55 % of Maternity Wards Do Not Meet Safety Standards
BBC analysis of official statistics has recently released an article stating more than half of England’s maternity units are consistently failing to meet safety standards.
A recent report from the Care Quality Commission (CQC) shows that 7% of maternity units pose a high risk of avoidable harm and 48% require improvement. These figures are slightly worse than a few years ago despite efforts from the recently appointed chair for maternity review, Donna Ockenden, who has been tackling the growing issue of failing maternity safety standards in England.
The health regulator of CQC says that “the pace of improvement has been disappointing.”
CQC’s Safety Ratings
From the most recent CQC safety ratings published in September 2022 for 137 maternity units there are:
- 9 units that have been given the lowest possible rating of inadequate for safety, meaning urgent action is required.
- 66 units requiring improvements to reduce the risk to mothers and babies, and to ensure legal requirements on safety are met.
- 62 which have a good rating for safety.
- 0 units that were given the top rating of outstanding which would mean a comprehensive safety system is in place.
Comparing Safety Standards Pre-Covid
It is difficult to fairly compare the current ratings to older ones because the CQC has changed its approach to inspections. During the pandemic, the CQC changed to a risk-based approach, focusing on units they were more concerned about.
Despite this, in December 2016, 50% of maternity and gynecology units had good ratings compared to the 45% now.
Comments From the CQC’s Director of Secondary Care, on the Maternity’s Safety Standards
Victoria Vallance, CQC Director of secondary care informs that inspections usually find similar issues of maternity services not managing risks when women are deteriorating. She states “We are worried. We are concerned. We have not seen the pace in improvement consistently, nationally, that we would hope and expect to see across maternity services.”
Maternity Unit Safety Standards for Ireland, Scotland, and Wales
The CQC only inspects maternity units in England.
Northern Ireland’s Regulation and Quality Improvement Authority has not inspected care in maternity units yet but will in the Autumn of 2023.
NHS Wales says it has recognised the need for improvement in maternity units.
The Scottish government says it is transforming maternity services with its Best Start program.
Safety Standards at Frimley Park Hospital
Before delivering her baby at Frimley Park Hospital, Laura Ellis checked the CQC ratings where it was reported “good,” although she was unaware that it had recently been told that it required improvement on safety.
Laura went into labour after an easy pregnancy but within the first hour, it became clear that the baby was breech. This meant, instead of the baby being head-down in the womb, his legs and feet were first, making for a much more challenging pregnancy.
Laura remembers the “complete sense of panic” in the room and remembers that no one seemed to have any idea what they should be doing.
Just after the baby’s legs and chest had been delivered the midwife said she could feel a heartbeat, however, a few minutes later, a senior midwife tried to listen for the heartbeat through the stethoscope and said they could not hear anything. Laura says she was told that the stethoscope was broken.
When her son, Theo, was fully delivered, his heart had stopped beating.
Medical staff tried to resuscitate him. At one stage the oxygen canister used on Theo ran out, before being replaced. After 39 minutes midwives stopped resuscitation.
Laura says Theo was “the most perfect baby, just absolutely beautiful. It was just so hard. So hard to deal with. So hard to leave as well. How would you leave your baby in hospital when you should be taking them home?”
Frimley Park NHS Foundation Trust has said they are extremely sorry for what happened. In addition, they have made several changes since Theo died. The changes include an emergency response if a baby is unexpectedly breech during advanced labour.
Maternity Unit Failings Over the UK
Unfortunately, what has been seen in Frimley Park only echoes similar failings throughout Maternity Wards across the UK. Morecambe Bay, Nottingham and Shrewsbury, and Telford have recently been investigated with reports being launched into ways to improve the safety of mothers and babies in their care.
The Royal College of Midwives chief executive Gill Walton says there is an “ongoing crisis in maternity services” and more funds are badly needed.
“Every time there’s an inquiry, there’s a flurry of ‘we’re going to do this, this, and this.’ And then it falls off the agenda.”
Currently, the NHS in England needs 2,000 more midwives and almost 500 obstetricians. However, last year 500 midwives left the profession.
The government recently invested £127m to grow the NHS maternity workforce and improve neonatal care. This is in addition to the government spending £95m a year to boost maternity staff numbers.
Failings in Safety Standards Resulting in Maternity Claims
Every year NHS England pays compensation when medical negligence occurs due to failing safety standards. