# A mapping survey of digital clinical consultations in maternity care in England

## TL;DR

This study maps how digital consultations are being used in maternity care in England, finding significant variation and gaps in training and implementation.

## Contribution

The study provides the first national survey of digital clinical consultations in NHS maternity care, identifying key barriers and areas for improvement.

## Key findings

- Telephone consultations are the most commonly used digital modality in maternity care.
- Low levels of staff training and inconsistent recording of women's consultation preferences were identified.
- Significant variation exists in the use of digital consultations across NHS maternity services.

## Abstract

Many areas of healthcare are exploring the use of digital technologies with the aim of improving and expanding care to service users. In England, maternity care is currently undergoing a digital transformation in line with the National Health Service’s (NHS) Long Term Plan, which seeks to enhance care delivery and accessibility through digital tools. However, there is a lack of data on the current use and practice of digital consultations across the country. This project aimed to map and explore how digital clinical consultations are currently being used by NHS maternity care services in England. An online survey was designed to capture data on current practice, guidance and procedures to address potential inequalities. The survey was distributed to each NHS Trust (n = 121) that provides maternity care (specifically to senior maternity care professionals and digital maternity leaders who could provide an overview of how digital consultations were being used where they worked). The survey was open between January and March 2024. 53 completed surveys were received representing 39 different organisations (32% of those currently providing maternity care in England). Quantitative summary statistics indicated that telephone consultations were the most commonly used digital modality across all stages of the maternity care pathway. Thematic analysis identified barriers such as a lack of staff consultation and lack of staff training on the use of digital consultations. It was uncommon for women to be asked about their consultation preferences or assessed for individual needs. In conclusion, the findings reveal significant variation in the use of digital consultations, highlighting a gap between policy intentions and practice. Key areas for improvement in the delivery and implementation of digital consultations include staff training, systems to record women’s consultation preferences/needs, and more research to support digital inclusion. The findings of this survey have the potential to have applications beyond maternity care and in different geographical contexts.

In recent years there has been a digital transformation in maternity care in England which includes the roll-out of digital consultations. However, the extent to which digital consultations are being used in practice, how they are being used and the nature of any training or guidance that is in place to support this, is currently unclear. To answer these questions, an online survey was distributed to senior maternity care professionals and digital maternity leaders who could provide an overview of how digital consultations were being used where they worked. Findings reflected variation in the use and practice of digital consultations in maternity care across England. Telephone consultations were found to be the most commonly used type of digital consultation (compared to video call, messaging services, email and App). Responses indicated low levels of staff training. Likewise, relatively few organisations reported a systematic approach to recording of women’s preferences or needs concerning the use of digital consultations in their care. The findings of this survey can be used to support the digital transformation of maternity care currently taking place in England.