Saving Babies’ Lives Version Two: Trusts must be supported to implement this expert-led, evidence-based guidance fully to save lives.
Baby Lifeline welcomes the release of NHS England’s newly expanded guidance, Saving Babies’ Lives Version Two: A Care Bundle for Reducing Perinatal Mortality (SBLCBv2) , released today.
Baby Lifeline supports evidenced-based best practice in maternity care by developing, delivering and campaigning for high-quality ongoing training for maternity healthcare professionals, and is pleased that the SBLCBv2 continues to emphasise the need for staff training throughout.
As an evidence-based bundle with the aim of saving babies’ lives, it is vitally important that trusts are supported to implement its guidance properly. Baby Lifeline investigated the training elements of the original Saving Babies’ Lives Care Bundle (2016)  in our Mind the Gap report (Nov 2018)  – we found that less than 10% of NHS trusts in England were providing all the staff training necessary to implement Saving Babies’ Lives.
Supporting trusts to save babies’ lives
Recommendations are only useful if healthcare professionals are fully supported to implement them, including by ensuring they have up-to-date training in evidence-based best practice. In the Mind the Gap report, NHS trusts identified that the biggest barriers to providing this up-to-date training were issues with staffing, and lack of financial resource .
In Mind the Gap, we recommended that funding must be made available to support staff attendance on training, and to support the provision of high-quality, relevant training . This recommendation has now been echoed in The Maternity Safety Training Fund: An Evaluation, commissioned by Health Education England . The £8.1million Maternity Safety Training Fund was a one a one-off government investment in training in the 2017/18 financial year; the evaluation states that, “without ongoing financial support, there is a risk that the benefits of the MSTF initiative and the impacts of the maternity safety training will diminish over time.” 
Mind the Gap shows us that guidelines alone do not save lives; we must invest in dissemination and support for professionals to implement life-saving best practice.
A care bundle for reducing perinatal mortality
We particularly welcome the widening focus of the bundle to reduce the numbers of babies dying before, during, and just after birth, as well as the addition of guidance on reducing preterm birth. This addition brings the bundle in line with the latest evidence, and the updated government ambition to halve the number of stillbirths and reduce the number of babies who are born preterm from 8% to 6%, by 2025 .
Worldwide, complications of preterm birth are the most common reason for children dying before their 5th birthday . In the UK, preterm birth is the leading cause of injury and death for babies in their first 28 days of life .
An evaluation, commissioned by NHS England, has shown that in 19 trusts where work was done to implement recommendations of the original bundle, rates of stillbirth fell by 20% . In 2019, almost 3 years following the first launch of this guidance, the NHS Long Term Plan  committed to ensuring that every maternity unit in the country will be supported to implement this guidance in full. This is essential if we are to reduce the numbers of babies dying before, during and shortly after birth, and reduce the numbers of babies who are born preterm.
What are we doing to support the bundle?
We have a proven track record of delivering high quality, expert-led training for maternity healthcare professionals. Our training programmes support and anticipate the implementation of national guidelines for improving maternity care. Several of our training programmes already support the recommendations of SBLCBv2.
In particular, our Implementing Saving Babies’ Lives training programme discusses the latest evidence to help professionals identify and care for babies at risk of preterm birth, stillbirth, and growth problems in the womb. The course has been taking place nationally since 2014 and continues to achieve fantastic feedback from delegates. Confidence levels have been shown to massively increase post-course in areas that enable the effective management of babies and mums at risk. We are pleased that national efforts are now in line with our work.
Implementing Saving Babies’ Lives has been developed and is delivered by some of the same nationally recognised experts who led the development of the new Saving Babies’ Lives Care Bundle.
Judy Ledger, CEO of Baby Lifeline, said, “Baby Lifeline is dedicated to ensuring the best outcome from pregnancy and birth by supporting healthcare professionals to provide safe, effective and evidenced-based care. This updated bundle contains evidenced-based interventions to reduce the number of babies dying during or soon after birth, in preventable circumstances.”
“For this reason, is absolutely essential that every maternity unit in the country is supported to fully implement the live-saving interventions described in this newest version of the Saving Babies’ Lives Care Bundle. Our Mind the Gap Report published last year, showed that, in terms of the original guidance, this was not the case for over 90% of NHS providers. If the government is to achieve the maternity safety ambition to halve the rates of stillbirths; neonatal and maternal deaths; brain injuries that occur during or soon after birth; as well as reduce the rates of preterm birth by 2025, there must be a commitment to continued investment in ongoing training for our maternity professionals.”
“Baby Lifeline believes that an investment in frontline staff, through training, is an investment in the lives of mothers and babies using our maternity services. A single maternity-based clinical negligence claim, settled in October 2018, cost the NHS £37 million. A comparatively small investment in training will save the NHS money and save babies’ lives.”
 NHS England. (2019). Saving Babies’ Lives Version Two: A Care Bundle for Reducing Perinatal Mortality. Retrieved 15 March 2019.
 O’Connor, D. (2016). Saving Babies’ Lives: A care bundle for reducing stillbirths. Retrieved 21 March, 2016.
 Ledger, S., Hindle, G. and Smith, T. (2018). Mind the Gap, An Investigation into Maternity Training for Frontline Professionals Across the UK (2017/18). Retrieved 14th March 2019.
 Grimwood, T. and Snell, L. (2018) The Maternity Safety Training Fund: An Evaluation. Cumbria: Health and Social Care Evaluations, University of Cumbria.
 Maternity Safety Programme Team, Department of Health. (2017). Safer Maternity Care. Retrieved 14th March 2019.
 World Health Organisation. (2018). Preterm Birth. Retrieved 14th March 2019.
 National Institute of Health and Care Excellence. (2015). Preterm labour and birth NICE guideline [NG25]. Retrieved 14th March 2019.
 Widdows, K., Roberts, S., Camacho, E. and Heazell, A. (2018). Evaluation of the implementation of the Saving Babies’ Lives Care Bundle in early adopter NHS Trusts in England. Manchester: Maternal and Fetal Health Research Centre, University of Manchester
 NHS England. (2019). The NHS Long Term Plan. Retrieved 14th March 2019.