• Insurance premiums to be linked to maternity service performance
  • Up to £40,000 available for each trust for maternity training
  • Trusts will be asked to commit to steps to improve safety

Trusts that demonstrate better outcomes in maternity care will be rewarded with reductions in the premiums they pay the NHS Litigation Authority, Jeremy Hunt announced today.

The health secretary launched a series of measures designed to improve safety in maternity care, including a new mortality review tool to enable standardised recording and investigation of every stillbirth and neonatal death, so lessons can be learned and shared across the NHS.

Speaking to HSJ, Mr Hunt said: “At the moment clinical negligence scheme for trust rates are retrospective so you pay a CNST premium based on your hospitals performance eleven and a half years ago.”

“What we need to do is make it so that if you improve your safety record now your premium will go down next year – so you don’t have to wait eleven and a half years. We think that creates a better incentive to trusts.

“It is a way of working out what the lead indicators are that can allow NHS Litigation Authority to predict what your risk is likely to be rather than having to wait for that time frame,” Mr Hunt said.

As part of the scheme, trusts will be asked to commit to key actions to improve safety in maternity care. Funding of up to £40,000 per trust with a maternity department will be available to help pay for the multidisciplinary training required.

“Once trusts are signed up to these actions we will then measure by results,” Mr Hunt said.

“By 2017-18 we will be rewarding trusts who demonstrate better maternal outcomes with reductions in the premiums they pay the NHS Litigation Authority.”

Mr Hunt said decisions about premium reductions would “be balanced to take into account of different demographics” of trusts.

The steps trusts will need to take include:

  • Appoint obstetric and midwifery safety champions who report directly to the board.
  • Use the standardised perinatal mortality review tool when it becomes available.
  • Report to the maternity services dataset, which will be mandatory from 2018.
  • Take part in the national maternity quality improvement programme run by Sign Up to Safety and the NHS Litigation Authority.
  • Use the NHS Improvement Attain resource pack to help teams avoid unnecessary separation of mother and babies.
  • Implement at least two of the four elements of the NHS England Saving Babies Lives care bundle.
  • Develop their own maternity safety improvement plan, approved at board level.

The NHS Litigation Authority spent £1.5bn on clinical negligence claims in 2015-16 with maternity claims accounting for 34 per cent.

On average, the authority settles two multimillion pound pay outs a year for children born with severe brain injuries as a result of medical error.

Trusts offered incentives to improve maternity safety