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<p>Women should receive excellent maternity services that focus on the best outcomes
for women and their babies and on women’s experience of care. For premature and sick
newborn babies and their families, neonatal services should deliver the best evidence-based
care to improve both life expectancy and quality of life for newborn babies.</p><p>
</p><p> </p><p> </p><p>Maternity services feature prominently in the key objectives
set out in the Mandate between the Government and NHS England, which states that women
should be offered the greatest choice of providers and a named midwife who is responsible
for ensuring she has personalised one-to-one care throughout pregnancy, childbirth
and during the postnatal period, including additional support for those who have a
health concern.</p><p> </p><p> </p><p> </p><p>To support these objectives the Government
has taken steps to improve the size and capacity of the maternity workforce and to
improve the quality of the environments in which women give birth and are cared for.
There is now a record number of midwives working in the National Health Service, nearly
2,000 more since 2010, and a record 6,400 midwifery students currently in training.</p><p>
</p><p> </p><p> </p><p>The number of midwifery-led units has increased from 87 units
in 2007 to 152 units in 2013, giving more women increased choice of place of birth.
79% of women of childbearing age in England now live within a 30 minute drive of both
a midwifery-led unit and an obstetric unit - up from 59% in 2007.</p><p> </p><p>In
2013 and 2014, the Government invested £35 million in capital which provided new equipment
and facilities such as birthing pools, reclining chairs and beds that allow fathers
to stay overnight, ensuite bathrooms, midwife-led units, complex needs suites for
women with mental health or substance misuse problems and bereavement rooms to support
families after a stillbirth or an early neonatal death.</p><p> </p><p> </p><p> </p><p>The
Friends and Family Test in December showed that 96% of women would recommend their
maternity service for antenatal care, 97% for their labour and birth care and 98%
for their postnatal community care.</p><p> </p><p> </p><p> </p><p>We have raised awareness
of the importance of good maternal mental health during pregnancy and the first year
after birth. The Mandate between the Government and NHS England also includes a specific
objective to reduce the incidence and impact of postnatal depression through earlier
diagnosis, and better intervention and support.</p><p> </p><p>In England, the number
of inpatient mother and baby units specialising in psychiatric care during the perinatal
period increased from 10 units in 2010 to 17 units in 2014.</p><p> </p><p>Health Education
England (HEE) will ensure that training in perinatal mental health is available so
that specialist staff will be available to every birthing unit by 2017. HEE will work
with the National College of Midwifery and the Royal College of Midwives to ensure
that there is a core module focussing on perinatal mental health in the undergraduate
training of all midwives.</p><p> </p><p>We have trained 400 perinatal mental health
visitor champions who are supporting health visitors with the identification and management
of anxiety, mild to moderate depression and other perinatal mental disorders and knowing
when to refer on.</p><p> </p><p> </p><p> </p><p>The Department has also commissioned
the National Perinatal Epidemiology Unit at Oxford University to develop a perinatal
mental health indicator, which will help us to better identify and address gaps in
our services. NHS England is developing a plan to support women with postnatal mental
health problems by March 2015 which will share best practice and learning with the
NHS.</p><p> </p><p> </p><p> </p><p>The Government has also made reducing stillbirth
an improvement area for the NHS in the NHS Outcomes Framework. The stillbirth rate
is falling – from 3,558 stillbirths in 2012 to 3,284 in 2013. The Department of Health
is working with key partners on programmes aimed at reducing stillbirth and neonatal
mortality by raising awareness of the known risk factors, identifying the currently
known and unknown factors and causes associated with perinatal and infant mortality
and facilitating the learning and sharing of good practice across the NHS.</p><p>
</p><p> </p><p> </p><p>As a specialised service, responsibility for commissioning
neonatal critical care rests with NHS England. In 2014, NHS England published service
specifications for neonatal critical care services and Neonatal Critical Care Retrieval,
which take account of the principles set out in the <em>Toolkit for High Quality Neonatal
Services</em> (2009).</p><p> </p><p> </p><p> </p><p>It is for local hospital trusts
and specialised commissioners to decide how best to use the guidance and the NICE
quality standard for specialist neonatal care to improve babies’ chances of survival
and minimise mortality associated with being born either premature or unwell. Trusts
should provide a family-centred approach to care and improve the quality of care by
working in partnership with other providers and commissioners through Operational
Delivery Networks as part of the broader Maternity and Children’s Strategic Network.</p><p>
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