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New NICE quality standard for antenatal care

London, UK (September 17, 2012) – NICE has today (17 September) launched a new quality standard on the care that should be offered to women during their pregnancy. This new quality standard on antenatal care represents the first component of a suite of maternity quality standards which, along with intrapartum care and postnatal care, will form the core pathway. Other quality standards in development include hypertension in pregnancy, caesarean section and multiple pregnancy.

This new quality standard consists of 12 quality statements that describe prioritised aspects of high-quality, cost-effective care that contribute to improving the effectiveness, safety and experience of care for pregnant women.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Careat NICE said: "Having a baby is one of the most important times in a woman’s life and healthcare professionals want to make sure this is a good and safe experience. The majority of women will not experience any complications during their pregnancy, but serious problems such as miscarriage, fetal growth restriction or preterm birth unfortunately still occur. This new quality standard identifies 12 key priority areas of routine care that healthy women should expect to receive during their pregnancy, including screening tests for complications. It includes a set of measures to enable commissioners and providers to track ongoing achievement against this standard.

"The new quality standard also firmly places women at the centre of decision making about their care, ensuring they are provided with up to date information to enable them to make informed decisions in partnership with healthcare professionals about their care and treatment."

David Richmond, Vice President (Clinical Quality) of the Royal College of Obstetricians and Gynaecologists said: "We welcome these important antenatal standards, based on existing guidelines. Implementation will be the key and all hospitals must be encouraged to adhere to them so that high quality care can be provided to a woman throughout her pregnancy.

"The Royal College of Obstetricians and Gynaecologists (RCOG) believes that women’s healthcare, organised in managed clinical networks across the country, are the best model for the NHS to adopt. Networks will ensure that these quality standards, alongside those for intrapartum and postnatal care, are embedded in each NHS trust. They are an invaluable tool for commissioners as they decide on the provision of local maternity services."

The quality standard on antenatal care consists of 12 statements including:

• Pregnant women are supported to access antenatal care, ideally by 10 weeks.
• Pregnant women are cared for by a named midwife throughout their pregnancy.
• Pregnant women have a complete record of the minimum set of antenatal test results in their hand-held maternity notes.
• Pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment are offered personalised advice from an appropriately trained person on healthy eating and physical activity.
• Pregnant women who smoke are referred to an evidence-based stop smoking service at the booking appointment.
• Pregnant women are offered testing for gestational diabetes if they are identified as at risk of gestational diabetes at the booking appointment.
• Pregnant women at high risk of pre-eclampsia at the booking appointment are offered a prescription of 75 mg of aspirin to take daily from 12 weeks until at least 36 weeks.
• Pregnant women at intermediate risk of venous thromboembolism at the booking appointment have specialist advice provided about their care.
• Pregnant women at high risk of venous thromboembolism at the booking appointment are referred to a specialist service.
• Pregnant women are offered fetal anomaly screening in accordance with current UK National Screening Committee programmes.
• Pregnant women with an uncomplicated singleton breech presentation at 36 weeks or later (until labour begins) are offered external cephalic version.
• Nulliparous pregnant women are offered a vaginal examination for membrane sweeping at their 40- and 41-week antenatal appointments, and parous pregnant women are offered this at their 41-week appointment.

The quality standard will be available on the NICE website from 17 September 2012

Notes to Editors

About the quality standards

1. Embargoed copies of the quality standard are available on request from the NICE press office.

2. NICE quality standards are a concise set of statements designed to drive and measure priority quality improvements within a particular area of care. They are derived from the best available evidence such as NICE guidance and other evidence sources accredited by NICE. They are developed independently by NICE, in collaboration with NHS and social care professionals, their partners and service users. Evidence relating to effectiveness and cost effectiveness, people’s experience of using services, safety issues, equality and cost impact are considered during the development process.

3. Maternity quality standards in development:

• Antenatal and postnatal mental health. NICE quality standard (In development)
• Caesarean section. NICE quality standard (In development)
• Diabetes in pregnancy. NICE quality standard (In development)
• Hypertension in pregnancy. NICE quality standard (In development)
• Induction of labour. NICE quality standard (In development)
• Intrapartum care. NICE quality standard (In development)
• Multiple pregnancy. NICE quality standard (In development)
• Pain and bleeding in early pregnancy. NICE quality standard (In development)
• Postnatal care. NICE quality standard (In development)
• Premature labour. NICE quality standard (In development)

About NICE

4. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

5. NICE produces guidance in three areas of health:

• public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies – guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

6. NICE produces standards for patient care:

• quality standards – these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework – NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
• Commissioning Outcomes Framework – NICE develops the potential indicators for the COF, the scheme starting in 2013, which will help measure the health outcomes and quality of care commissioned by Clinical Commissioning Groups.

7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.

This page was last updated: 14 September 2012

National Institute for Health and Clinical Excellence (NICE), 17.09.2012 (tB).