Unwarranted variation in maternity care can cause issues including introducing risks to patient safety, sub-optimal clinical practice and complications for staff who regularly rotate between different units. All this can adversely affect patient care and safety.
Since 2015 the Oxford AHSN Maternity Clinical Network has developed, agreed and implemented sets of clinical guidelines which optimise care across the Oxford AHSN region. Consistency of care and aligning guidelines mitigates potential patient safety issues, especially when women can be seen in more than one hospital during their pregnancy.
The content of these guidelines was written by network members based on best available evidence and current national guidance. The network steering group (which has clinical and midwifery representation from all member trusts) was given the opportunity to comment and amend all guidelines during a three-month consultation period. The guidelines are also linked into the Local Maternity System (LMS) and are presented in this forum for high-level agreement.
Building on this initial set, stakeholders put forward suggestions for further guideline alignment. With this and local needs in mind, a new set of guidelines was chosen. These guidelines are now embedded, or in the process of being embedded, in each trust in the region.
Ratified and agreed guidelines
The current agreed and ratified network-wide guidelines are:
- Pregnancies complicated with red cell antibodies other than anti c, anti d and anti K Guideline, V1
- Pregnancies complicated with anti c, anti d and anti k alloimmunisation Guideline, V1
Extreme preterm bundle:
Intrauterine growth restriction (IUGR)
Improving the use of placental histology
Perinatal Palliative Care Framework
Oxytocin for the Augmentation of Labour
Guidelines in development
The Maternity Network Steering Group has agreed to tackle the following across the Oxford AHSN region:
- Cardiotocograph (CTG) interpretation sticker and training package – currently at the implementation stage. An evaluation process is being mapped out and conducted before general release on the website.
- Reduced Fetal Movement (RFM) Audit – the audit is currently at the regional analysis stage. Once common themes have been identified, if appropriate, the network will develop regional guidelines and care pathways.
- Cervical Length in the Prevention of Spontaneous and Severe Preterm Birth – currently being developed in collaboration with the Patient Safety Academy.
- Improving the Care of Women with Medical Problems in Pregnancy – in development with Dr Lucy Mackillop, one of four Obstetric Physicians in the UK currently based at Oxford University Hospitals NHS Foundation Trust.
- Soluble FlT / PlGF Ratio in the Management of Suspect Preclampsia – in the final stages of ratification.