Implementation support toolkit
Implementation: getting started
Why this is important
Putting NICE antenatal guidance into practice benefits service users and their family, friends and carers, and healthcare professionals and organisations.
NICE guidance can help patients, carers and service users to:
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Receive care that is based on the best available clinical evidence.
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Be accountable for their care and know they will be cared for in a consistently evidence-based way.
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Improve their own health and prevent disease.
NICE guidance can help organisations to:
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Plan for service provision and commissioning, reflecting national maternity, neonatal and health inequalities priorities set by NHS England and the Department of Health and Social Care, including:
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Meet recommendations made in national reviews, inquiries, or reports, such as:
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Benefit from any identified disinvestment opportunities, cost savings or opportunities for re-directing resources.
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Promote the social wellbeing of their communities.
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Meet NHS Litigation Authority (NHSLA) risk management standards and benefit from reduced claims and risk management premiums.
How this toolkit can help you
We have reviewed the data associated with the uptake of NICE's quality standard on antenatal care. This quality standard describes 5 priority areas for quality improvement in antenatal care and consists of a prioritised set of specific, concise, and measurable statements. It draws on existing NICE guidance that provides an underpinning, comprehensive set of recommendations.
The 5 priority areas for improvement in antenatal care are as follows.
In the antenatal period, women and pregnant people:
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are supported to access antenatal care by 10 weeks of pregnancy
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have a risk assessment at routine antenatal appointments
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have coordinated care from a small team of midwives
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are offered vaccinations at routine antenatal appointments
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if they or their partners smoke, are referred for stop-smoking support and treatment at routine antenatal appointments.
Data and system intelligence showed notable variation in the following areas:
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Attendance at the first antenatal ("booking") appointment by 10 weeks of pregnancy.
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The recording of recommended risk assessments in the first, and subsequent, antenatal appointments.
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Carbon monoxide testing of women and pregnant people at their 10- and 36-week antenatal appointment.
The data and system intelligence also reinforced the existence of, and ongoing need to address, a known unacceptable level of health inequalities experienced by some ethnic groups across maternity and neonatal care.
We have developed this toolkit in collaboration with system partners. It provides implementation advice, support and resources that may be useful to support commissioners, providers and practitioners to implement NICE guidance.
For targeted support on how to try to reduce the unwarranted variation in these identified areas, see the sections on routine antenatal appointments, ethnic health inequalities and smoking.
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