This maternity profile brings together a wide range of information and analysis related to the maternity pathway in one, easy to use, reference document. It aims to provide a better understanding of the quality of maternity care in your local area. Profiles should be interpreted in the context of local demography. For further demographic information about your local area, please refer to our Health Needs Assessment Toolkit http://hna.londonhp.nhs.uk/. Further information on maternal and child health please refer to the ChiMat website http://www.chimat.org.uk/
1   Barking,   Havering   and   Redbridge
University   Hospitals
2   Barnet   and   Chase   Farm   Hospitals
3   Barts   and   the   London
4   Central   Middlesex   &   Northwick
Park
5   Chelsea   and   Westminster
Hospital
6   Ealing   Hospital
7   Epsom   and   St   Helier   University
Hospitals
8   Guy’s   &   St.
Thomas'
9   Hillingdon   Hospital
10   Homerton   University   Hospital
11   Imperial   College   Healthcare
12   King's   College   Hospital
13   Kingston   Hospital
14   Lewisham   Hospital
15   Mayday   Healthcare
16   Newham   University   Hospital
17   North   Middlesex   University
Hospital
18   Princess   Royal   University
19   Queen   Elizabeth
20   Queen   Mary’s
22   St   George's   Healthcare
23   University   College   London
Hospitals
24   West   Middlesex   University
Hospital
25   Whipps   Cross   University
Hospital
26   Whittington   Hospital
Source: LSA. Contains Ordnance Survey data. Crown copyright and database right 2011
This map presents the birth rate per 1,000 women aged 15-44 at local authority level. Maternity providers are shown as brown circles, with the colour of the circle representing the number of births at that location.
• There are around 2,200 births to Kensington and Chelsea residents each year. Just under 60% of these babies are delivered at Chelsea and Westminster Hospital NHS trust. Kensington and Chelsea also has a high number of privately funded births, some of which are in NHS hospitals; this has implications for mode of delivery and NHS spend.
• There is a significantly higher proportion of older mothers in Kensington and Chelsea compared to England as a whole.
Almost 40% of all births are to women over 35, nearly double the national average.
• Recording of early antenatal assessment is higher than average, and this shows that just over half of pregnant women have an antenatal assessment within the first 12 weeks of pregnancy, significantly fewer than England as a whole.
• Rates of breastfeeding initiation and breastfeeding continuation are significantly higher in Kensington and Chelsea compared to London and England and are among the some of the highest rates for breastfeeding in the country.
• The rate of deliveries by caesarean section is significantly higher than for England as a whole, and is the highest rate in
London. The rate of elective caesareans in Kensington and Chelsea is over 3 times higher than the lowest rate in England and is the highest in London.
• Normal delivery rates in Kensington and Chelsea are among the lowest in the country.
• Infant mortality rates, and the proportion of babies born with low birth weight in Kensington and Chelsea is statistically similar to the national average.

The spine chart below shows how maternity data for this local authority compares with London and the rest of England. Your local authority’s results for each indicator are displayed as a circle. The average rate for England is shown by the black line in the centre of the chart. The range of results for all local authorities in England is shown as a grey bar. Green and red circles show differences from the England average. A green circle may still indicate an important public health problem.
KEY Significantly better   than   the   England   average
Significantly   lower   than   the   England   average
Not   significantly   different from   the   England   average
Significantly worse   than   the   England   average
Significantly   higher   than   the   England   average
Significance not   calculated.
