Objective To review the IOL pathway by a multi-disciplinary team in March 2011 using BICS as the number of IOLs was anticipated to increase from 900 to 1500 due to merging with 2 neighbouring units.

Findings Inconsistency in practice in offering membrane sweep

Inconsistency in dates for IOL for postdates

No information leaflet for IOL

Difficult to obtain slot in IOL dairy (6 spaces on weekdays and 2 on weekend)

Delays in prescription of Propess

Actions Offer membrane sweeps to nulliparous women at 40 weeks and to all women at 41 weeks (NICE recommendation)

IOL for postdates ≥ term + 11 days

Design IOL leaflet

Update IOL guideline

Check IOL diary daily to free slots by removing delivered women

Patient Group Directive for Propess for midwives

Conclusion There was improvement in the IOL pathway with decreased delays and more spaces in IOL dairy. There was decrease in % of IOL for postdates, increase in membrane sweeps offered and increase in IOL after ≥ term + 11. However, there was decrease in vaginal delivery, instrumental delivery rate and increase in section rate.