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The Delivery Framework for Miscarriage Care in Scotland outlines a plan for introducing a graded model of miscarriage care. The Framework sets out 34 actions to help NHS Boards prioritise change locally and move to a ‘One Scotland’ approach.

Introduction

This document will use the term ‘women’/‘woman’ throughout. However, it is important to highlight that it is not only those who identify as women who require access to miscarriage care. For example, some transgender men, non-binary people, and intersex people or people with variations in sex characteristics may also experience miscarriage. Miscarriage services and the delivery of care must therefore be appropriate, inclusive and sensitive to individual needs. The term couple is used to describe two individuals of any sexuality or gender.

The Delivery Framework for Miscarriage Care in Scotland was developed by an Expert Short Life Working Group, along with a writing group, and outlines a plan for introducing a graded model of miscarriage care in Scotland. The groups brought together a wide range of expertise that informed discussions, including wide representation from third sector organisations. Annex A details the membership of the groups.

The Framework brings together professional guidance, including guidance from the National Institute for Clinical Excellence (NICE) and Royal College of Obstetricians and Gynaecologists (RCOG), with the recommendations in the Lancet series, Miscarriage Matters. Miscarriage care in Scotland is generally considered to be of high quality and NHS Boards have been further improving miscarriage care as a result of the drivers set out in the above-mentioned guidance and recommendations, and both of the published Scottish Government, Programme for Government commitments on improving miscarriage care.

The group considers that 15 months is a reasonable timeframe for NHS Boards to implement the majority of the key actions/deliverables in this document but recognises that a few of the actions/deliverables listed as ‘medium’ status priority may take longer to put in place in a few areas.

The group suggests the following prioritisation categories of the actions/deliverables. However, it is recognised that miscarriage services in Scotland are at different stages of delivery against the actions/deliverables in the Framework, as many have been following good practice and implementing professional guidance, including offering progesterone treatment where appropriate, for some time. The actions/deliverables have been given the following status:

• N – priority now and implemented within 6 months
• S – should be implemented in the short term within 12 – 15 months
• M – should be implemented in the medium term within 15 – 24 months

The status given to each action will help NHS Boards prioritise change locally and move to a ‘One Scotland’ approach.

Review and Monitoring Progress

NHS Boards will be asked by Scottish Government to assess what their service is delivering now, and report on their progress towards implementing the key actions/deliverables. Annual and Local Delivery Plan guidance for NHS Boards from 2025-26 highlights improving miscarriage care and implementing this Framework as a specific planning priority. NHS Boards will therefore be expected to report to the Scottish Government on progress towards implementation.

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