OBJECTIVES: To perform an early-stage economic analysis for adopting the Fit for Labour (FfL) test in the labour management pathway and to assess potential cost savings from improved Cardiotocography (CTG) interpretation for three hypothetical scenarios within the NHS in England.

METHODS: The FfL test is a clinical decision-support tool designed for use at the onset of labour to identify a baby at risk of brain damage or death due to lack of oxygen during childbirth so that a caesarean section can be performed, if needed, in a timely manner. A key outcome is improved CTG interpretation, providing a risk score using individual clinical risk factors, leading to better decision making. A literature review was performed to identify costs associated with labour management and adverse events. An early-stage economic analysis was conducted to assess the potential utility of introducing the FfL test into the labour management pathway. Possible cost savings from implementing this novel decision support tool were modelled in three hypothetical scenarios: reducing the need for additional health professional “fresh eyes support” to interpret CTGs, reduction in cerebral palsy incidents and improved decision-making for caesarean section. This early economic analysis demonstrated the value of this novel tool identifying cost savings in the labour management pathway.

RESULTS: The results suggest that all three scenarios analysed may benefit from the use of this novel decision support tool for enhanced interpretation of CTG traces; saving £49,681 based on a 2.5% annual reduction in “fresh eyes” support; saving £1,509,646 of NHS litigation costs if even 1 cerebral palsy incident was prevented and saving £596,197 annually if there is a 1% of reduction in caesarean section.

CONCLUSIONS: This hypothetical early-stage economic analysis indicates that implementing the FfL test in the labour management pathway could result in cost savings for the NHS in England.