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Birmingham Symptom specific Obstetric Triage System (BSOTS)

Birmingham experts are delivering remote training for maternity units on how to make triage safer during the COVID-19 pandemic. 

The training enables maternity units to adopt the Birmingham Symptom specific Obstetric Triage System (BSOTS) which uses symptom-specific prioritisation algorithms to define the level of clinical urgency on a four category scale.

The initial BSOTS triage assessment takes around five minutes and based on clinical determinants allocates a ‘traffic light’ colour code to the woman, so clinical staff can see at a glance who needs to be prioritised.

Evaluation has shown that BSOTS is easy to use, standardises and improves decision-making, and increases the number of women seen within 15 minutes of arrival.  

Previously training for key staff took place in Birmingham for a day and within the units, required staff to be released for half a day’s training. 

The training had been on hold during the lockdown, but in response to recent requests from six maternity units who want to make their departments safer during the COVID-19 pandemic, it is now being delivered via a two hour video conference, supplemented by an hour’s internal staff training delivered by those trained via video.

The training is provided by Professor Sara Kenyon (a midwife by background) from the University of Birmingham's Institute of Applied Health Research. This system itself was developed with Dr Nina Johns and Birmingham Women’s and Children’s NHS Foundation Trust (BWC).

Professor Kenyon has also recently worked with clinical staff from BWC and West Midlands Ambulance Service in response to the exceptional circumstances posed by COVID-19 to rapidly develop standardised advice for telephone triage. The advice has been circulated by NHS Improvement to all maternity units and, while it has not yet been formally evaluated, it has been well received in practice.

Professor Kenyon commented: “Shortening the training for both the key staff and those who work in the area has meant it’s easier to implement BSOTS. We are now rolling out the training to as many maternity units as possible, to help maternity units standardise the prioritisation of patients during the COVID-19 pandemic.”

BSOTS is currently used in 15 maternity units in the UK, with over 20 maternity trained in the last six months and in the process of implementation. More widespread implementation is currently being supported by MidTECH Innovations (the NHS Innovation Hub for the West Midlands), the Academic Health Science Networks in the West Midlands, East Midlands and UCL Partners.