In response to a request from the Chief Nursing Officer of an NHS Trust, MIAA Solutions conducted an independent advisory review of fetal medicine and termination of pregnancy (ToP) services to;

• provide assurance on current practices
• identify risks
• support the development of updated clinical guidance

The outcomes not only strengthened governance and compliance in a sensitive area of care but also demonstrated a scalable approach applicable to other clinical pathways.

The Challenge

The Trust had not undertaken a proactive review of its fetal medicine and ToP services in recent years. With evolving national guidance and the development of new internal protocols underway, the executive clinical leadership team required:

• A baseline assessment of current service delivery.
• Independent assurance on legal and clinical governance.
• Identification of risks and improvement opportunities.
• Support in aligning with Human Tissue Authority and CQC standards.
• Given the complexity and sensitivity of the services, the Trust needed a partner with both clinical insight and governance expertise.

Our Approach

MIAA Solutions deployed a senior advisory team to deliver a structured, evidence-based review. The methodology included:

• Stakeholder Engagement: Collaboration with the Chief Nursing Officer, Chief Medical Officer, and clinical leads.
• Policy and Document Review: Analysis of national and local guidance, Trust policies, SOPs, and inspection reports.
• Data Insight: High-level analysis of termination of pregnancy activity, types, and service locations.
• Governance Mapping: Evaluation of decision-making processes, prescribing practices, and fetal tissue management.
• Assurance Testing: Triangulation with Human Tissue Authority findings and CQC registration data.
• The process was transparent, iterative, and aligned with the Trust’s strategic goals.

Outcomes and Impact

The review delivered a comprehensive report with clear findings, actionable recommendations, and an executive summary tailored for board-level discussion. Key outcomes included:

• Enhanced Assurance: Clear understanding of current compliance with legal and clinical standards.
• Risk Mitigation: Identification of gaps in documentation, prescribing protocols, and tissue management.
• Strategic Alignment: Support for the development of updated guidance and service models.
• Transferable Model: A replicable framework for reviewing other high-risk or complex clinical pathways.

Broader Applicability

While focused on fetal medicine and ToP, the approach demonstrated by MIAA Solutions is adaptable to:

• End-of-life care
• Mental health services
• Safeguarding pathways
• Medicines governance
• Any area requiring robust clinical oversight and assurance

Client Feedback
“The review provided clarity, confidence, and a clear path forward. MIAA’s independent perspective was invaluable in navigating a complex and sensitive area of care.”
Chief Nursing Officer, NHS Trust

Next Steps

If your Trust is seeking to strengthen clinical governance, improve assurance, or prepare for regulatory inspection, MIAA Solutions can help. Our independent advisory services are tailored, evidence-based, and delivered by experienced NHS professionals.

To discuss how we can support your clinical governance goals, contact Steve Warburton, Director of Delivery – Healthcare & Transformation