Antenatal and postnatal mental health: clinical management and service guidance

NICE has published a case study by Frimley Health ICB and NHS Frimley Health Foundation Trust on understanding local themes for Black maternity service users booking late (over 16 weeks' gestation), which explores why some Black maternity service users book their first antenatal appointment after 16 weeks of pregnancy. Through data audits and thematic analysis, it identifies key reasons such as transfers of care, complex needs, provider errors, and data inaccuracies. The findings challenge assumptions about late booking trends and highlight the need for improved communication, accurate data recording, and better support for migrant and vulnerable populations.

There is a dedicated section on NICE's website which provides information and advice on how NICE can help you tackle health inequalities.

NICE's guideline on community engagement: improving health and wellbeing and reducing health inequalities covers community engagement approaches to reduce health inequalities, ensure health and wellbeing initiatives are effective and help local authorities and health bodies meet their statutory obligations.

NICE has published a quality standard on promoting health and preventing premature mortality in Black, Asian and other minority ethnic groups, which draws attention to some of the specific areas of inequality for people from Black, Asian and other ethnic minority groups, such as increased health risks, poor access to and experience of services, and worse health outcomes. It aims to support public authorities in considering their equality duty when designing, planning, and delivering services.

The NICE guideline on antenatal care outlines the care that everyone should be offered during their pregnancy. However, those with complex social factors may also have additional needs. The NICE guideline on pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors sets out what healthcare professionals as individuals, and antenatal services as a whole, can do to address these needs and improve pregnancy outcomes in this group.

The NHS Race and Health Observatory have developed 7 anti-racism principles to guide organisations in embedding anti-racism throughout their practices and policies. This evidence-based model of anti-racism is a good start for healthcare organisations and systems to begin to think about the steps needed to help shift the dial on racial inequalities for their communities. To help address the challenges associated with ethnic and racial inequalities, an Anti-Racism Infographic (PDF only) and an associated explainer video on 7 anti-racism principles have been created by the NHS Race and Health Observatory to guide healthcare organisations and systems in building equitable and inclusive healthcare landscapes.

These resources outline practical steps to foster anti-racist practice, raise awareness, and address racial inequities in healthcare, and have been co-produced with the expertise of members from the Observatory's Stakeholder Engagement Advisory Group, Academic Reference Group, and the Board, to help support healthcare organisations, staff and patients.

The Health Action Resource Platform (HARP) is a digital tool by the NHS RHO addressing racial health disparities within the NHS by bringing together data metrics, learning resources, and case studies highlighting good practice. The HARP offers insights which can lead to informed, targeted action to tackle inequalities at both local and national levels. Admission, attendance and length of stay metrics are visualised by ethnicity across national, regional, and integrated care board (ICB) levels for focus areas including maternal and neonatal health, mental health, and cardiovascular disease. There is a specific section for Maternal and Neonatal Health on the platform. They welcome case study submissions from organisations to showcase replicable practice which address inequalities experienced in health and healthcare by Black, Asian and ethnic minority patients, communities and the workforce.

The decolonising midwifery education toolkit from the Royal College of Midwives has been developed for midwifery educators and other stakeholders involved in planning and delivering midwifery education. The aim of the toolkit is to empower midwifery educators to challenge the implicit and explicit legacies of colonial perspectives in all aspects of midwifery education when they are developing and improving their programmes. The toolkit provides a checklist of considerations for midwifery educators and those involved with midwifery education when recruiting for, planning, delivering and assessing midwifery education.

The maternity disadvantage assessment tool (MatDAT) from the Royal College of Midwives is a standardised tool for assessing social complexity in maternity, based on women and pregnant people's broad social needs. It guides midwives to identify the appropriate care level and assists with providing personalised care and planning appropriate support. The tool supports multidisciplinary communication and helps services plan resource allocation.

The Sands Listening Project report highlights barriers, biases, and poor care, which might be contributing to inequalities in baby deaths in the UK. The report also shines a light on care that works well.

The Royal College of Midwives i-learn programme training module on health inequalities: the power of maternity care enables the learner to:

Tommy's helpline for Black and Black mixed-heritage women is a specialist helpline that supports Black and Black mixed-heritage women and birthing people in the UK with any aspect of their pregnancy journey.

The Maternity and Newborn Safety Investigations (MNSI) programme Health Equity Warning Score (HEWS) and Health Equity Assessment and Resource Toolkit (HEART) can help identify and address systemic inequities in maternity care.

HEWS, a structured risk stratification tool, similar to a maternity early warning score (MEWS), assesses equity barriers such as ethnicity, disability, deprivation, and communication challenges. Since its implementation, HEWS has enhanced the consistency and depth of MNSI investigations by systematically recognising and analysing the impact of inequities on outcomes, including maternal and neonatal deaths. HEWS supports MNSI in developing targeted recommendations to help trusts address inequalities and promote equitable perinatal outcomes.