Despite efforts to reduce healthcare disparities, socioeconomically deprived and ethnic minority populations continue to face worse outcomes in maternity and neonatal care. Reports like Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries by MBRRACE-UK highlight that these groups experience higher risks and worse clinical outcomes. The problem is compounded by operational inefficiencies that prevent personalised care, which further exacerbates health inequities. Healthcare systems are often unable to respond effectively to the diverse needs of these vulnerable populations.

The challenge lies in not only improving the care provided but also ensuring that healthcare systems are designed to address these disparities. Currently a lack of operationally oriented research limits progress in designing and implementing effective solutions. Without interventions that are both targeted and efficient, health inequalities will persist, limiting access to necessary care and worsening health outcomes for those most in need.

This research takes an evidence-based approach to improving maternity care by leveraging patient-level data from MSDS and its linked datasets, which for the first time includes public records from the COVID-19 pandemic and spans an extended time horizon. The study will employ advanced analytical techniques, including causal inference, machine learning, and stochastic modelling, to classify patients into clinically relevant clusters and identify the key factors that drive disparities in outcomes for deprived and minority populations. The research will evaluate the effectiveness of operational interventions, such as continuity of care, and explore the impact of digital tools, including SMS reminders with cognitive nudges, on reducing late antenatal bookings, missed appointments, and improving patient engagement and health outcomes during pregnancy.

Leveraging recent, granular data to provide a holistic view of maternity services in England, the aims is to provide evidence-based, actionable insights for NHS, supporting targeted interventions at the local level. The focus of this research is on improving care delivery for socioeconomically deprived and ethnic minority populations, ultimately advancing health equity. Overall, this study contributes to the academic

literature on healthcare operations management, and aligns with the growing national effort to identify and address the drivers of health inequality in maternity care.