Data   recording
<50%  ‐ interpret   with   caution
Domain Indicator
1 Women
2 Births
of   childbearing
3 Total   period   fertility
age
4 Births   to   women   aged   >35
5 Births   to   women   aged   >40
6 Teenage   pregnancy
7 Early
8 Early
antenatal antenatal
9 Smoking   during
assessment*† assessment pregnancy*
recording*
10 Abortions   (<10wks   gestation)*
11 Inpatient   admissions   before   delivery*
12 Births   in   NHS   hospitals
13 Births   at   home   or   midwifery   unit*
14 Unplanned   transfer   to   hospital*
15 Inductions
16 Normal   deliveries
17 Caesarean   deliveries
18 Elective   caesareans
19 Emergency/other   caesareans
20 Vaginal   birth   after   caesarean*
21 Midwives
22 Obs   and   Gynae   consultants
23 Consultant:   Midwife   ratio
24 1:1   care   in   labour
25 Multiple   births
26 Premature   births
27 Length   of   hospital   stay   after   delivery
28 Breastfeeding   initiation*
29 Breastfeeding   continuation*
Local
Number
38,500
2,221
n/a
879
198
146
895
1,599
55
640
2,667
1,921
949
8
364
878
641
315
326
34
60
6
n/a
Local
Value
22.7
57.8
1.6
39.6
8.9
25.7
56.0
93.6
3.1
82.5
1.2
86.5
57.1
0.9
18.3
45.9
33.5
16.5
17.0
24.1
31.2
3.2
9.8
Lon Avg Eng Avg
23.6
72.1
2.0
24.9
5.3
43.7
56.8
68.6
6.5
79.6
1.0
96.6
14.2
38.0
15.2
58.5
26.7
9.9
16.8
30.9
31.3
2.8
11.2
20.1
65.5
2.0
20.1
3.9
40.2
63.0
67.7
13.5
76.9
1.0
97.0
10.6
38.0
17.2
61.4
24.0
9.6
14.4
31.1
31.5
2.6
12.1
Eng
Worst
29.7
113.9
3.2
41.6
9.7
69.4
4.3
0.3
32.5
60.6
2.5
99.4
0.0
100.0
37.5
45.9
38.9
19.4
22.2
18.7
15.2
0.2
187.2
England Range Eng Best
30 Perinatal
31 Neonatal
32 Infant
mortality
33 Low   birth   weight   <2500g
34 Very   low   birth   weight   <1500g
35 Total   maternity   spend*
36 Maternity
37 Maternity
mortality
mortality spend spend
(<1
(<7   days
(<28   year) primary days)
+   stillbirth) care* secondary   care*
110
212
1,874
1,618
1,470
40
13
21
142
27
14,289,000
589,000
13,700,000
4.9
11.4
2.1
91.5
78.4
6.0
2.0
3.2
6.4
1.2
6,416
264
6,152
3.5
12.4
1.9
86.3
64.1
7.8
3.0
4.5
7.8
1.6
5868.3
255.6
5612.6
3.3
12.3
1.7
73.6
45.7
7.5
3.1
4.6
7.3
1.4
5,483
392
5,091
6.0
63.6
4.9
39.0
19.2
19.2
19.2
19.2
11.5
3.3
9,955
0
9,863
* PCT level data †   Local data may differ from recorded HES data
1 % female pop aged 15-44, 2010 mid year estimates (ONS).
2 Birth rate per 1,000 female pop aged 15-44, 2010 (NCHOD).
3 Average no. of children, 2010
(NCHOD).
4-5 % total births, 2010 (ONS).
6 Conceptions per 1000 pop aged 15-17, 2007-2009 (DfE).
7 % assessed within 12 weeks where antenatal assessment recorded at delivery, 2009/10 (HES/NHS Comparators).
8 % maternities where antenatal assessment recorded at delivery, 2009/10 (HES/NHS
Comparators).
9 % mothers smoking at time of delivery, 2010/11 (DH).
10 NHS and private abortions <10 weeks gestation as a % of all abortions, 2010
(NCHOD).
11 Ratio of antenatal admissions not related to delivery, 2009/10 (NHS Comparators).
12 % total births, 2010 (NCHOD).
13 % total births, 2009/10
(NHS Comparators).
14 % deliveries with an unplanned transfer to hospital, 2009/10 (NHS Comparators).
15-19 % total deliveries, 2009/10 (HES/London
Health Programmes).
