King's College London

The tool, called The Tommy’s App, enables midwives and doctors to more accurately assess each woman’s needs during pregnancy and to personalise their care, using latest evidence and national clinical guidelines. This aims to reduce the variation in care across the NHS and ensure that each woman and pregnant person is offered the right care at the right time, no matter where they live.

The funding award from the National Institute for Health and Care Research (NIHR) will enable the team behind the tool’s development to trial its implementation at scale, investigating and overcoming any challenges ahead of potential NHS-wide adoption.

The Clinical Decision Support Tool, in development at the Tommy’s National Centre for Maternity Improvement, is led by the University of Bristol with partnership from King’s. Jane Sandall, Professor of Women's Social Science and Women’s Health in the School of Life Course & Population Sciences, leads the implementation research theme and Dr Jenny Carter, a Research Fellow at King’s and in the Tommy’s National Centre for Maternity Improvement, manages this work.

Prof Sandall and Dr Carter will assess the effect of the ‘real world’ implementation of the Tommy’s support tool within the NHS. The implementation evaluation includes looking at whether women who are eligible for assessment are properly reach, the experiences of staff and women and processes of care, and improvement in care outcomes for women from some ethnic groups who are at risk of poorer outcomes.

The trial will start in Summer 2023, and will run across 26 NHS Trusts for 36 months, involving around 39,000 women each year.

Earlier this year, the Centre published evidence demonstrating the algorithms used in the Clinical Decision Support Tool can help reduce health inequality in Black, Asian and other minority ethnic pregnant women. The Centre is developing the tool as part of a broader maternity improvement programme supporting Government targets to reduce the rates of preterm birth and stillbirth across the UK.

Co-designed with women, the tool is accessed using a web application so women and pregnant people can access their own care information with ease, encouraging engagement and supporting them to be heard if they have any questions or concerns. It also offers them access to pregnancy information and guidance from trusted sources, to support informed decision making.

The Tommy’s National Centre for Maternity Improvement is jointly led by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM). The Clinical Decision Support Tool has been co-developed by a team of healthcare professionals from leading UK universities brought together by the Centre, including King’s, the University of Sheffield, the University of Bristol and St. George’s University of London, and charitable partners Mothers for Mothers and the PROMPT Maternity Foundation.

Prof. Basky Thilaganathan, Clinical Director to the Tommy’s National Centre for Maternity Improvement, said “We believe that our Clinical Decision Support Tool can make a significant change in the delivery and experience of maternity care. We are thrilled to be able to expand our work with this funding, and further our learning to support our aim for NHS-wide adoption.”

Dr Edward Morris, President of the RCOG, said “Reducing stillbirth and preterm birth rates in the UK remains a priority. This exciting trial is a huge stepping stone towards offering more personalised care that can save babies’ lives.”