Welcome and Thank you ?. to everyone who is here today and to all the individuals and organisations who have helped us develop the revised standards over the last two years.. Developing the revised standards. Separate CNST Maternity Clinical Risk Management Standards first introduced in 2003.Review
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1. CNST Maternity Standards launch seminar Professor Dame Joan Higgins
2. Welcome and Thank you … to everyone who is here today and to all the individuals and organisations who have helped us develop the revised standards over the last two years.
3. Developing the revised standards Separate CNST Maternity Clinical Risk Management Standards first introduced in 2003.
Review began in 2007/8 to ensure that they reflected the latest thinking and were fit for purpose.
4. Review process Analysis of NHSLA maternity claims
Review of current literature, guidance, best practice (from Royal Colleges and others)
Meetings with stakeholders, including patients
Focus groups for NHS staff: 230 delegates, representing 75% of all NHS Trusts
‘Keep or cull’ exercise of the risk areas in existing standards
5. Pilot assessments In 2008 volunteer maternity services were sought, to pilot the draft standards. 100 applied and 42 pilot assessments were eventually completed.
During the pilot process 1,500 comments or queries were received. Areas of most interest were: leadership, staffing, attendance at A and E, assisted vaginal delivery.
6. Main changes: The standards are more distinct and progressive. Level 3 requires maternity services to monitor effectiveness and make changes to reduce risk.
New risk areas introduced (e.g. obesity)
New standards are less prescriptive.
New standards are more clinically focused.
7. Why are the standards so important? Obviously of great significance to the health and well being of children and their families. 1 in 6,000 children is born brain damaged.
Important to provide clarity and support to staff.
Cost to families and to the NHS, when things go wrong. NHSLA receives around 350 maternity claims a year.
8. Total number of reported CNST claims by specialty as at 31/03/08
9. Total value of reported CNST claims by specialty as at 31/03/08
10. Cost of claims Since 1995, 61% of all negligence payments relate to claims arising out of birth.
Total cost of CNST maternity claims in 2007/8 was £163 million.
Cerebral palsy claims accounted for 66% of these payments (and stillbirths 2%).
11. Gross CNST maternity contributions per trust 2008/09
12. Maternity contributions 2009/10 Will rise to £8 million (gross) for the largest maternity units and an average of £3 million.
Level 1 = 10% discount, Level 2 = 20%, Level 3 = 30%. So, reaching Level 3 could save the larger units £2.4 million and the average unit £1 million.
13. Comparison of levels achieved in the CNST maternity standards
14. What happens next? Final version of revised standards published March 2009.
3 launch seminars March 2009.
Formal assessments, using revised standards, begin in September 2009.