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RCOG publishes Good Practice Paper on Maternity Triage

11 Dec 2023

The Royal College of Obstetricians and Gynaecologists (RCOG) has published a new Good Practice Paper providing recommendations for maternity triage operational structure and pathways, to support safe care of pregnant and newly postnatal woman and people outside of scheduled appointments.

The paper recommends that maternity triage departments implement the Birmingham Symptom-specific Obstetric Triage System (BSOTS), which is the recommended triage system in England and has been widely adopted in the UK. Using this system offers standardised initial assessment and symptom-specific algorithms to identify those women who require more urgent attention in a busy clinical setting.

To support this process, the paper also recommends that women should be provided with information regarding how and when to call or to attend the maternity triage unit, and that a dedicated telephone advice line answered by a midwife is made available 24/7 outside the clinical area. Women attending the unit should be initially assessed by a midwife within 15 minutes of attendance and prioritised using algorithms which determine urgency of further investigations and seniority of review.

Mrs Geeta Kumar, Vice President of the Royal College of Obstetricians and Gynaecologists, said: “Maternity triage units play a vital role as the emergency portal to access maternity services for pregnant or newly postnatal women who have unexpected complications or concerns. The RCOG has produced this Good Practice Paper to support local maternity services to offer responsive, safe and evidence-based care through their units. It also provides advice on how to deploy NHS resources most effectively and potential additional requirements.

“Implementing the recommendations within the Good Practice Paper may require significant system-level change and investment, and a commitment to multidisciplinary working to improve local pathways. However, we believe the recommendations are crucial to address the concerns being identified in maternity service inspections, including around robust systems to triage women and prioritise their care in a timely manner, and clear guidance for escalation.”

The Good Practice Paper has been produced for all stakeholders responsible for developing and improving maternity services. It responds to the 2021 petition to UK Government and Parliament, urging a nationwide review of triage procedures in NHS maternity wards and establishment of a standardised risk assessment-based system for maternity triage.

  • To read Good Practice Paper No. 17 Maternity Triage, click here.
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  • Pregnancy and birth