Summary
Quick, accurate blood tests are helping rule out pre-eclampsia, ensuring safer pregnancies and better outcomes for women and their babies. By reducing unnecessary hospital admissions maternity services are able to focus on those women who need closer monitoring. The pandemic underlined the importance of safe and effective care outside hospital where possible.
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This test has improved our ability to make the right decision on admission. The right patients are being discharged, leaving us to focus on those women who are at greater risk of developing pre-eclampsia.
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Dr Sofia Cerdeira, obstetrician and research leader, Oxford University Hospitals
What the project involved
In 2017, the Oxford AHSN initiated a project to increase uptake and adoption of placental growth factor-based (PlGF) testing which highlights women who are likely to develop pre-eclampsia within 7-14 days.
The Oxford AHSN helped three of the first hospitals in England to adopt PlGF blood tests into standard clinical practice, working with the Oxford Patient Safety Collaborative and clinical leads, laboratory heads, finance and management functions.
This demonstrated that by offering tests to women suspected of having pre-eclampsia clinical teams were better able to identify women who did not have the disease and could safely go home, avoiding unnecessary hospital admissions for monitoring. These results provided a platform for wider spread and adoption.
The test was selected for the NHS England Accelerated Access Collaborative, Innovation Technology Payment and Rapid Uptake programmes which introduce an accelerated pathway to market for highly transformative innovations. In 2021 PlGF-based testing was one of four technologies included under the new NHS MedTech Funding Mandate.
All AHSNs have been working together to ensure rapid and widespread adoption of the test into standard clinical practice in maternity units across England.
Outcomes
Within four years of the first real world evaluation in the Oxford AHSN region there has been widespread adoption of PlGF testing into standard clinical practice, due in large part to a rapid adoption project led by AHSNs. By April 2022, 86% of eligible maternity units in England had either adopted or were implementing PlGF testing. This is benefitting an estimated 35,000 pregnancies per year.
Projected annual savings in England are estimated at £4m per year relating to reduced hospital bed occupancy.
Widespread adoption of the PlGF test has brought additional environmental benefits linked to fewer hospital journeys and overnight stays in hospital beds.
The Oxford AHSN won two prizes relating to this work in 2019: an HSJ Partnership Award and a Univants of Healthcare Excellence Award. It was also a finalist in the HSJ Awards.
Next steps
This change in practice is now being sustained in everyday practice in the majority of maternity units in England.
