A Refreshed Framework for Maternity Care in Scotland: The Maternity Services Action Group

Ministerial Foreword

The Scottish Government is committed to ensuring that all children in Scotland get the best possible start in life, even before they are born. Maternity care plays a vital role in providing women, their partners and their babies with the care and support they need at this important time. The ambitions of NHSScotland's Healthcare Quality Strategy are at the heart of this refreshed framework. We know that women and their partners want a healthy baby. Women want for themselves and their baby a service that is person centred, safe and effective. They need timely, relevant and easily accessible information to help them make the choices they face. They want care that is of equitable quality regardless of their individual circumstances, with consistent support, advice and continuity of that care.

NHS staff providing maternity care are committed to providing high quality care. This refreshed framework recognises that all staff will need learning and development support to continue to develop the knowledge and the skills they need to deliver tailored maternity care of equitable quality for all women. This includes staff having the skills to work with women and their families using health asset or strengths based approaches- approaches that start with and harness the high levels of motivation women have to do what's best for their babies.

We know from the evidence gathered for the Early Years Framework that maternal and parental circumstances and behaviour during pregnancy have an impact on children's outcomes. High risk factors such as alcohol and drug misuse, domestic abuse, smoking as well as diet and maternal nutrition impact on health outcomes at birth, in infancy, and across the whole of the life course. Crucially we now know that there is a strong link between antenatal anxiety and maternal depression, and poor outcomes for children including development, parental bonding and behavioural problems. The evidence tells us that the most promising services for pregnant women are therefore those offering high-quality social support alongside antenatal healthcare.

This refreshment of Scotland's Framework for Maternity Care is the product of the Maternity Services Action Group ( MSAG). MSAG is the strategic group for maternity services in Scotland, bringing together key professional and service stakeholders with policy officers from the Scottish Government's Child and Maternal Health Division. The aim of the refreshment is to strengthen the contribution NHS maternity care makes to improving maternal and infant health and reducing the unacceptable inequalities in maternal and infant health outcomes. In addition, in response to the specific recommendation in Equally Well that NHS Boards improve their capacity to reach and manage women and babies in high risk groups, MSAG have produced practical antenatal inequalities evidence into action guidance to accompany this framework.

I believe this refreshed Framework sets the pace for continuous improvements in maternity care. Stakeholders have welcomed the inclusion of service improvement measures. They have highlighted three key areas that will benefit from national support to ensure that the framework is effectively implemented, these are:

• workforce development,
• improvements in information and data collection and analysis
• risk assessment of pathways of care between primary care, maternity services and public health nursing.

I am delighted that an implementation support group will therefore be charged with working closely with the named executive lead for each NHS Board area, to address these three key areas and support NHS Boards develop their own outcome focussed implementation plans that meet the needs of their local communities.

Shona Robison, Minister for Public Health and Sport