BSol Maternity Allocative Efficiency Review (STAR Project)

Building a fairer, more effective maternity system for Birmingham and Solihull

Birmingham and Solihull Integrated Care System (BSol ICS) is partnering with the NHS England’s Health Economics Unit to undertake an innovative project – known as an Allocative Efficiency Review – to ensure that every pound spent delivers maximum value for families and communities. This work is about making smarter, evidence-based decisions on how resources are allocated across system, so care is safer, more personalised, and more equitable.

BSol ICS is working together on thisadvanced approach to resource allocation in maternity services and will receive in-depth support and guidance to carry out this project. This is a recognition of both the scale and complexity of our Local Maternity and Neonatal System (LMNS) and our commitment to improving outcomes for families.

Our area faces unique challenges:

  • High number of birth across a diverse population.
  • Persistent inequalities in outcomes between communities.
  • Variation in patient experience and service delivery.
  • Workforce and financial pressures that demand smarter use of resources.

What we’re doing

We are applying two proven methodologies to look at our Maternity services. These methodologies are;

  • Socio-technical Allocation of Resources (STAR): A structured, participatory approach that combines technical analysis (costs, outcomes, value-for-money) with stakeholder input.
  • Multi-Criteria Decision Analysis (MCDA): A systematic framework for weighing multiple priorities—such as safety, effectiveness, equity, and patient experience.

Together, these approaches provide a transparent, evidence-based way to make resource decisions that balance clinical priorities, patient voices, and financial sustainability.

The insights from this review will not only inform local improvements but also contribute to learning across the NHS.

This opportunity will contribute to the wider national ambitions set out in Better Births, the Three-Year Delivery Plan for Maternity and Neonatal Services, and the Core20PLUS5 framework, ensuring equity and safety are at the heart of maternity care.

Why this matters

Although BSol’s maternity services are not under any formal national review scheme, we are not complacent and are constantly seeking to improve care wherever we can.

Our patients and communities deserve care in the right place delivered in the right way at the right time, therefore we are delighted to be able to use an approach that could support us in;

  • Overcoming persistent inequalities in maternity outcomes across our diverse populations.
  • Ensuring we create pathways that withstand increasing pressure from high birth volumes, workforce challenges, and financial constraints.
  • Delivering transparency, equity, and care that better meets the needs of our communities aligned with Better Births, the Three-Year Delivery Plan for Maternity and Neonatal Services, and the Core20PLUS5 framework.

How it works

The project will run through four phases:

  1. Programme Set-Up: Governance, stakeholder engagement, and planning.
  2. Data Collection: Gathering evidence on costs, outcomes, and population needs, including the voice of staff, and women and families.
  3. Decision Conferences: Facilitated workshops where clinicians, managers, and representatives of those who accessed maternity services, agree priorities and recommendations.

Implementation & Evaluation: Turning recommendations into action and sharing learning across the system.

Who’s involved in the project

Key organisations across the ICS are working together to deliver this project. This includes:

  • BSol ICB
  • Birmingham Women’s and Children’s NHS Foundation Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • Wider NHS Provider Organisations
  • Birmingham City Council
  • Solihull Metropolitan Borough Council
  • Maternity and Neonatal Voices Partnership (facilitated by Gateway Family Services)
  • Voluntary Sector Organisations

What we hope to achieve

This is undoubtedly an ambitious project and the success of this will depend on multiple factors. Through collaboration and participation across the LMNS, we aim to deliver;

  • Resources aligned to interventions that deliver the greatest health benefit and equity.
  • Decisions that are transparent, inclusive, and grounded in evidence.
  • Improved outcomes for families and measurable reductions in inequalities within 12–24 months.

How you can be part of this important work

We are keen to include all the views and experiences of people who are connected to our maternity system.
If you would like to be involved in this project please provide your details using the fields below and we will get in touch with you.

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