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Local Maternity and Neonatal System

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LMNS Guidelines 

The LMNS Guidelines Group is developing a suite of guidelines/guidance to be used by colleagues at Hull University Teaching Hospitals NHS Trust, York & Scarborough Teaching Hospitals NHS Foundation Trust and Northern Lincolnshire and Goole NHS Foundation Trust. 

Guideline/Guidance Publication Date 
Conflict of Clinical Opinion 17 October 2022 - updated 17 November 2022
Latent Phase of Labour 23 September 2021

Prevention and prediction of preterm birth and optimising perinatal care of the preterm infant

May 2024 

PMRT Guidance 

13 September 2021

PReCePT Guideline - Magnesium Sulphate Protocol

19 June 2023 

Frenotomy (Division of Tongue Tie) 

02 December 2020

It has been agreed that all HNY Trusts will use/refer to the Royal College of Obstetricians and Gynaecologists information on Group B Streptococcus (GBS) in pregnancy and newborn babies which can be found here . 

Perinatal Optimisation - LMNS Baby Passport 

In line with Version 3 of the SBLCB a Perinatal Optimisation Baby Passport has been developed for babies under 34 weeks gestation, based on the clinical and baby passports produced by PERIPrem (Health Innovation South West and West of England regions).

This document can be given to women either when they are identified as at risk of preterm birth or presenting with signs of preterm labour. It acts as a source of parent information and data collection for perinatal optimisation interventions. If born before 34 weeks the passport should accompany the baby to the Neonatal Unit.

A printable version of the passport can be downloaded here.

Passports in different languages can be downloaded by clicking on the languages below: 

A trans-friendly version of the passport can be downloaded here.

PERIPrem Maternal Early Breast Milk Patient Leaflet

This leaflet can be given to every parent of a preterm baby. It is designed to help inform and fully involve parents in the care of their preterm baby by outlining in detail the benefits of maternal early breastmilk. 

You can download the English version of the breast milk leaflet here

The leaflet in different languages can be downloaded by clicking on the languages below: 

LMNS Implementation Guidance on Roles and Responsibilities of the Preterm Birth (PTB) Lead Team 

The purpose of this document is to support Trusts to implement an effective PTB lead team. It provides guidance on the responsibilities of the PTB leads to ensure standardisation of the roles in line with national recommendations and ensure teams have the capacity to effectively fulfil their function.

The guidance can be downloaded here

LMNS Safety Alerts 

Safety Alert  Publication Date 
Herpes Simplex Virus 3 September 2021

Links to key national and regional safety documents/websites

Ockenden Maternity Review 

Published on 10th December 2020 the Ockenden Maternity Review details the failures at Shrewsbury and Telford hospitals (SaTH) that led to the deaths and harming of mothers and babies from 2000-2019. These included a reluctance to conduct caesarean sections; a tendency to blame mothers for problems; a failure to handle complex cases; a lack of consultant oversight, and a lack of kindness and compassion. The review details a series of immediate actions and “must do” recommendations for all hospital trusts to improve maternity safety “at pace”. These include formal risk assessment at every antenatal contact, twice-daily consultant-led maternity ward rounds, women and family advocates on the board of every NHS trust, and the appointment of dedicated lead midwives and obstetricians.

Published on 30th March 2022 the final report of the Ockenden Review details the findings, conclusions and essential actions from the independent review of maternity services at the SaTH. Based on a review of all family cases that formed part of this investigation, the final report outlines system-wide learnings; and immediate and essential actions to improve maternity care.

Maternity and neonatal services in East Kent: 'Reading the signals' report

On 13 February 2020 the Minister of State, DHSC, confirmed in Parliament that, following concerns raised about the quality and outcomes of maternity and neonatal care, NHS England and NHS Improvement (NHSEI) had commissioned Dr Bill Kirkup CBE to undertake an independent investigation into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust. 

The primary reason for this report is to set out the truth of what happened, so that maternity services in East Kent can begin to meet the standards expected nationally, for the sake of those to come. This report identifies 4 areas for action. The NHS could be much better at:

  • identifying poorly performing units
  • giving care with compassion and kindness
  • teamworking with a common purpose
  • responding to challenge with honesty

The full report can be accessed here . 

Maternity Incentive Scheme - Year 5 (published on 31 May 2023)

NHS Resolution is an arm’s-length body of the Department of Health and Social Care. It provides expertise to the NHS on resolving concerns and disputes fairly, sharing learning for improvement and preserving resources for patient care.

NHS Resolution is operating a fifth year of the Clinical Negligence Scheme for Trusts (CNST) Maternity Incentive Scheme (MIS)  to continue to support the delivery of safer maternity care. 

