Manuscript Title National variation in emergency caesarean section decision-to-delivery interval reporting in NHS Trusts: a national quality improvement analysis using publicly available data Author

Manuscript Title National variation in emergency caesarean section decision-to-delivery interval reporting in NHS Trusts: a national quality improvement analysis using publicly available data Author | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 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Data may be preliminary. 25 January 2026 V1 Latest version Share on Manuscript Title National variation in emergency caesarean section decision-to-delivery interval reporting in NHS Trusts: a national quality improvement analysis using publicly available data Author Author : David Agunede 0009-0006-5977-9823 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176930288.89996970/v1 150 views 81 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract makecell, tabularx makecell, tabularx Objective To evaluate national variation in emergency caesarean section activity and the transparency of public reporting of decision-to-delivery interval (DDI) performance across NHS Trusts in England, and to identify system-level quality improvement opportunities. Design National quality improvement analysis using publicly available, aggregated maternity data. Setting NHS maternity services in England. Population or Sample All NHS Trusts providing consultant-led maternity services and reporting emergency caesarean section activity during the final September 2025 reporting period. Methods Emergency caesarean section activity data were extracted from the NHS Maternity Services Data Set (MSDS). Trust-level volumes were recorded and publicly available Trust maternity reports were reviewed to assess whether DDI performance was reported. Descriptive analysis was undertaken to examine variation in activity and transparency of reporting. Main Outcome Measures Emergency caesarean section activity volume and presence or absence of publicly reported DDI performance. Results A total of 119 NHS Trusts were included. Emergency caesarean section activity ranged from 25 to 380 procedures per Trust, demonstrating substantial variation in service volume. DDI performance was not reported within the national MSDS, and public reporting of compliance with the recommended 30-minute standard varied between Trusts, limiting national benchmarking of time-critical obstetric care. Conclusions Despite routine national reporting of emergency caesarean section activity, DDI performance is not consistently or transparently reported across NHS Trusts. Standardized reporting of DDI metrics may support benchmarking, identification of variation, and system-level improvement in emergency obstetric care. Supplementary Material File (emergency_csection_ddi_nhs_qi.xlsx) Download 26.14 KB File (rcog.docx) Download 45.48 KB File (table1_regional_ecs.docx) Download 36.18 KB Information & Authors Information Version history V1 Version 1 25 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords delivery: breech delivery: caesarean section general obstetrics health services research maternity services medical education Authors Affiliations David Agunede 0009-0006-5977-9823 [email protected] Independent Researcher View all articles by this author Metrics & Citations Metrics Article Usage 150 views 81 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation David Agunede. Manuscript Title National variation in emergency caesarean section decision-to-delivery interval reporting in NHS Trusts: a national quality improvement analysis using publicly available data Author. Authorea . 25 January 2026. DOI: https://doi.org/10.22541/au.176930288.89996970/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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