20 % vaginal deliveries after a prior caesarean section, 2009/10 (NHS Comparators).
21 No. FTE midwives per 1,000 births, 2009/10
(Annual Workforce Census/HES).
22 No. FTE Obs & Gynae consultants per 1,000 births, 2009/10 (Annual Workforce Census/HES).
23 No. midwives per consultant, 2009/10 (Annual Workforce Census/HES).
24 Data not currently collected.
25 Multiple births as a % of total births, 2009 (ONS/London Health
Programmes).
26 % births with gestation of less than 37 weeks, 2009/10 (HES/London Health Programmes).
27 Total no. of bed days and average no. of days spent in hospital after delivery per delivery, 2009/10 (HES/London Health Programmes).
28 % breastfed within 48 hours, 2010/11 (DH).
29 % totally or partially breastfed at 6-8 weeks, 2010/11 (DH).
30-32 Rate per 1,000 births, 2008-2010 (NCHOD).
33-34 % total births, 2010 (NCHOD).
35-37 £ per birth
2009/10 (DH & HES).
0.0
1.2
3.9
0.0
2,389
2,010
2,265
1.3
0.0
0.9
92.3
83.1
3.2
14.6
88.0
99.3
3.1
85.1
0.3
65.7
9.5
24.4
0.7
7.7
0.0
98.6
0.0
0.2
76.3
11.8
4.9
7.9
54.7
80.9
7.9
7.0
Spine chart preparation based on West Midlands Public Health Observatory Spine Chart Tool version 4

Standardised z scores were calculated for each local authority for outcome (low birth weight) and spend data (primary and secondary spend per head on maternity). Z scores measure the distance of a value from the mean in units of standard deviation. A positive z score indicates that the value is either higher spend or better outcome than the national average whereas a negative z score indicates lower spend or worse outcome than the national average. A z score below -2 or above +2 indicates that the value is statistically significantly different from the national average (at 95% confidence level). The graph presents an overall picture of spend and low birth weight at a local level and does not, therefore, imply causality.
Analysis undertaken by the Clinical & Health Intelligence team, NHS London Health Programmes.
Inner North East London
North Central London
North W est London
Outer North East London
South East London
South W est London
2 Standard deviations
1 Barking and Dagenham PCT
3
4
Bexley Care Trust
Brent Teaching PCT
17 Hounslow PCT
19 Kensington and Chelsea PCT
20 Kingston PCT
7 City and Hackney Teaching PCT
9 Ealing PCT
11 Greenwich Teaching PCT
12 Hammersmith and Fulham PCT
13 Haringey Teaching PCT
14 Harrow PCT
16 Hillingdon PCT
23 Newham PCT
25 Richmond and Twickenham PCT
27 Sutton and Merton PCT
28 Tower Hamlets PCT
29 Waltham Forest PCT
30 Wandsworth Teaching PCT

The chart below displays differences in low birth weight according to local levels of deprivation. Low birth weight is displayed as a percentage of total live births with birth weight recorded (birth weight is recorded for an average of 99% of records). Small areas within each local authority are divided into quintiles according to the level of deprivation defined by the Index of Multiple
Deprivation 2010.
12
10
8
6
4
2
0
1  ‐ Least   deprived
Source: ONS (C&HI team analysis)
2 3
Quintile   of   deprivation   (IMD   2010)
4 5  ‐ Most   deprived
The chart below displays differences in antenatal booking rates according to ethnic group. The percentage of women who have
London. The percentage of records where the information is recorded is shown by blue bars. The data should be interpreted with caution where recording is poor.
100
80
60
40
20
0
100
80
60
40
20
0
Ethnic group
Source: HES PCT level data; Analysis: NHS Comparators
Ethnic group
Pathway Profiles are produced by the Clinical & Health Intelligence team at NHS London Health Programmes. You may use this profile for non-commercial purposes providing you acknowledge where the information came from by printing ‘Source: NHS London Health Programmes. © Crown Copyright 2011.