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Risk assessments in the

AN period
Iram Fiaz
What are we auditing

 That a place of birth has been discussed at booking and 36/34 weeks
 That a risk assessment has been completed at all antenatal contacts
 That a personalised care support plan has been completed at all antenatal
contacts
Why are we auditing it

 It is an element of the Ockenden’s report Essential Actions


 All women must be formally risk assessed at every antenatal contact so that
they have continued access to care provision by the most appropriately
trained professional.
 Risk assessment must include ongoing review of the intended place of birth,
based on the developing clinical picture.
May data
Risk Personalised Care
Assesssment Support Plan
NHS Number Place of birth discussed Completed Completed
Booking 36/40 Booking 16/40 20/40 26/40 29/40 31/40 34/40 36/40 16/40 20/40 26/40 29/40 31/40 34/40

3000508978 YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES

300578488 YES YES YES YES YES YES YES YES YES YES YES NO YES YES YES YES

600023675 YES YES YES YES NO (ANC) YES YES YES YES YES NO NO (ANC) YES YES YES YES

300695502 YES YES YES NO (ANC) YES YES YES YES YES YES NO (ANC) YES YES YES YES YES

400044990 YES YES YES Yes YES YES YES YES YES YES NO YES YES YES YES YES

300748503 YES YES YES NO (ANC) YES YES YES YES YES YES NO (ANC) YES YES YES YES YES

100272221 YES YES YES YES NO (ANC) YES NO (ANC) YES YES YES YES NO (ANC) YES NO (ANC) YES YES

500118021 YES YES YES YES NO (ANC) YES YES NOT SEEN YES YES YES (NO ANC) YES YES NOT SEEN NO

300544940 YES YES YES YES YES YES NO (ANC) YES YES YES YES NO YES NO (ANC) YES YES

600023123 YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES

Total 100% 100% 100% 80% 70% 100% 80% 100% 100% 100% 60% 50% 100% 80% 100% 90%
Figures
Place of Birth Discussed

At Booking 100% Risk assessments completed


At booking 100%
At 34/36 weeks 100%
At 16 weeks 80%
At 20 weeks 70%
Personalised Care Support Plan
Completed At 26 weeks 100%
At 16 weeks 60% At 29 weeks 80%
At 20 weeks 50% At 31 weeks 100%
At 26 weeks 100% At 34 weeks 100%
At 29weeks 80% At 36 weeks 100%
At 31 weeks 100%
At 34 weeks 90%
At 36 weeks 90%
Findings

Positives Negatives

Place of birth was discussed with Risk assessment and personalised care
audited women at booking at 34/36 support plans rarely being completed in
weeks ANC
100% of risk assessments were Only 50% of Personalised care support
completed at most AN visits plans completed at 20 weeks visit
100% of personalised care and support
plans were completed at 26 and 3
weeks visit
Actions

 All clinicians must adopt a consistent and systematic approach to risk


assessment at booking and throughout pregnancy to ensure women are
supported effectively and referred to specialist services where required.
 Everyone’s responsibility to complete risk assessment and personalised Care
Support plan at each contact
 To continue discussing place of birth
 To re-audit in 3-4 months to check the compliance

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