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A national ask was received in September 2021 for all LMS' s across England to submit an Equity and Equality Gap Analysis by 30th November 2021 .These were the asks:
- Understand the local population needs
- Map the community assets
- Conduct a baseline assessment of the experience of maternity and neonatal staff by ethnicity
- Set out a plan to co-produce interventions to improve equity for mothers ,babies and race equality for staff
EXECUTIVE SUMMARY
GMEC demographics:17% of the GMEC population are from Black, Asian, or Minority Ethnic backgrounds, with a higher than national average of young women of childbearing age living in Manchester. 33% of pregnant women are from Black, Asian, or Minority Ethnic backgrounds.
• GMEC has high levels of social deprivation, with more than a third of pregnant women and people living in the 10% most deprived Local Super Output Areas (LSOA). Over 25% children (0-15 years) live in poverty, compared to the England average of 15.6%.
• GMEC data highlights that overall, there is a significant and growing pregnant population from ethnic minority backgrounds, particularly in Bolton, Manchester, Oldham and Rochdale.
• More than 40% of women did not book before 10 weeks of pregnancy in 2019. It is unclear whether this is due to access, language barriers, culture or other health inequality/inequity reasons. Further work is required to ensure access is equitable for all ethnic minority communities.
• Manchester has higher than the national average number of asylum seekers/refugees who face unique health challenges and additional support to overcome the barriers they face when attempting to access care. Many of these are pregnant and with children who require additional perinatal support.
• Data highlights the high levels of obesity above the national average which is linked to increased interventions and poorer perinatal health outcomes.
Completing this analysis has highlighted pockets of good work undertaken at local maternity service level, linked to postcode or geography as bespoke pieces of work. However, there are many more gaps in data related to maternity outcomes broken down by ethnicity and indices of deprivation across GMEC as a whole. The ability to harness this valuable information would allow areas of concern to become the focus of health and social care initiatives.
Community Assets: A huge range of community assets exist - but not all professionals or women. people and their families are aware of what is available.
• Some geographical areas in GMEC have more assets than others.
• There is no central portal for community assets for clinicians and families to sign post / access.
• We acknowledge that there are likely to be further assets not yet captured.
• Staff experience: The experiences of Midwives from minority ethnic groups have been disproportionately worse when compared to their White counterparts across all the WRES indicators.
• We have no greater understanding of the wider Maternity workforce experience including obstetric, neonatal and MSW staff.
• Some WRES Indicators have little data and need further exploration locally.
• Co-production: There are many organisations working on projects to improve health inequalities across GMEC.
• The ask of MVP's and VSCE is increasing markedly with a clear need to increase the capacity and funding to improve the pace for progression
of work.
• The staff experience findings indicate significant need for improvement for BAME midwives which can be achieved through planned co-design work.
Maternity services cannot single-handedly address all the issues highlighted in this analysis.
The GM Health and Care Partnership will work to tackle the inter dependencies of deprivation and ethnicity to improve health outcomes in their entirety.
GMEC LMS, including, valuable support from HIM, set a task and finish group to complete this enormous task in the short time span required and are now need to undertake an action plan for submission by 28th February 2022.A big thank you is extended to everyone involved for their continued help and very valuable contributions.
Chantal Knight GMEC Maternity Safety Lead
Saving Babies Live Care Bundle(2)
Maternity providers continue to embed the SBL Care bundle. Current work includes standardised definitions and methods of collation of common metrics across the LMS and adjustments to key guidelines including Fetal Growth Restriction, Preterm birth and Reduced Fetal movements.
Dr Samiksha Patel, Obstetrician at St Mary’s Oxford Rd, has been appointed as SBL lead for fetal monitoring. Planned work will include updating the fetal monitoring standards and teaching package, visiting each provider unit to discuss training, and establishing a fetal monitoring forum held 2 or 3 times a year for clinicians to attend, share learning and discuss common issues.
Eileen Stringer
Clinical Lead Midwife
Greater Manchester & Eastern Cheshire Strategic Clinical Networks
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