A new tool which is able to identify early in pregnancy a woman’s chance of preterm birth or of developing problems with the placenta that may lead to stillbirth will be tested across 26 NHS Trusts for 36 months. The University of Bristol-led trial, will test the Tommy's App, a Clinical Decision Support Tool and will involve around 39,000 women each year.
The Tommy's App, which is in development at the Tommy’s National Centre for Maternity Improvement, has been awarded £1.8 million through the National Institute for Health and Care Research (NIHR).
The tool will enable midwives and doctors to more accurately assess each woman’s needs during pregnancy and to personalise their care, using latest evidence and national clinical guidelines. This aims to reduce the variation in care across the NHS and ensure that each woman and pregnant person is offered the right care at the right time, no matter where they live.
It supports healthcare professionals to offer care recommendations in line with national clinical guidelines for best practice maternity care, to help lessen the chance of these complications developing.
The funding award will enable the team behind the tool’s development to trial its implementation at scale, investigating and overcoming any challenges ahead of potential NHS-wide adoption.
Earlier this year, the Centre published evidence demonstrating the algorithms used in the Clinical Decision Support Tool can help reduce health inequality in Black, Asian and other minority ethnic pregnant women. The Centre is developing the tool as part of a broader maternity improvement programme supporting Government targets to reduce the rates of preterm birth and stillbirth across the UK.
Co-designed with women, the tool is accessed using a web application so women and pregnant people can access their own care information with ease, encouraging engagement and supporting them to be heard if they have any questions or concerns. It also offers them access to pregnancy information and guidance from trusted sources, to support informed decision making.
The Tommy's National Centre for Maternity Improvement is jointly led by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM). The Clinical Decision Support Tool has been co-developed by a team of healthcare professionals from leading UK universities brought together by the Centre, including University of Bristol, King's College London, University of Sheffield, and St George's University of London, and charitable partners Mothers for Mothers and the PROMPT Maternity Foundation.
Professor Basky Thilaganathan, Clinical Director to the Tommy's National Centre for Maternity Improvement, said: "We believe that our Clinical Decision Support Tool can make a significant change in the delivery and experience of maternity care. We are thrilled to be able to expand our work with this funding, and further our learning to support our aim for NHS-wide adoption."
Andy Judge, Professor of Translational Statistics at the University of Bristol and co-principal investigator of the trial, said: "This trial is an important step forward in exploring safe and effective use of the tool, to inform making it widely available in the NHS."
Maria Viner, CEO of Mothers for Mothers and Patient and Public Involvement Lead at the Centre, said: "Through the safe implementation of such an easy-to-use tool, we could make a huge impact on the experience and outcomes for many women and pregnant people and their families, across the UK."
Dr Ranee Thakar, President of the RCOG, said: "Reducing stillbirth and preterm birth rates in the UK remains a priority. This exciting trial is a huge stepping stone towards offering more personalised care that can save babies' lives."
Gill Walton, Chief Executive of the RCM, said: "Midwives play a fundamental role in identifying those women at heightened risk during pregnancy, which is why the RCM is a very proud partner in the development of the Clinical Decision Support Tool. This investment will take us a step closer to rolling this out across the country."
Kath Abrahams, Chief Executive of the charity Tommy's, added: "Sadly in the past year we have seen the number of stillbirths in parts of the UK rise and inequalities in access to good care widen. By supporting healthcare professionals to offer the right care at the right time during pregnancy, we hope this important new technology will help meet our goal of making the UK the safest place to give birth."
The Centre welcomes expressions of interest from hospital trusts on potentially trialing the tool in the future. To discuss your interest please contact us at tommyscentre@rcog.org.uk
Further information
About the Tommy's App: A Clinical Decision Support Tool
The Tommy's National Centre for Maternity Improvement, a consortium of academics, practicing midwives and doctors, and women with lived experience, has co-designed and developed the Tommy's App: A Clinical Decision Support Tool. Bringing the latest evidence-based innovation to the NHS front line, this CE marked medical device, applies the use of clinically validated algorithms to routine antenatal care assessments to provide a more accurate assessment of each woman's chance of preterm birth (when your baby is born early) and of developing problems with the placenta (known as placental dysfunction) which can show as pre-eclampsia or prevent your baby from growing). Early identification enables care to be personalised according to individual needs, in order to lessen the chance of these outcomes. Since the Centre was established in 2019, the tool has been successfully implemented in four maternity units in England.
About the Tommyss National Centre for Maternity Improvement
The Tommy's National Centre for Maternity Improvement was established in September 2019 with funding from Tommy's charity, and is led jointly by the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG).
The Centre is built on collaboration, comprising a diverse team of women with lived experience, research, digital and practicing midwives, doctors and academics working across our collaborating academic and charitable partners: University of Bristol; University of Sheffield; St George’s University of London; King’s College London; and the Mothers for Mothers and PROMPT Maternity Foundation charities and our Women’s Advisory Group shaping our activity and outputs at every stage. For further information about the Centre please contact the Tommy’s National Centre for Maternity Improvement at tommyscentre@rcog.org.uk
About the Royal College of Obstetricians and Gynaecologists
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. To find out more visit www.rcog.org.uk
About the Royal College of Midwives
The Royal College of Midwives (RCM) is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit www.rcm.org.uk
About Tommy's
1 in 4 pregnancies end in loss during pregnancy or birth. Tommy’s believes that every baby lost is one too many.
Tommy’s is a national charity that works tirelessly to reduce the UK's unacceptable rates of miscarriage, stillbirth and premature birth. Tommy's funds pioneering medical research to discover the causes of baby loss and helps women and people who give birth at every stage of their pregnancy journeys, supporting them and their partners with expert information and care. Tommy's wants to make pregnancy safer for all and ensure that excellent maternity care is available for every family, every baby, everywhere. www.tommys.org
About the National Institute for Health and Care Research
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
- Funding high quality, timely research that benefits the NHS, public health and social care;
- Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
- Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
- Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
- Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
- Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
