New Maternity Triage guidance from Royal College of Obstetricians and Gynaecologists: A step forward in patient care

What does it mean?

Published in December 2023, the guidance recommends all maternity units implement the Birmingham Symptom-Specific Obstetric Triage System. The system is designed to ensure all pregnant or newly post-natal individuals are offered standardised initial assessments and symptom specific algorithms to identify who needs more urgent attention in busy clinical settings. This assessment should take place within 15 minutes of arrival.

The guidance also advises that all pregnant individuals are provided with information regarding how and when to call or attend maternity triages units. 

It arises from a 2021 petition to the government to undertake a nationwide review of NHS maternity wards. 

Why is this new guidance important?

As a medical negligence solicitor, I've supported a number of families who have sadly lost children as a result of failings in maternity triage care. 

Pregnancy can be both an exciting and worrying time. I've supported parents whose pregnancies had been progressing smoothly until they then became concerned by a new symptom and presented to maternity triage units which then failed to acknowledge or investigate a symptom, sadly resulting in injury to their baby. 

NHS maternity units are busy clinical settings, as this new guidance acknowledges, however it's important that any person presenting unplanned with a concern needs a detailed assessment to avoid harm.

As an example, the initial signs of pre-eclampsia can present as relatively minor symptoms to begin with such as pain in the ribs, minor swelling in hands and feet and headaches. These are all symptoms that unfortunately can easily be dismissed as nothing of concern without proper consideration. 

Pre-eclampsia is a serious condition for both mother and baby, as a women’s blood pressure can become very high and those initial symptoms that can easily be dismissed become much more severe. If pre-eclampsia is not identified and a treatment plan put it in place quickly, it can result in significant injury to both mother and baby and, in the most severe cases, it can progress to eclampsia which can be life-threatening. 

Conclusion

I'm hopeful the new guidance is a positive step forward in ensuring prompt and detailed assessment of those who are pregnant and newly post-natal, leading to a reduction in avoidable harm to parents and children.

The vice president of RCOG has acknowledged that implanting these recommendations may require significant system level change and investment.  In my view, that investment is crucial to ensure improvement in UK maternity services, many of which are currently rated as inadequate by the Care Quality Commission.

Find out more about Irwin Mitchell's expertise in supporting families affected by issues in maternity care at our dedicated birth injuries section.