How we are improving our Maternity services

Using national best practice tools to provide exceptional care to you. We have made significant improvements to how we care for women, birthing people and babies by embedding national best practice care in areas including managing a heavy bleed, maternity triage and how we monitor babies' heart rates.  

• Improved the way we triage women and birthing people: Women and birthing people who require urgent or emergency support during pregnancy will now be assessed and triaged using the Birmingham Symptom Specific Obstetric Triage System (BSOTS), that is nationally recognised as the best and safest way to triage and assess people within 15 minutes, by using a similar model to A&E that prioritises those who are seriously unwell >.
  
  
• Changed how we monitor babies during labour: Maternity staff complete a training programme on an evidence-based, more personalised approach to fetal monitoring called physiological fetal heart monitoring. This means we have a single consistent approach to monitoring babies before they are born which helps our teams better track and respond to any changes to your baby's heart-rate during labour. Since this focused piece of work, we have seen fewer hypoxic-ischaemic encephalopathy (HIE) cases, a condition caused by a lack of oxygen to the brain before or shortly after the birth. We have a full-time fetal monitoring lead midwife in post and are in the process of recruiting a second fetal monitoring lead midwife to give dedicated attention to this work.
  
  
• Changed how we measure any bleeding during and after birth: we are using a nationally developed process for reducing major bleeding after birth. It helps us to identify women at risk of bleeding after birth, and provides a more consistent measure of blood loss so we can quickly identify when someone is bleeding abnormally. This means we can take steps to stop any abnormal bleeding earlier and try and avoid someone needing a blood transfusion.
  
  
• Embedded a new process to support clinical accuracy:  Since August 2023 we have embedded 'Fresh eyes', where a review happens by a second clinician every hour for women in labour. Over 90% of patients on labour ward across both sites now have fresh eyes assessments with independent checks.

Training and compliance - to ensure our dedicated colleagues are providing best practice and high-quality care, they attend regular training to refresh and test their skills and to improve our compliance with national safety measures. 

• For Saving Babies Lives, which sets standards for reducing perinatal mortality, we have improved compliance from 33% in September 2023 to 86% in April 2025.
  
  
• For the Maternity Incentive Scheme, which sets 10 safety standards for improving quality of care, we were compliant with 2/10 measures in 2023 which has improved to 8/10 in 2025, with clear plans to continue improving.
  
  
• Our perinatal mortality rates have consistently been below the national average for over 12 months. For May 2025, the rolling yearly stillbirth rate has decreased to 2.45 per 1000 births against a national average of 3.54 per 1000 births. The rolling neonatal death rate has remained at 0.98 per 1000 births compared to national average of 1.65 per 1000 births.
  
  
• We have changed how we track our staff training. We support staff to refresh and test skills regularly, like how they monitor your baby during labour, with annual training to make sure all staff caring for you are experienced, knowledgeable and confident. As an example, for fetal heart monitoring training, our compliance for midwives is 93.8%, above the national target - so you can be assured everyone looking after you is trained in what they are doing for you and your baby.

Recruitment and culture - as well as improving the experience for our families, we want to improve the experience of our teams too.

• Recruited more staff - we have boosted staff numbers across obstetrics, anaesthetics, maternity, neonatal, theatres and imaging (where you go for scans) and are actively recruiting more experienced midwives too. We have one of the lowest vacancy rates in the Midlands with kind, caring and compassionate staff who are committed to making a difference to your pregnancy journey and birth experience.  
  
  
• A good safety culture - We know that a good safety culture is one that involves value, respect and civility. Our frontline colleagues, including midwives, support workers and consultants, have worked together to develop a shared set of behaviours and values for everyone to sign up to.
  
  
• Looking at who does it best: We remain the only Trust in the country who proactively asked to join the Maternity Safety Support Programme, a national improvement programme led by NHS England through which we can learn from other maternity units and bring the best back to UHDB. 
   

Improving our facilities, systems and software - we have invested in new equipment to support our experienced teams when caring for women, birthing people and babies: 

• We have invested £1.6m in a dedicated electronic patient record for maternity services called BadgerNet, with a patient portal so that women can access their records, advice and support through an app. This system also means that wherever you access care at UHDB, our clinical teams will have instant access to your notes. To find out more about this, visit our Badger Notes page >
  
  
• We have invested £250k in ultrasound software that automates and maps the scan measurements for babies who require regular growth monitoring during pregnancy.
  
  We have introduced wireless telemetry, which means you can have continuous monitoring via a cardiotocograph (CTG) machine but without the need for wires which can sometimes restrict movement. A CTG is a medical device used to monitor a baby's heart rate and a mother's contractions during pregnancy and labour. Telemetry can be utilised in the birthing pool and encourages movement in labour for those that are recommended or request continuous fetal monitoring. You can find out more about telemetry, which is now available in the labour wards at Queen's Hospital Burton and Royal Derby Hospital, here >

• Improving our induction pathway - at Royal Derby Hospital, we now have dedicated induction side rooms and at Queen's Hospital Burton we have a private examination room that is used during intimate examinations. We are also reviewing how our inductions are booked and managed to reduce the time you wait before an intervention.
  
  
• Neonatal transitional care - after birth, some babies require more frequent observations, this is called neonatal transitional care, and some babies require antibiotics. We have created transitional care spaces within our postnatal wards, which means at set times babies requiring neonatal care can now be administered their antibiotics in wards beside their parents, minimising the separation between infants and families. 
  
  
• Supporting research trials which can support better outcomes: Research can help improve quality of care not just here at UHDB, but for women and babies everywhere. We have already been involved in research trials for things like routine testing for Group B Streptococcus; a Smoking Nicotine and Pregnancy 2 trial, which looks at interventions on smoking cessation in late pregnancy, and an investigation into the role of previous in-labour caesarean section in future pre-term birth risk and protection against invasive Group B Streptococcus disease.

Listening to women, birthing people and their families and supporting you to have a personalised birthing experience: if you have accessed our services we value your feedback in helping to shape further improvements within maternity. 

• To offer more birthing options we have reintroduced the home birth service to support people who want to birth in this way. If you would like to know more about a home birth please speak to your community midwife or read this story about Laura who was the first to use the service when it reopened and had a 'positive and personal' labour with daughter Kleo >.
  
  
• We are working closely with people who have used our services, including our Patient Safety Partner, who has firsthand experience of our services and acts as an independent voice, representing our communities formally on our Maternity and Neonatal Improvement programme. We have strengthened our partnerships with key voluntary sector organisations including family hubs and Connected to identify how we can better work together to support women, birthing people and their families during pregnancy and as they transition away from maternity or neonatal care >. We have also started a series of community conversations with the public, in partnership with our two local Maternity and Neonatal Voices Partnerships (MNVPs).
  
  
• You can contact the MNVPs to share anything about our service:
  • ddicb.derbyshirematernityvoices@nhs.net (Derbyshire)
  • sasot.mnvp@nhs.net (Staffordshire)

If you are interested in joining us as a Patient Safety Partner, we would love to hear from you > We are committed to continuing on this journey at pace, to listen, to improve, and to make positive changes.

Check back for regular updates on our progress and improvements.