NICE has identified 12 key priority areas in a new quality standard on antenatal care.

New guidelines include women being cared for by a named midwife throughout their pregnancy and offered foetal anomaly screening in accordance with current UK programmes.

Jane Munro, Quality and Audit Development Advisor at the Royal College of Midwives, said the standard “will contribute to safer and healthier pregnancies for women”.

The quality standard represents the first component NICE is creating in a series of maternity quality standards which will eventually form the care pathway.

The key priority areas have been identified in aspects of high-quality, cost-effective care which NICE says will improve the “effectiveness, safety and experience of care for pregnant women”.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, said the quality standard “firmly places women at the centre of decision making about their care, ensuring they are provided with up to date information to enable them to make informed decisions in partnership with healthcare professionals about their care and treatment.”

The quality standard on antenatal care includes:

• Pregnant women are supported to access antenatal care, ideally by 10 weeks.
• Pregnant women are cared for by a named midwife throughout their pregnancy.
• Pregnant women have a complete record of the minimum set of antenatal test results in their hand-held maternity notes.
• Pregnant women with a body mass index of 30 kg/m2 or more at the booking appointment are offered personalised advice from an appropriately trained person on healthy eating and physical activity.
• Pregnant women who smoke are referred to an evidence-based stop smoking service at the booking appointment.
• Pregnant women are offered testing for gestational diabetes if they are identified as at risk of gestational diabetes at the booking appointment.
• Pregnant women at high risk of pre-eclampsia at the booking appointment are offered a prescription of 75 mg of aspirin to take daily from 12 weeks until at least 36 weeks.
• Pregnant women at intermediate risk of venous thromboembolism at the booking appointment have specialist advice provided about their care.
• Pregnant women at high risk of venous thromboembolism at the booking appointment are referred to a specialist service.
• Pregnant women are offered foetal anomaly screening in accordance with current UK National Screening Committee programmes.
• Pregnant women with an uncomplicated singleton breech presentation at 36 weeks or later (until labour begins) are offered external cephalic version.
• Nulliparous pregnant women are offered a vaginal examination for membrane sweeping at their 40- and 41-week antenatal appointments, and parous pregnant women are offered this at their 41-week appointment.

More than 44 new indicators have been proposed in the first Commissioning Outcomes Framework (COF) by NICE.

The proposed indicators include care for stroke patients, plus ones for COPD, maternal care and access to mental health services.

The ‘menu’ of indicators covers the five domains outlined in the NHS Outcomes Framework.

Professor Danny Keenan, COF Advisory Committee Chair, said he hoped the “robust” set of indicators would “lead to improved health outcomes”.

From April next year, the COF will be used to hold CCGs to account for improvement in quality of local healthcare and patient outcomes through the services they commission.

The indicators have been developed using the Outcomes Framework, NICE Quality Standards and existing indicator collections, such as national audits.

A further menu of indicators will now be developed using NICE’s quality standards to ensure that all topics are covered.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, said the indicators will “support high quality commissioning”.

“Each indicator has been through public consultation and feasibility testing (conducted by the Health and Social Care Information Centre), so commissioners can be reassured that they will work in practice,” she said.

The final selection of indicators that will be included within the 2013/14 COF will be decided by the NHS Commissioning Board later this year.