Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will list which recommendations from the MBRRACE confidential enquiry into thrombosis and thromboembolism (a) have been implemented (b) remain outstanding.
Answered by Preet Kaur Gill
We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.
VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.
NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self assessment questionnaire on VTE risk, for all women at first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.
All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.
Baroness Amos’ final report of her independent National Maternity and Neonatal Investigation in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE. We will consider how the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s recommendations feed into this work. We have committed to publishing a national action plan that translates the recommendations into action by December 2026.
Locally, some individual trusts also produce information about reducing the risk of blood clots and VTE in pregnancy.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to publish a delivery plan and timeline for implementation of MBRRACE maternity recommendations.
Answered by Preet Kaur Gill
We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.
VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.
NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self assessment questionnaire on VTE risk, for all women at first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.
All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.
Baroness Amos’ final report of her independent National Maternity and Neonatal Investigation in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE. We will consider how the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s recommendations feed into this work. We have committed to publishing a national action plan that translates the recommendations into action by December 2026.
Locally, some individual trusts also produce information about reducing the risk of blood clots and VTE in pregnancy.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential implications for his policies of the rise in maternal mortality identified by MBRRACE; and what actions has his Department taken specifically in response to maternal deaths from venous thromboembolism.
Answered by Preet Kaur Gill
We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.
VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.
NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self assessment questionnaire on VTE risk, for all women at first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.
All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.
Baroness Amos’ final report of her independent National Maternity and Neonatal Investigation in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE. We will consider how the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s recommendations feed into this work. We have committed to publishing a national action plan that translates the recommendations into action by December 2026.
Locally, some individual trusts also produce information about reducing the risk of blood clots and VTE in pregnancy.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the reasons why the death rate due to venous thromboembolism in pregnancy and the puerperium is higher in the UK than in other European countries.
Answered by Preet Kaur Gill
We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.
VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.
NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self assessment questionnaire on VTE risk, for all women at first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.
All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.
Baroness Amos’ final report of her independent National Maternity and Neonatal Investigation in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE. We will consider how the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK’s recommendations feed into this work. We have committed to publishing a national action plan that translates the recommendations into action by December 2026.
Locally, some individual trusts also produce information about reducing the risk of blood clots and VTE in pregnancy.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of potential impact of second-generation antipsychotic drugs on levels of risk of venous thromboembolism.
Answered by Preet Kaur Gill
Antipsychotic medicines are used to treat a range of mental health disorders, mainly schizophrenia and bipolar disorder, sometimes called manic depression, but may also be used in severe or difficult to treat anxiety or depression. Antipsychotics are generally classified as either first-generation, conventional or typical, or second-generation, atypical medicines. Second-generation, atypical, antipsychotics act on a broader range of neurotransmitter receptors than first-generation antipsychotics.
In 2009 the Medicines and Healthcare products Regulatory Agency (MHRA) conducted a Europe-wide review of data on the risk of venous thromboembolism (VTE) associated with the use of antipsychotic medicines.
Second‑generation, atypical, antipsychotics licensed in the United Kingdom at the time of the MHRA review included amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, and zotepine. Since then, additional newer atypical antipsychotics have been authorised in the UK, including medicines such as lurasidone, paliperidone, and cariprazine.
Following the review, the MHRA updated prescribing information and published advice for healthcare professionals indicating that:
antipsychotics use may be associated with an increased risk of VTE;
at that time there was insufficient data available to determine any difference in risk between atypical and conventional antipsychotics, or between individual drugs; and
all possible risk factors for VTE should be identified before and during antipsychotic treatment and preventive measures undertaken.
As a result of this review and subsequent regulatory action, UK product information of second-generation antipsychotics, including those licenced after the review, contains warnings regarding the potential risk of VTE. The safety of these medicines continue to be monitored by the MHRA.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help improve awareness among healthcare professionals of the risk of venous thromboembolism associated with second-generation antipsychotic drugs.
Answered by Preet Kaur Gill
Healthcare professionals are supported by national guidance and safety information to understand and manage the risks associated with antipsychotic medicines, including the risk of venous thromboembolism.
National Institute for Health and Care Excellence (NICE) guidance on psychosis and schizophrenia recommends that the choice of antipsychotic medicine is made jointly by the patient and healthcare professional, taking account of possible side effects, and that physical health is monitored during treatment.
The Medicines and Healthcare products Regulatory Agency (MHRA) reviewed the risk of venous thromboembolism with antipsychotic medicines in 2009 and issued advice to healthcare professionals. Product information for second-generation antipsychotics includes warnings about this risk, and the MHRA continues to monitor the safety of these medicines.
Asked by: Alicia Kearns (Conservative - Rutland and Stamford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of staffing levels on the timeliness of venous thromboembolism (a) assessment and (b) prevention.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No assessment has been made.
The responsibility for staffing levels sits with providers of National Health Services at a local level, working with their commissioners, responding to local needs, supported by guidelines by national and professional bodies and overseen and regulated in England by the Care Quality Commission.