Maternity and Neonatal Equity and Equality Action Plan

This page sets out how Bristol, North Somerset and South Gloucestershire ICB will continue to work towards achieving Maternity Services equity and equality outcomes for our women and their families, for the population of Bristol, North Somerset and South Gloucestershire.

This will be achieved through working closely with our acute maternity service providers – North Bristol Trust (NBT) and University Hospitals Bristol and Weston (UBHW) within local hospital and community settings.

Our improvements will be based on service user and population data, and working towards achieving specific equitable maternity outcomes where inequality is evident.

Happy mother carrying and kissing on newborn baby on their head.

What is the difference between equity and equality?

Although equity and equality are often used interchangeably, they are very different.

Equality means that everybody has the same resources and opportunities, regardless of their circumstance. Equality is a statement.

Equity is recognising that individuals and their backgrounds have strengths and limitations, meaning that some will require more support than others to ensure equity. Our plans will focus on equity in order to achieve equality.

What is an outcome?

Outcomes are the result of care which individuals receive. For example, a preterm baby in good health returning home is what we always strive for.

Priorities – How we will support you

1. Improve data collection

Develop and launch a Maternity Services data dashboard to identify, evidence and monitor the required improvements for you and your family.

Progress report

  • The dashboard has been developed, and the first version is scheduled for release in Autumn 2025.
  • Clinicians will be consulted to ensure the dashboard data is checked for accuracy.

2. A fair start for pre-term newborns

Improve maternity intervention uptake to support the healthy development of pre-term newborns where they are within ethnicities presenting with inequity; in line with the NHS Race and Health Observatory.

Progress report

  • Past and current data have been reviewed to identify areas for improvement.
  • Black women who experienced preterm birth have shared their experiences through trauma-informed interviews.
  • Insights from the data and interviews are being used to test and improve care processes.

3. Healthy lifestyle

If you are currently a smoker or have a higher BMI, we will support you in changing your smoking status and reducing your body weight for both your health and the health of your future child.

Progress report

Smoking

  • A team is in place to help pregnant women stop smoking with support, including vapes and nicotine replacement therapy.
  • University Hospitals Bristol and Weston to provide better ongoing support in the community to help people quit smoking.
  • Carbon monoxide checks now happen at every appointment.
  • More women are using the service, and new guidelines are being reviewed.

Healthy Weight

  • Healthy Eating Network available for those within North Somerset with a raised BMI.
  • Trusts participating in a pilot to promote exercise in pregnancy. Two midwives and two health visitors will be trained as ambassadors.
  • Exercise classes will be provided for free or at low cost in areas with high deprivation and diverse communities.

4. Maternity and Neonatal Voices Recruitment

Drive recruitment of maternity service users in the public to Maternity Neonatal Voice Partnership (MNVP) roles, proportional to the service user ethnic representation to ensure all voices are included in the improvement of our maternity services.

Progress report

  • The full Maternity and Neonatal Voices Partnership team(will this link to their page?) is now in place, including leads for strategy, community, hospital engagement, and neonatal care.
  • A pilot between BNSSG & Somerset is trialling a neonatal-specific representative to ensure neonatal voices are better included in the Maternity and Neonatal Voices Partnership.

5. Data-driven equity

Using our maternity data as evidence, work toward equity of outcomes for you and your babies, by identifying differences in outcomes, then investigating possible causes, and developing solutions that restore health equity.

Progress report

  • Local hospitals are working to understand how ethnicity, deprivation, language barriers, and citizenship impact health outcomes.
  • Consideration of ethnicity is being made when reviewing unexpected admissions of term babies to the Neonatal Intensive Care Unit.

6. Accessible maternity care

Drive equitable access to maternity services for all women and their babies, ensuring no matter your background you will have the care you need to give you and your baby the best possible outcomes. Within this, we want to focus on perinatal pelvic health and postpartum contraception.

Progress report

  • Midwives are working with local community groups to help women access care earlier, especially refugees and Black mothers.
  • Women in prison now receive full pregnancy care inside the prison.
  • New materials like translated leaflets, prayer-time signs, and culturally appropriate hospital gowns are now available.
  • Addressing digital exclusion by providing free SIM cards to women who cannot afford them, allowing access to digital healthcare records.
  • People with learning disabilities to have better access to perinatal pelvic health care.

7. Maternity staff training

Drive training of all our maternity and neonatal staff, to continuously improve the delivery of equitable care, by enabling them to notice service areas that could be increasing inequity, which may be due to ethnic differences. An example of this is working delivering the Black Maternity Matters training.

Progress report

  • Over 300 staff have received anti-racism training through the Black Maternity Matters programme.
  • Both trusts to incorporate culture competency training into their mandatory training.

8. Inclusive recruitment

We will check our recruitment practices within our services, to identify cultures less proportionally present in our workforce, creating an action plan to work closer with those communities to ensure they do not face barriers to important employment within our services.

Progress report

  • Programmes are in place to support career development for staff from diverse backgrounds.
  • Schools and colleges in low socio-economic areas are being supported to encourage more students to consider midwifery.
  • Interviews for student midwives now include local service users to make recruitment more inclusive.