The Birmingham Symptom specific Obstetric Triage System (BSOTS) is a maternity triage system which appears to improve the safety of mother and baby and the management of the department. It consists of a prompt and brief assessment (triage) of the women on presentation, and then a standardised way of determining the clinical urgency in which they need to be seen. Women found to have a lower clinical priority can be sat back in the waiting room, thus improving the pathway, and the standardised assessment and excellent inter-rator reliability means variation in the clinical urgency of women between midwives is minimal. The shared language between health care professionals supports clear communication. The system can be amended to personalise it to individual maternity units but the principle that the assessment is a triage (ie both prompt and brief) and the algorithms (which are used to define the women’s clinical priority) cannot be changed.

BSOTS was developed by clinicians and researchers from Birmingham Women’s Hospital and the University of Birmingham. It has been adopted by over 30 UK NHS Trusts so far, with another 38 trained and in the process of implementation. In all sites (where there has been good initial receptivity) there is evidence of notable changes in work organisation and practices (clinical prioritisation by level of urgency, communication at hand-overs, shared language and standardisation of care for women in higher risk categories) along with a reduction in staff anxiety often associated with triage work (staff feel that they are working more safely).

Implementation of the system is supported by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM). BSOTS was awarded AHSN WM Meridian Awards for Safety and Innovation in July 2019 and won the HSJ Patient Safety Award in 2020 for Maternity and Midwifery Initiative of the year.

To facilitate more widespread implementation we have moved all the training and support materials to be accessible remotely, facilitated by the WM AHSN. There is no charge for access to these materials but units will need to agree to the non-negotiable ‘Terms and Conditions’. BSOTS is also newly available on BadgerNet EPR and if you want to implement BSOTS you will need to follow the process detailed on the website (for information please click the link BSOTS Public Page)

Lead: Sara Kenyon

Dates: 01/10/2019 - TBC

Funding: ARC funded