNST. MIS, developed in partnership with the national maternity safety champions, Dr Matthew Jolly and Professor Jacqueline Dunkley-Bent OBE, rewards Trusts that meet 10 safety actions designed to improve the delivery of best practice in maternity and neonatal services.

Saving Babies' Lives Care Bundle Version Three (SBLCBv3) (published on 31 May 2023)

SBLCBv3 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 third version of the care bundle brings together six 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
• Management of pre-existing diabetes in pregnancy.

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.

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.

MBRRACE-UK Reports

MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) is being led from the National Perinatal Epidemiology Unit (NPEU) at the University of Oxford by Prof Jenny Kurinczuk and will build on existing research programmes, including the UK Obstetric Surveillance System (UKOSS ) led by Prof Marian Knight at the NPEU, and The Infant Mortality and Morbidity Studies (TIMMS ) led by Profs Elizabeth Draper and David Field at the University of Leicester.

MBBRACE-UK reports can be accessed here .

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.