Perinatal equity and equality

In summer 2022, NHS Kent and Medway asked people from Black, Asian and minority ethnic communities and those living in neighbourhoods with high levels deprivation about their experiences of maternity services.

We wanted to find out what was working and what could be improved so Kent and Medway Local Maternity and Neonatal System could develop an action plan to reduce inequalities in perinatal, or maternity care.

Community engagement

Working with local community organisations, NHS Kent and Medway’s Engagement Team spoke to more than 350 people to help shape a perinatal equity strategy.

Compas, The Gr@nd, Medway Diversity Forum, Diversity House, People Dem Collective and Involving Medway and Swale helped reach families from specific communities, who experience poorer outcomes and may be less likely to trust statutory bodies.


  • developed a survey and letter asking people to share their experiences in the online survey
  • worked with children’s centres in target areas to share the survey and reach communities
  • worked with our community partners so they could carry out  interviews and run focus groups
  • worked with the four acute hospital trusts to share the survey and reach communities.

The four acute hospital trusts are:

  1. Dartford and Gravesham NHS Trust
  2. East Kent Hospitals University NHS Foundation Trust
  3. Maidstone and Tunbridge Wells NHS Trust
  4. Medway NHS Foundation Trust

What did we ask?

  • What was your recent experience of maternity services?
  • What worked well?
  • What could be improved?
  • What cultural traditions do you have that are relevant to maternity services?

A perinatal equity planning day was held in October 2022, which provided an opportunity for community organisations to give feedback and work with maternity partners to create a plan.

You said… “Translation was not always available when needed and information was not always accessible or understandable.”

We commit to…

  • reviewing and improving our provision of translation services within each maternity service

  • making sure more information is available in different languages and easy read versions, including our personalised care and support plan, which will be launched in 2023

  • making sure antenatal education is made available in a choice of digital and face-to-face formats, with digital versions having translation available

  • expanding the content of our Bump Birth and Beyond website to include information about neonatal services.

You said… “More person-centred consistent care and to see the same staff at each appointment.”

We commit to…

  • midwifery continuity of care to enable women and birthing people to be seen by the same small team of people at each appointment – as soon as maternity staffing levels have improved enough to start working in this way, the first continuity teams will be implemented in the most deprived areas and for those from Black, Asian and mixed ethnic group

  • personalised care and support plans in maternity services during 2023, in a format, which was co-produced  2022 with people who use maternity services. This will help make sure the right information is provided and the right questions are asked to help you make choices about your care, and you can make choices about involving your family in your care.

You said… “Care and support after birth needs to be improved.”

We commit to…

  • making sure our maternity and neonatal services achieve the standards of infant feeding support recommended by the Unicef UK baby friendly initiative

  • working in partnership with other organisations in Kent and Medway to improve the range of breastfeeding support across communities, including through development of family hubs

  • making sure Thrive, our specialist maternal mental health in east Kent for people who have experienced birth trauma and loss, becomes available across Kent and Medway and families know how to access it

  • making sure our new personalised care and support plans enable you to make choices after your baby is born, which respect your traditions and customs.

You said… “We should encourage feedback and create a safe space for those from diverse backgrounds to share their experiences and demonstrate accountability when things go wrong.”

We commit to…

  • taking part in the national pilot of the maternity independent senior advocate role, meaning we will employ two new people across Kent and Medway to support people from diverse backgrounds to make complaints and have discussions with maternity services when things go wrong

  • making sure we improve awareness of the maternity voices’ partnership and diversity of the representation there, so more people use this way of providing feedback.

You said… “We need to create a culture where racism and discrimination is not tolerated.”

We commit to…

  • identifying an equality and diversity champion in each maternity and neonatal service, who will take the lead on identifying ways to improve awareness and address racism and discrimination, including helping staff to feel safe to speak out when they observe it happening and making sure people using the service are able to report when it happens to them.

You said… “We need to make sure all maternity staff understand cultural diversity and can act on needs and values of diverse cultures.”

We commit to…

  • making sure all maternity and neonatal staff take part in cultural proficiency training to enable them to understand unconscious bias and engage with people across diverse cultures.

You said… “We need to recruit more staff from diverse backgrounds.”

We commit to…

  • continuing our programme of international midwife recruitment, which will increase the diversity of midwives in our maternity services 

  • implementing the workforce race equality standard in our maternity and neonatal services to improve the experience of black and minority ethnic staff in our workplaces

  • advertising vacant roles in our services within local community settings, where people from diverse backgrounds are more likely to see these work opportunities.

You said… “You felt empowered by taking part in this community outreach work and we should keep involving people from diverse backgrounds.”

We commit to…

  • developing a network of maternity community champions within voluntary sector organisations across Kent and Medway who can help provide a link to diverse communities to keep people involved with our improvement work

  • increasing the diversity of membership and participation in the maternity voices’ partnership by creating safe spaces for people to become involved in ways they feel comfortable with

  • providing training to help people from diverse backgrounds tell their own stories within senior NHS meetings and training sessions to improve understanding of all leaders and staff

  • further targeted engagement work with voluntary sector partners for other groups, which may experience inequalities of outcomes or experience, such as those with physical disabilities, learning disabilities, young parents, LGBTQ+ and travelling communities.

The equality and equity action plan 

A stakeholder group has developed an action plan to inform the perinatal equity strategy – an overview of the action plan can be viewed in the full reports and appendices document library at the top of this page.

The group includes representation from maternity and neonatal services in the four acute provider trusts, Kent and Medway NHS and Social Care Partnership Trust perinatal mental health services, Kent and Medway Maternity Voices Partnership, NHS Kent and Medway Engagement Team, inequalities leads, and representatives of Kent County Council and Medway Council public health teams.

Work to achieve the goals set out in the action plan and embed a sustainable approach to perinatal care started in September 2022. The equity action plan was agreed by the board in March 2023 (item 15, page 5). 

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