Outstanding maternity care is possible, even in challenging contexts
The Thinking Differently webinar “Maternity Services in Crisis: Designing Better Beginnings” opened with a question from chair Naeem Younis, Founder and CEO of Strasys: “Think about the last birth story you heard. Was it a story of safety and joy, or one of fear and uncertainty?” Maternity services across England are under real pressure. No unit inspected by the CQC was rated outstanding for safety. The Strasys Maternity Index exists because this data gap is unacceptable.
Kate Shields
Former CEO, Royal Cornwall Hospitals Trust
A journey to being brilliant
Kate Shields, former Chief Executive of Royal Cornwall Hospitals Trust, described how after a 2017 CQC crisis their leadership team engaged staff, especially midwives, to define what great care meant. They set a shared ambition to become “brilliant.” A pivotal moment came when two women confronted the team about poor experiences, prompting the creation of the Maternity Voices Partnership. By 2019, maternity services were rated Good by the CQC, maintained in 2023 despite national pressures. Kate was clear: kind and compassionate leadership does not have to be soft. When paired with psychological safety, it allows people to voice difficulties and address systemic issues.
Dr Andy Heeps
Interim CEO, University Hospitals Sussex NHS Foundation Trust
Data underpins all improvement work
Dr Andy Heeps, Interim Chief Executive of University Hospitals Sussex NHS Foundation Trust and consultant obstetrician, described services across four acute sites each delivering around 2,000 to 2,500 babies yearly. The trust is one of 12 in Baroness Amos’s National Maternity and Neonatal Investigation. Since April 2023, UHSussex has noted reduced stillbirth and perinatal mortality rates. Live data and SPC charts now help identify variation, special-cause concerns, and underlying drivers. Centralised telephone triage reduced triage incidents from 13 cases to zero, and births before arrival fell by 40%. Midwifery vacancy rates, previously 20%, are now fully established. The Strasys Maternity Index provides exactly this kind of trust-level visibility.
Mark Jennings
Chief Solutions and Services Officer, Strasys
Why NHS leaders cannot name the ten highest-risk maternity units
Mark Jennings, Chief Solutions and Services Officer at Strasys, described Decision Intelligence as simply using data appropriately to make better decisions. “NHS leaders cannot objectively name the ten highest-risk maternity units in the country because such data is not available.” Strasys has created the Strasys Maternity Index (SMI) to help trusts understand month by month how they are performing relative to others, processed through over 140,000 lines of code, offering 3 cumulative scores, 5 themes, and 84 individual data item rankings per trust. Trial access is available for NHS organisations.
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CQC-inspected maternity units rated outstanding for safety
40%
reduction in births before arrival after centralised triage
2x+
higher mortality risk for Black women in pregnancy
Key takeaways
Are we providing a fantastic service? Are people telling us their experience is fantastic? And does anyone want to work with us? Three questions every board should be able to answer about their maternity services.
If your board cannot objectively assess where your maternity services stand relative to every other trust in the country, a short conversation can clarify how the Strasys Maternity Index could give you that visibility and help you target improvement where it matters most. No pitch. Just a practical starting point.
Further reading: The Strasys Maternity Index. SMI data and methodology.
Questions leaders ask about maternity safety
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No maternity unit inspected by the CQC was rated outstanding for safety. Black women face more than twice the mortality risk. National data exists but arrives 50 days in arrears with variable quality. The gap between data collection and actionable intelligence means risks accumulate before boards can respond. The Strasys Maternity Index was built to close this gap.
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The SMI uses 58 measures from national maternity data to track and understand maternity risk across NHS Trusts. It combines current performance, 12-month trend, and birth volume into a single score showing which trusts present the greatest risk to patient safety. Every month, a clear narrative pulls out the most significant factors with suggested actions.
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Prof Sir Muir Gray identifies four types: waste left after a job has been done; waste due to low productivity; waste when interventions fail to achieve outcomes that matter; and waste due to opportunity costs where resources would produce more value elsewhere.
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Kate Shields described it clearly: kind and compassionate leadership does not have to be soft. Psychological safety, paired with clear expectations, allows people to voice difficulties and address systemic issues. Leaders should be decisive, define what good looks like, and engage widely. Board oversight must close gaps between service and board governance. The Strasys Academy helps leadership teams build this capability.