Appendix 1: Development of the maternity care standards

A review of the literature was carried out using an explicit search strategy developed by Healthcare Improvement Scotland’s Research and Information Service. Additional searching was done through citation chaining and identified websites, grey literature and stakeholder knowledge. Searches included Scottish Government, Public Health Scotland, National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), NHS Evidence and Department of Health and Social Care websites. This evidence also informed impact assessments, including an equalities impact assessment.

Standards are mapped to a number of information sources to support statements and criteria. This includes, but is not limited to:  

• government policy  

• approaches to healthcare delivery and design, such as person-centred care  

• clinical guidelines, protocols or standards  

• professional or regulatory guidance, best practice or position statements 

• evidence from improvement. 

The development of standards is underpinned by the views and expectations of healthcare staff, third sector representatives, people accessing the service and the public. The standards development process included:  

• scope engagement and consultation period  

• development group meetings held between November 2024 and February 2026 

• an editorial review panel meetings on 4 September 2025 and 13 March 2026. 

The membership of the standards development group and the review and editorial panels are set out in Appendix 2 and 3.  

All Healthcare Improvement Scotland standards follow the same format. Each standard includes: 

• an overarching standard statement 

• a rationale explaining why the standard is important 

• a list of criteria describing what is needed to meet the standard 

• what the standard means to woman and their babies 

• what the standard means if you are a member of staff 

• what the standard means for NHS boards 

• examples of what meeting the standard might look like in practice. 

The examples provided are intended to support NHS boards in assessing, benchmarking, and evidencing their performance against the criteria. These examples are illustrative only and should not be regarded as an exhaustive or prescriptive list of all possible forms of evidence. Given the variation in scale, service configuration, population needs, and delivery models across NHS boards, the specific examples relevant to each service or organisation may differ.  

Examples that NHS boards may use to demonstrate how they are meeting the standards, should reflect their local context including population, configuration of services and partnership working. The same piece of evidence can be used to demonstrate that NHS boards are meeting multiple criteria within these standards. 

Following consultation, the standards development group reconvened to review the comments received on the draft standards and make final decisions and changes. More information can be found in the consultation summary and log report and the consultation change report, both are available on request from the standards and indicators team.

All standards development group members were responsible for advising on the professional aspects of the standards. Clinical members of the standards development group advised on clinical aspects of the work. The co-chairs had lead responsibility for formal clinical assurance and sign off on the technical and professional validity and acceptability of any reports or recommendations from the group. 

All standards development group members made a declaration of interest at the beginning of the project. They also reviewed and agreed to the standards development group’s terms of reference. More details are available on request from the standards and indicators team.

The standards were developed within the Operating Framework for Healthcare Improvement Scotland and the Scottish Government (2022), which highlights the principles of independence, openness, transparency and accountability. 

For more information about Healthcare Improvement Scotland’s role, direction and priorities, please visit: Healthcare Improvement Scotland.  

The Healthcare Improvement Scotland Quality Management System (QMS) Framework supports health and social care organisations to apply a consistent and coordinated approach to the management of the quality of health and care services. By using standards as part of a quality management system, organisations can work in partnership to develop learning, plan improvement and understand their whole system. Central to this is the relationship between women/birthing people, their care partners and organisations.

The maternity care standards will support the spread of person-centred and trauma-informed approaches to care and support for all women and their babies accessing maternity services. 

Healthcare Improvement Scotland may use these standards in a range of assurance and inspection activities. They may be used to review the quality and registration, where appropriate, of health and social care services.