Antenatal and postnatal mental health: clinical management and service guidance

  • Clinical guideline
  • CG192
  • Published: 
  • Last updated: 
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Implementation support toolkit

Guidance from NICE

NICE has published several key pieces of guidance in relation to pregnancy and antenatal care (see the NICE topic page on pregnancy). This includes NICE guidelines on:

The guidelines provide evidence-based advice for the provision of high-quality individualised care for women and their families and empower them to make informed choices about their care. Implementation strategies aim to help ensure that disparities in outcomes and experiences of mothers and their babies are reduced and that maternity services can deliver the best possible care in what are often very difficult and challenging working environments.

Marie Anne Ledingham, Consultant Clinical Advisor, NICE, Consultant Obstetrician, NHS GGC

Support from NICE

  • NICE's website features a dedicated Implementing NICE guidance homepage that provides helpful implementation support, resources and information.

  • Baseline assessment tools are published for each NICE guideline and can be found on each guideline's tools and resources tab. They can be used to evaluate whether local practice is in line with the recommendations in the guideline or to plan activity to meet the recommendations.

  • The NICE system implementation team are regionally based and engage with key health and care organisations, networks and system partners to help them use NICE guidance and standards in practice. Key activities include:

    • encouraging, informing and facilitating regional and local activities for the implementation of NICE guidance

    • raising awareness of the range of NICE products

    • gathering feedback and intelligence from stakeholders to inform NICE activities

    • seeking examples of good practice to share with NICE and other organisations

    • connecting NICE to local health and care systems.

      The team has been working with various maternity and neonatal services, helping integrated care systems and provider organisations understand and embed NICE's evidence-based products, aiming to improve the quality, safety and outcomes of maternity and neonatal care, reduce unwarranted variation, and ensure a high-quality healthcare experience for all parents, babies and families.

      For practising clinicians, NICE has developed an 'at a glance' antenatal resource which details NICE's evidence-based guidance, quality standards, tools and resources that can help contribute to improvements in the safety, quality and personalisation of managing antenatal care. This resource is available upon request from the system implementation team. The team's engagement activities help NICE to understand available data and variation in uptake and support prioritised activity.

      If you would like further information or support to implement NICE guidance on maternity topics, please contact the system implementation team at systemimplementation@nice.org.uk.

  • The NICE indicator menu contains multiple indicators on pregnancy suitable for use at a system or network level that can support quality improvement activity.

  • The NICE Resource Impact Assessment Team produce reports, templates and statements alongside guidance that detail the potential impact of guidance on organisations' finances and other resources (workforce, capacity and demand, infrastructure and training and education).

    • Resource impact reports use national estimates to summarise the expected resource impact of the guidance. Any assumptions are fully explained in the document. If national estimates are not possible, or if there is likely to be local variation, the report highlights areas for you to consider at a local level.

    • Reports are supported by resource impact templates. These Excel spreadsheets enable organisations to get a more accurate estimate of the local resource impact of guidance. Templates are produced when the resource impact is expected to be significant (greater than £5 million for England). If costs cannot be quantified, the template identifies major cost drivers to consider at a local level. Templates are based on the population of England but can be amended to estimate the impact for Wales, Northern Ireland and local commissioning organisations.

    • Resource impact statements are provided if costs and savings are not considered to be significant (less than £5 million for England).

      The tools can be found through the 'tools and resources' tabs on individual guidance and standards pages. For further information, please see NICE's page on assessing resource impact.

Support from our partners

  • Professional organisations that offer information, education, resources, or advice on the topic of antenatal care to health professionals include:

  • The NHS Race & Health Observatory are an independent expert body, established by the NHS to identify and tackle inequalities experienced in health and healthcare by Black and minority ethnic patients, communities and the workforce in England.

  • Voluntary and community sector partners, who provide information, training and education to women and pregnant people, their families and carers, as well as training and educational resources for healthcare professionals include:

  • The NHS England Maternity and Neonatal Programme is implementing the 3-year delivery plan for maternity and neonatal services. The plan sets out key actions for trusts, systems, and NHS England across 4 themes:

    • Listening to and working with women and pregnant people and families with compassion

    • Growing, retaining and supporting our workforce

    • Developing and sustaining a culture of safety, learning and support

    • Standards and structures that underpin safer, more personalised and more equitable care.

      The overarching vision is to make maternity and neonatal care safer, more personalised and more equitable.

  • Quality improvement initiatives in maternity and neonatal services are supported by 15 regionally based Patient Safety Collaboratives (PSCs), hosted by the Health Innovation Networks.

    • The aims are to improve the safety and outcomes of maternal and neonatal care by reducing unwarranted variation and provide a high-quality healthcare experience for all parents, babies and families across maternity and neonatal care settings in England.

    • PSCs are involved in reducing inequalities in maternity care, co-producing services to ensure a variety of voices are heard, and creating safety-focused cultures in maternity units. Key areas of work include:

      • Improving the optimisation and stabilisation of the preterm infant.

      • Improving the prevention, identification, escalation, and response (PIER) to maternal and neonatal deterioration.

      • Sustaining the work of the Perinatal Culture and Leadership Programme and supporting perinatal leadership teams to create and craft the conditions for a positive culture of safety and continuous improvement.

  • The Maternity and Newborn Safety Investigations programme (MNSI) is part of a national strategy to improve maternity safety across the NHS in England. All NHS trusts in England are required to tell MNSI about certain patient safety incidents that happen in maternity care. This is so that MNSI can carry out an independent investigation and, where relevant, make safety recommendations to improve services at local levels and across the whole maternity healthcare system in England. Throughout investigations MNSI works closely with the families, NHS trusts and staff involved. MNSI does not place blame on individuals or investigate individual members of NHS staff.

  • FutureNHS is a free collaboration platform managed by NHS England that welcomes and empowers everyone working in health and social care to safely connect, share and learn across boundaries. The Maternity and Neonatal Hub on the platform provides a bespoke environment for staff working in trusts, Local Maternity and Neonatal Systems, Clinical Networks and PSCs to access, discuss and share useful tools and resources.

  • The NHS England maternity services dashboard aims to bring together maternity information from a range of different sources including the NHS England Maternity Services Data Set (MSDS). The dashboard enables providers of maternity services to compare their performance with their peers on a series of national indicators (including those from the NICE indicators menu) for the purposes of identifying areas that may need local clinical quality improvement.

  • The Saving Babies' Lives Care Bundle (SBLCB) provides evidence-based best practice, for providers and commissioners of maternity care across England to reduce perinatal mortality. Version 3 of the care bundle has been co-developed with clinical experts including front-line clinicians, Royal Colleges, and professional societies; service users and maternity voices partnerships; and national organisations including charities, the Department of Health and Social Care and a number of arm's length bodies

  • NHS England's eLearning for healthcare has several maternity and newborn based programmes.

Note that external websites and resources have not been produced by NICE. NICE has not made any judgement about the methodology, quality or usability of the websites or resources.

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