Safety of maternity services
This indicator is a rate. Risk adjustment is not necessary at a national level.
In 2010, 135 trusts submitted data for a full calendar year, compared to 159 in 2011 and 161 in 2012. There are neonatal units submitting data for babies who receive neonatal care within a neonatal unit of an NHS trust and units submitting data for babies who receive neonatal care within the neonatal unit and outside the neonatal unit (but still within the same NHS trust). Users are asked to consider these data quality issues when making comparisons between years.
There is approximately a two-year time lag for this indicator, with data for a calendar year typically published in November two years later. This is because the Office for National Statistics (ONS) uses a specially linked dataset known as the NHS Numbers for Babies (NN4B). This links birth notifications to birth registrations and subsequent infant deaths. This is necessary because certain variables, such as gestation (required to identify full-term births) are only available on birth notifications, not registrations. ONS requires Section 251 permission from the Care Quality Commission to access birth notifications data. Permission to access birth notifications data was granted to study infant mortality, specifically for the output Gestation-specific Infant Mortality in England and Wales. ONS cannot send out the births data until after the Gestation-specific Infant Mortality bulletin has been published. This complex situation, over which HSCIC has no control, is responsible for the long time lag.
There is a possibility an infant (especially a term infant) will be admitted to a paediatric ward rather than a neonatal unit and may only receive care there, thus never entering the National Neonatal Research Database. Some neo-natal admissions may not be avoidable or as the result of inappropriate care provided by the NHS. Only neonatal admissions that could be linked to a Primary Care Trust (PCT) are included in the numerator. This is for historical reasons and will be reviewed before 2013 data is released.
For more information see: Indicator Quality Statement: NHS Outcomes Framework 5.5 -Admission of full-term babies to neonatal care.