Saving Babies’ Lives Care Bundle

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Version two of the Saving Babies’ Lives Care Bundle (SBLCBv2), has been produced to build on the achievements of version one and address the issues identified in the its evaluation.  This version aims to provide detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. The second version of the care bundle brings together five elements of care that are widely recognised as evidence-based and/or best practice. The new fifth element is reducing pre-term birth.

This is an additional element to the care bundle developed in response to the Department of Health’s ‘Safer Maternity Care’ report which extended the ‘Maternity Safety Ambition’ to include reducing preterm births from 8% to 6%. This new element focuses on three intervention areas to improve outcomes which are prediction and prevention of preterm birth and better preparation when preterm birth is unavoidable.

Evaluation

The detailed report shows that stillbirths fell by a fifth at the maternity units where implementation of the Care Bundle was evaluated over the two years to April 2017. The best practice guidance is being rolled out across the country and has the potential to prevent around 600 women and families a year from suffering a stillbirth.

The evaluation report is available to download from The University of Manchester University website.

Background

In November 2014, Secretary of State for Health announced a new ambition to reduce the rate of stillbirths by 50 per cent in England by 2025, with a 20 per cent reduction by 2020.

Despite falling to its lowest rate in 20 years, one in every 200 babies is stillborn in the UK; this is more than double the rate of nations with the lowest rates.

There are currently around 665,000 babies born in England each year. But there are over 3,000 still births. This new guidance – called Saving Babies’ Lives Care Bundle – is part of a drive to halve the rate of still births from 4.7 per thousand to 2.3 per thousand by 2030, potentially avoiding the tragedy of still birth for more than 1,500 families every year.

While the majority of women receive high quality care, there is around a 25 per cent variation in the stillbirth rates across England. This presents us with opportunities to make improvements spanning both public health and maternity care services in order to make an overall improvement.

The Saving Babies’ Lives Care Bundle addresses this variation by bringing together four key elements of care based on best available evidence and practice in order to help reduce stillbirth rates. It will support commissioners, providers and professionals in making care safer for women and babies.

Reducing stillbirth continues to be a priority for the NHS. It is one of the mandate objectives from central government. It will also be included in the 2016-17 business plan, as part of a wider objective to implement the recommendations from the National Maternity Review, published on 23 February 2016.

Saving Babies’ Lives is designed to tackle stillbirth and early neonatal death and a significant driver to deliver the ambition to reduce the number of stillbirths, bringing four elements of care together:

  1. Reducing smoking in pregnancy
  2. Risk assessment and surveillance for fetal growth restriction
  3. Raising awareness of reduced fetal movement
  4. Effective fetal monitoring during labour

The package was developed by groups brought together by NHS England, including midwives, obstetricians and representatives from stillbirth charities. Though the NHS already follows much of this best practice, this is the first time that guidance specifically for reducing the risk of stillbirth and early neonatal death has been brought together in a coherent package.

The care bundle approach is now a recognised and familiar approach to improvement across the NHS. Care bundles typically bring together a small number of focused interventions designed to effect improvement in a particular disease area, treatment or aspect of care. When implemented as a package, evidence shows that greater benefits are achieved at a faster pace than if those improvements had been implemented individually.

The care bundle will now be tested and piloted by volunteer maternity care providers and NHS England will then consider how to support implementation nationwide, as part of the National Maternity Review.

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