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A maternity triage system developed by clinicians and researchers from the West Midlands has launched training online for the first time, becoming readily available to maternity teams across the UK.

Midwives, obstetricians, and doctors across the NHS can now access the Birmingham Symptom-specific Obstetric Triage System (BSOTS) programme and training materials online for free via the Meridian Health Innovation Exchange.

There is no standardised triage system in maternity care. The Birmingham Symptom-specific Obstetric Triage System (BSOTS) assesses women presenting themselves with unexpected pregnancy related problems or concerns, and then allocates a colour code, so hospital staff can see at a glance who needs to be prioritised.

Developed collaboratively between Birmingham Women’s and Children’s NHS Foundation Trust, the University of Birmingham, supported by the West Midlands Academic Health Science Network (WMAHSN) and MidTECH Innovation, BSOTS was established to provide a standardised method of safely and efficiently assessing women when they attend with unexpected clinical concerns.

Until now, there has been no consistent process available. BSOTS involves a brief standardised assessment of the women on presentation, followed by clear guidance developed to help midwives and clinicians determine the clinical urgency in which women need to be seen. This ensures that variation in treatment and outcomes is minimal and that participating maternity triage departments are working cohesively.

An initial evaluation at Birmingham Women’s and Children’s NHS Foundation Trust showed that BSOTS increased the number of women seen within 15 minutes of attendance to maternity triage from 38% (159/421) to 53% (209/391). The system also appeared to reduce the time between attendance to medical review for those who required it.

By digitising the resources and training materials, trusts from further afield can sign up and implement the award-winning programme more easily and quickly than ever.

BSOTS has been adopted by 34 maternity units in the UK with a further 20 in the process of implementation, and 17 awaiting training. Sunshine Hospital in Victoria, Australia are the first international maternity unit to implement BSOTS with interest from others. Participating Trusts have already noticed positive changes in work organisation and practices, along with a reduction in staff anxiety often associated with triage work.

Its success in safeguarding women has seen the BSOTS programme gain support by the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) who support its implementation.

The programme has also been recognised at the Health Service Journal (HSJ) Patient Safety Awards 2020, as Maternity and Midwifery Services Initiative of the Year and was shortlisted for its Patient Safety Innovation of the Year award.

Helen Hunt, Patient Safety Assistant Programme Manager at WMAHSN, said: “We are so proud to be launching BSOTS on the Meridian Health Innovation Exchange. Streamlining the care of expecting mums is vital and taking the programme online will allow more NHS Trusts and maternity departments across the UK to take a step forward and help ensure that this happens nationwide. We’re so excited to see the roll out.”

Sara Kenyon, Professor of Evidence Based Maternity Care at the University of Birmingham, added: “Previously, BSOTS training has been done either face-to-face or over Zoom, meaning that training and materials haven’t been as accessible to maternity teams as we would have liked.

“However, the new electronic sign-up process makes it easier for maternity sites across the country to access the resources necessary to put BSOTS into practice and improve the way maternity triage work is managed.”

Dr Nina Johns, Consultant Obstetrician at The Royal Wolverhampton NHS Trust and co-creator of BSOTS added: “The BSOTS programme has proved to be invaluable to midwives, obstetricians, and doctors across the UK; not only does it improve quality of care and the safety of pregnant women and staff, it also allows for better communication and creates a less stressful triage environment for staff.

“We hope that by digitising the sign-up process, many more teams will be able to access and implement the service to improve safety & clinical safety in maternity triage.”

Maternity teams will be able to sign up for access to the BSOTS training materials for free via the Meridian Health Innovation Exchange. Existing BSOTS users will also be able to sign up to access to the digital triage resources which can be used independently or in conjunction with BadgerNet.

To find out more about BSOTS, or to sign up to the programme, visit the Meridian Health Innovation Exchange website here.