Improving Maternity Services During a Global Pandemic by Elinore Macgillivray, Senior Improvement Manager

What an unexpected and difficult time 2020 has been for everyone, particularly if you have been pregnant or had a baby during the past nine months. I can’t imagine anyone – from the pregnant person, their family, support systems or those working in maternity services – ever thought that 2020 would bring about an almost complete change in the way pregnancy, childbirth and bringing home a new baby is experienced.

Since March 2020, the COVID19 pandemic has placed huge burden on the whole NHS and created a situation whereby maternity services have been under enormous pressure to adapt, digitise and innovate at an unprecedented pace. Given the time critical nature of maternity care, providers have faced an almost unique challenge of delivering a service where postponement or cancellation of care has simply not been an option. We have seen how incredibly hard our dedicated maternity colleagues have been working during this time to ensure not only that care remained safe, but also that the experience remained positive. Anyone following maternity user forums on social media will have seen the overwhelmingly positive way women have been speaking about their experiences of giving birth in Wales during the pandemic.

Amongst all of this change, the much anticipated Health Inspectorate Wales (HIW) National Review of Maternity Services Phase One was published on 19 November. When the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives Review of Maternity Services at Cwm Taf UHB was released in January 2019, the whole maternity service in Wales was asked to reflect on the quality, safety and experience of its service and more lately to consider and plan how it might meet the expectations set out in the Welsh Government Five Year Vision for Maternity Services (2019-2024). What they could not foresee at that time was that a global pandemic would have such a significant impact on the whole healthcare system and make working towards the recommendations particularly challenging. Despite that, due to the commitment of maternity teams, improvements have still been continuing, albeit in a different way. Whilst the response to the pandemic has been a huge challenge, it has also demonstrated that change is possible, can happen quickly and is within everyone’s gift.

Unfortunately, it has not been a positive experience for all and there will undoubtedly be lessons to be learned from the COVID19 response. As and when we move out of the pandemic, we need to take the time to reflect on the changes and consider how we leave behind the unwelcome restrictions and recognise and embed the positive, innovative practice. An important part of this will be working in partnership with women and their families to consider how they would like to see maternity services delivered in the ‘new normal’ world. The HIW report highlights many areas of good practice as well as acknowledging the hard work of the staff, but it also recommends a number of areas for improvement.  Improvement Cymru hope that the Spring will bring with it the opportunity to support our colleagues working in maternity services to use improvement methodologies to take those recommendations into action. By providing improvement support and training to the frontline staff, we can work together towards the vision to provide a high quality, safe and person-centred experience.

Improvement Cymru will be working with the Maternity and Neonatal Network Wales and Health Boards to understand and explore the recommendations in the report.  If you would like help thinking about how improvement methodologies can help and support maternity services, please contact