The MIS supports the delivery of safer maternity care through an incentive element to Trust contributions to the CNST. MIS, developed in partnership with the national maternity safety champions, Dr Matthew Jolly and Professor Jacqueline Dunkley-Bent OBE, rewards Trusts that meet 10 safety actions designed to improve the delivery of best practice in maternity and neonatal services.

Saving Babies' Lives Care Bundle Version Three (SBLCBv3) (published on 31 May 2023)

SBLCBv3 has been produced to help reduce perinatal mortality across England. It provides detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. The third version of the care bundle brings together six elements of care that are widely recognised as evidence-based and/or best practice, these are:

  • Reducing smoking in pregnancy
  • Risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction (FGR)
  • Raising awareness of reduced fetal movement (RFM)
  • Effective fetal monitoring during labour
  • Reducing preterm birth
  • Management of pre-existing diabetes in pregnancy.

Healthcare Safety Investigation Branch (HSIB)

HSIB conduct independent investigations of patient safety concerns in NHS-funded care across England. The safety recommendations it makes aim to improve healthcare systems and processes in order to reduce risk and improve safety. The maternity investigation programme is part of a national action plan to make maternity care safer. HSIB undertakes approximately 1,000 independent maternity safety investigations to identify common themes and influence systemic change.

Maternity and Neonatal Safety Improvement Programme

The Maternity and Neonatal Safety Improvement Programme (formerly known as the Maternal and Neonatal Health Safety Collaborative) supports improvement in the quality and safety of maternity and neonatal units across England.

MBRRACE-UK Reports

MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) is being led from the National Perinatal Epidemiology Unit (NPEU) at the University of Oxford by Prof Jenny Kurinczuk and will build on existing research programmes, including the UK Obstetric Surveillance System (UKOSS ) led by Prof Marian Knight at the NPEU, and The Infant Mortality and Morbidity Studies (TIMMS ) led by Profs Elizabeth Draper and David Field at the University of Leicester.

MBBRACE-UK reports can be accessed here .

Nursing and Midwifery Council (NMC)

The NMC is the professional regulator for nurses and midwives in the UK, and nursing associates in England and it:

  1. Maintains the register of nurses and midwives who meet the requirements for registration in the UK, and nursing associates who meet the requirements for registration in England.
  2. Sets the requirements of the professional education that supports people to develop the knowledge, skills and behaviours required for entry to, or annotation on, the register.
  3. Shapes the practice of the professionals on the register by developing and promoting standards including its Code, and promotes lifelong learning through revalidation.
  4. Investigates and takes action, if needed, where serious concerns are raised about a nurse, midwife or nursing associate’s fitness to practise.
2019-07-03 (7)

Your baby is now officially an embryo and is about the size of a poppy seed.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/4-weeks-pregnant/ for more information.

2019-07-03 (4)

Your baby is now the size of a kidney bean and weighs 1g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/8-weeks-pregnant/ for more information.

2019-07-03 (6)

Welcome to the second trimester!

Your baby is about the size of a small lime and weighs approximately 14g.

You have hopefully seen your midwife for your 'booking in' appointment, if you have not yet seen a midwife please make an appointment quickly, so you can have all of your choices about screening tests explained and offered to you.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/12-weeks-pregnant/ for more information. You can also link to the 'Pregnancy Journey' area here.  

2019-07-03

Your baby is about the size of an avocado and weighs approximately 100g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/16-weeks-pregnant/ for more information.

2019-07-03 (2)

Your baby has grown in length and is now the length of a small banana and weighs approximately 300g. Around this time you will be offered your '20 week' scan, also known as the 'anatomy' or 'anomaly' scan.Click here for more information about screening. 

This is a also a good time to talk and sing to your bump as your baby can now hear sounds. This is great way for you and your partner/family to bond with your baby.

Please visit www.nhs.uk/conditions/pregnancy-and-baby/20-weeks-pregnant/ for more information.

2019-07-03 (8)

Your baby has grown again to the approximate length of an ear of sweetcorn and weighs about 600g. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/24-weeks-pregnant/ for more information.

2019-07-03 (1)

Welcome to the third trimester!

Your baby is now approximately the weight of an aubergine; about 1kg and approximately 37cm in length. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/28-weeks-pregnant/ for more information.

2019-07-03 (3)

Your baby now weighs approximately the same as a coconut; around 1.5kg. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/32-weeks-pregnant/ for more information.

2019-07-03 (5)

Your baby is now around the same size as a lettuce, approximately 47cm long and weighs around 2.6kg. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/36-weeks-pregnant/ for more information.

2019-07-03 (9)

Your baby is now the weight of a small watermelon which is approximately 3.3kg and around 50cm in length. 

Please visit www.nhs.uk/conditions/pregnancy-and-baby/40-weeks-pregnant/ for more information.