National Institute for Health and Clinical Excellence (NICE)
More than one thousand neonatal admissions could be avoided per year by following NICE guidance
Regularly monitoring women who are pregnant with twins or triplets, to spot any possible complications, can lead to better outcomes for mothers and their babies, as highlighted in NICE’s impact report.
The impact report focuses on how NICE’s evidence-based guidance contributes to improvements in maternity and neonatal care. Neonatal care refers to the care a baby born premature or sick receives in a neonatal unit.
From 2016 to 2019, the Twins and Multiple Births Association (TAMBA) ran a project to increase the use of NICE guidance on twin and triplet pregnancies in maternity units across England. In the maternity units that made improvements;
- 65% reduced neonatal admissions and,
- 60% reduced the emergency caesarean section rate.
If all maternity units applied NICE’s recommendations on twin and triplet pregnancies, such as labelling the fetuses during scans so they can be told apart and monitored closely for complications, it could lead to 634 fewer emergency caesarean sections and 1,308 fewer neonatal admissions in England, per year. This could mean preventing around one in ten neonatal admissions of babies from multiple births in the UK each year.
Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, yesterday said:
“Most women having twins or triplets have a healthy pregnancy. However, there is a higher chance of complications for both the mother and babies that means women need to be monitored more closely during pregnancy, labour and birth.”
NICE guidance recommends that neonatal transfer services are available to provide babies with safe and efficient transfers to and from specialist neonatal care services. This is important as unwell new-borns may have difficulty with breathing or keeping warm and require support as they are transferred. Over the past 3 years more babies have had a normal core body temperature after transfer to or from specialist care; 91.7% in 2015, 93% in 2016 and 94.4% in 2017.
In 2010, NICE made recommendations on how to identify women who are pregnant and smoke and how to help them quit. Over the last 3 years, the proportion of mothers who smoke at time of delivery has remained steady; 11.7% in 2015/16, 10.5% in 2016/17 and 10.8% in 2017/18.
Professor Leng added:
“It’s extremely encouraging to see the improvements maternity units have made by following NICE guidance, however there is still more work to be done in areas such as helping women, who are pregnant, to stop smoking. These improvements will have multiple benefits for mothers and babies and will help meet the NHS Long Term Plan to halve the number of still births and neonatal and maternal deaths by 2025.”
In 2014, NICE recommended that women should be asked about their emotional wellbeing at antenatal appointments. Since then the proportion of midwives asking has steadily increased from 87% in 2015, 90% in 2017, to 92% in 2018.
The report also highlights that there is more work to be done in reducing valproate prescriptions, a medication for treating epilepsy and bipolar disorder which can have harmful effects on unborn babies. In 2018 NICE guidance was updated to state that women capable of becoming pregnant should not be prescribed valproate. There may be exceptions if other treatments are not suitable but only if the terms of a pregnancy prevention programme are followed. Between January to March 2019, the proportion of female patients aged 14- 45 receiving these prescriptions ranged from 6% to 13% across the country. This suggests there is wide variation and a continuing need to promote the current advice.
Latest News from
National Institute for Health and Clinical Excellence (NICE)
Digital and mobile interventions could support regular health services in helping people stop smoking and reduce their risk of obesity, says NICE24/01/2020 11:15:00
Health professionals can consider digital and mobile interventions as a supplement to regular services to support behaviour change in people at risk of developing chronic conditions.
Care matters – Working together to get support right for adult carers23/01/2020 11:15:00
Dame Philippa Russell, Vice-President of Carers UK and Topic Adviser for the NICE guideline on Supporting Adult Carers.
NICE encourages further data collection on ‘game changing’ histology independent cancer drugs17/01/2020 14:10:00
Larotrectinib (also called Vitrakvi and made by Bayer), a new treatment for a range of cancers, can’t be recommended for use in the NHS because at its current price, it doesn’t have the potential to be cost-effective.
Make use of community pharmacists’ skills, says NICE17/01/2020 13:05:00
Community pharmacy teams have the potential to play a greater role in health promotion and prevention says NICE, in a new draft quality standard.
Breast cancer patients to have further NICE-approved drug combination option on Cancer Drugs Fund17/01/2020 11:15:00
Another potentially life-extending drug combination for some people with advanced breast cancer will now be available on the Cancer Drugs Fund (CDF) following its approval by NICE in final guidance published recently (15 January 2020).
Implantable cardiac monitors detect atrial fibrillation after stroke of unknown cause recommended for routine NHS adoption15/01/2020 11:15:00
Doctors can check on their patients remotely using Reveal LINQ monitor.
Shared Learning Awards 2020 now accepting entries07/01/2020 14:15:00
Submit your shared learning entry by 4 March 2020 for a chance to be one of our 20 finalists at this year’s NICE Conference.
Additional evidence needed to assess histology-independent cancer drugs says paper co-authored by NICE staff03/01/2020 10:15:00
Paper looks at how histology-independent cancer drugs might be appraised.
Use of out-of-area rehabilitation placements for adults with complex psychosis should be curtailed says NICE20/12/2019 14:15:00
A new draft NICE guideline published today (20 December 2019) on the rehabilitation of adults with complex psychosis and related mental health conditions says they should have access to rehabilitation services in their local area and the use of out-of-area placements limited.