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Reflections on the National Maternity Review
  1. Caroline Lee-Davey
  1. Correspondence to Caroline Lee-Davey, Bliss, London, UK; carolined{at}

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There are just over 660 000 live births in England each year,1 the majority of which are of healthy, term babies. However, one in nine babies born—more than 77 000 each year—is admitted to neonatal care.i In recent years, there has been a significant and sustained focus on improving the quality and consistency of care in maternity services across England, encompassing a range of initiatives led by bodies including the Department of Health,2 NHS Improvement3 and the Royal College of Obstetricians and Gynaecologists.4 Most notably in 2015, NHS England Chief Executive Simon Stevens commissioned a National Maternity Review,5 with terms of reference to:

  1. review the UK and international evidence and make recommendations on safe and efficient models of maternity services, including midwife-led units;

  2. ensure that the National Health Service (NHS) supports and enables women to make safe and appropriate choices of maternity care for them and their babies;

  3. support NHS staff including midwives to provide responsive care.

The Review culminated in the publication of the Better Births report in February 2016,6 following which NHS England has established a wide-ranging Maternity Transformation Programme with nine distinct work streams to deliver on its recommendations. NHS England has also asked providers and commissioners of maternity services to come together to form Local Maternity Systems (LMSs), which will plan the design and delivery of future services for populations of 500 000–1 500 000 people. These LMSs—coterminous with the footprint of Sustainability and Transformation Plans and designed to be the maternity element thereof—are expected to have plans in place by the end of October 2017.8

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  • i A total of 77 262 babies were discharged from neonatal care in England in 2013 (Neonatal Data Analysis Unit, NDAU 2013 Report, Imperial College London, 2013). This equates to 11.6%, or one in nine, of the 664 517 live births in England in 2013 (Office for National Statistics, Birth Summary Tables, England and Wales, 2013).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.