Maternity Incentive Scheme

Latest updates

New Maternity (and Perinatal) Incentive Scheme guidance for year 6 published

On 2 March 2024, we sent Trusts a letter giving an MIS Year 6 Summary for Trusts 2 March 2024.

Full guidance for year 6 of the Maternity Incentive Scheme was published on 2 April. We have made some amendments to how the MIS document is presented this year to try and simplify the requirements and improve clarity. The MIS document will be published with an accompanying MIS Year 6 audit tool this year. It is not mandatory to use this tool, but we hope trusts will find it helpful. The tool has been developed for your internal use only and is not intended for submission to NHS Resolution. It will allow trusts to track progress with the actions and record when supporting evidence has been approved and where it is saved.

The new NHS Resolution FutureNHS MIS Workspace also went live on 2 April, which will provide access to shared resources and updates.

Results for Year 5 will be published in the results section below in April 2024. All Trusts will be notified individually and given an opportunity to submit an appeal prior to publication. All appeals should be submitted within the designated timeframe using the MIS-Appeal-template.

If contact details have changed for your nominated Maternity Incentive Scheme leads please let us know here.

What is the Maternity Incentive Scheme?

The Maternity Incentive Scheme (MIS) is a financial incentive program designed to enhance maternity safety within NHS Trusts. It rewards Trusts that can demonstrate they have implemented a set of core safety actions, ultimately aiming to improve the quality of care for women, families and newborns.

Maternity safety remains a critical area of focus within the NHS. The MIS was established on the instruction of the Department of Health and Social Care to incentivise Trusts to actively adopt best practices and implement essential safety measures. This not only reduces the risk of adverse outcomes, including brain injuries, but also fosters a culture of continuous improvement in maternity services.

The 10 safety actions

The ten safety actions for year six have been agreed and updated in partnership with the MIS Collaborative Advisory Group (CAG).

The CAG was established by NHS Resolution to bring together other arm’s length bodies and the Royal Colleges to support the delivery of the MIS and has also advised NHS Resolution on the refined safety actions.

Members of the group include:

NHS Resolution
Department of Health and Social Care (DHSC)
NHS England (NHSE)
Royal College of Obstetricians and Gynaecologists (RCOG)
Royal College of Midwives (RCM)
Neonatal Clinical Reference Group (CRG)
Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE)
Royal College of Anaesthetists (RCoA)
Care Quality Commission (CQC)
Maternity and Newborn Safety Investigations (MNSI) programme

The ten agreed groups of Safety Actions are:

1. Perinatal Mortality reporting and investigations.

2. Maternity Services Dataset reporting (digital).

3. Transitional Care and avoiding separation of families. Investigation of admissions to neonatal units.

4. Medical workforce (including obstetric, anaesthetic, and neonatal)

5. Midwifery workforce

6. Saving Babies’ Lives. Implementation of the NHS England care bundle.

7. Maternal and Neonatal Voices Partnership. Working with families and ensuring their voices are heard.

8. Training.

9. Board oversight and Safety Champions ensuring floor to Board communication.

10. Reporting all qualifying incidents to MNSI and the Early Notification Scheme for investigation

How the Maternity Incentive Scheme works

Participating Trusts contribute an additional 10% of their CNST maternity premium to a dedicated MIS fund.
The scheme outlines the ten key maternity safety actions as above, encompassing aspects like staff training, governance, staffing, and specific measures to prevent hypoxic ischemic encephalopathy (HIE), a major cause of brain injury in newborns.
Trusts that can demonstrate they have achieved all ten safety actions recover their contribution to the MIS fund and are eligible for a share of any unallocated funds.
Trusts that do not achieve all safety actions must develop an action plan for safety improvements and can apply for discretionary funding to support this. ICBs must ensure that any discretionary funding awarded is utilised to support the action plan.
The MIS is a self-certification scheme, with all scheme submissions requiring sign-off by
Trust Boards and ICBs following conversations with trust commissioners.
All submissions also undergo an external verification process and are sense-checked by the Care Quality Commission (CQC).

Evaluation

Since its launch, the Maternity Incentive Scheme (MIS) has undergone a comprehensive interim evaluation in 2020, alongside an annual survey distributed to NHS trusts to gather their ongoing perspectives on each year of the scheme.

To build upon the work of this previous evaluation, we initiated an extensive 18-month evaluation of the MIS in the late summer of 2023, aiming to examine the scheme’s internal processes and its broader impact on outcomes and stakeholders. This evaluation is crucial, and to ensure its robustness, we have embarked on an in-depth listening exercise, engaging with a wide array of clinicians from maternity units across England. This collaborative approach highlights the critical role of stakeholder feedback and experiences in refining the MIS and enhancing its contribution to maternity care improvements.

As our evaluation progresses through the end of 2024, the insights and participation of our stakeholders are pivotal. Their involvement not only enriches our understanding but also steers the MIS towards generating meaningful improvements in maternity care, emphasising the value of community engagement in our evaluation efforts.