NHS England and NHS Improvement
HSIB recommends that NHS England and NHS Improvement amends the ‘Saving Babies’ Lives care bundle version 2’ to enhance the role of the ‘fetal monitoring lead’ to include, training and competency checks of all maternity staff on the use and functionality of cardiotocograph (CTG) equipment.
NHS England and NHS Improvement welcome this report. We agree that all relevant maternity staff should be trained and competent in the use and functionality of CTG equipment. We have included this in the minimum requirements for this year’s Clinical Negligence Scheme for Trusts Maternity Incentive Scheme safety action 8 and this is also being added to the next iteration of the core competency framework. We will update SBLCBv2 to reflect the HSIB recommendation but we think Trusts should decide the best way of ensuring staff are trained rather than specifically stipulating that this is the role of the ‘fetal monitoring lead’. Timeline: March 2022
Response received on 4 October 2021.
NHS England and NHS Improvement
HSIB recommends that NHS England and NHS Improvement amends the ‘Saving Babies’ Lives care bundle version 2’ to remove specific references to Dawes-Redman and instead use a generic term such as ‘computerised cardiotocograph (CTG) analysis’.
We note that Dawes Redman criteria are only referenced once in the document and that is in the in the introductory section of the Care Bundle and not in the element section which describe the recommended pathways. We do however agree to make this change.
We will remove the specific reference to Dawes-Redman and instead use a generic term such as ‘computerised CTG analysis’. Timeline: March 2022.
Response received on 4 October 2021.
National Institute for Health and Care Excellence
HSIB recommends that the National Institute for Health and Care Excellence considers reviewing its telemetry recommendation as part of the current update of clinical guideline CG190, taking into account the existing evidence and the findings of this report.
In its guideline on intrapartum care for healthy women and babies [CG190], the National Institute for Health and Care Excellence (NICE) recommends that any woman who needs continuous cardiotocography during labour (monitoring of the baby’s heart rate) should be offered telemetry, which allows the woman to move around and change position (see recommendation 1.10.9).
NICE is currently updating CG190 and will review recommendation 1.10.9 as part of this.
Action: Review recommendation 1.10.9 as part of current update of CG190. Timeline: Present to July 2022.
Action: Public consultation on guideline update. Timeline: 27 September 2022 to 8 November 2022.
Action: Publication of guideline update. Timeline: 22 March 2023.
Response received on 8 October 2021.