• Run by NHS Borders, in partnership with the Scottish Government’s Early Years Collaborative and the Digital Health Institute.
  • Focusing on risk management in maternity care.
  • Aiming to improve maternal outcomes and engage pregnant women in managing the risks associated with pregnancy.
  • Will develop and implement ‘SAFER’, a risk assessment tool to assess antenatal risks and develop comprehensive clinical management plans.



Early identification and management of the risks associated with pregnancy is essential to providing optimal treatment to pregnant women. In Scotland there are six areas that have been targeted for improved maternal care: post-partum haemorrhage, stillbirth, sepsis, venous thromboembolism, smoking cessation, and appropriate induction of labour.

Effective identification of maternal risk and its subsequent management is guided by nationally recognised evidence and best practice. However, with so much evidence and practice guidelines available, health care staff can be overwhelmed by bureaucracy and can miss key clinical factors. Risk assessment is frequently carried out in an ad hoc manner, and is not always undertaken.

This project aims to engage pregnant women themselves, at the earliest stage of their pregnancy, in the development of new ways of identifying and managing the risks associated with pregnancy. It will involve the creation of a community-based model that will improve outcomes for women and their families.

‘SAFER’ is a risk assessment and risk management system that has been developed and tested by a small team of Scottish clinicians in a rural setting. It is used to assess antenatal risks and develop a comprehensive clinical management plan. This NHS Borders project will engage and involve women in the development and use of the tool. It will become a patient-held record that can dynamically assess risks and mitigate them through the production of a live patient-owned management plan. 

The initiative will be initially implemented with around 60 pregnant women a month in one rural community.

Contact details

For more information about this project, please  Brian Magowan, Consultant Obstetrician and Gynaecologist, Borders General Hospital.

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