CNST Maternity Standards launch seminar

1
CNST Maternity Standards launch seminar

• Professor Dame Joan Higgins
• Chair, NHSLA

2
Welcome and Thank you

• to everyone who is here today and to all the
  individuals and organisations who have helped us
  develop the revised standards over the last two
  years.

3
Developing the revised standards

• Separate CNST Maternity Clinical Risk Management
  Standards first introduced in 2003.
• Review began in 2007/8 to ensure that they
  reflected the latest thinking and were fit for
  purpose.

4
Review process

• Analysis of NHSLA maternity claims
• Review of current literature, guidance, best
  practice (from Royal Colleges and others)
• Meetings with stakeholders, including patients
• Focus groups for NHS staff 230 delegates,
  representing 75 of all NHS Trusts
• Keep or cull exercise of the risk areas in
  existing standards

5
Pilot assessments

• In 2008 volunteer maternity services were sought,
  to pilot the draft standards. 100 applied and 42
  pilot assessments were eventually completed.
• During the pilot process 1,500 comments or
  queries were received. Areas of most interest
  were leadership, staffing, attendance at A and
  E, assisted vaginal delivery.

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Main changes

• The standards are more distinct and progressive.
  Level 3 requires maternity services to monitor
  effectiveness and make changes to reduce risk.
• New risk areas introduced (e.g. obesity)
• New standards are less prescriptive.
• New standards are more clinically focused.

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Why are the standards so important?

• Obviously of great significance to the health and
  well being of children and their families. 1 in
  6,000 children is born brain damaged.
• Important to provide clarity and support to
  staff.
• Cost to families and to the NHS, when things go
  wrong. NHSLA receives around 350 maternity claims
  a year.

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Total number of reported CNST claims by
specialty as at 31/03/08
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Total value of reported CNST claims by specialty
as at 31/03/08
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Cost of claims

• Since 1995, 61 of all negligence payments relate
  to claims arising out of birth.
• Total cost of CNST maternity claims in 2007/8 was
  163 million.
• Cerebral palsy claims accounted for 66 of these
  payments (and stillbirths 2).

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Gross CNST maternity contributionsper trust
2008/09
Trusts
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Maternity contributions 2009/10

• Will rise to 8 million (gross) for the largest
  maternity units and an average of 3 million.
• Level 1 10 discount, Level 2 20, Level 3
  30. So, reaching Level 3 could save the larger
  units 2.4 million and the average unit 1
  million.

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Comparison of levels achieved in theCNST
maternity standards
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What happens next?

• Final version of revised standards published
  March 2009.
• 3 launch seminars March 2009.
• Formal assessments, using revised standards,
  begin in September 2009.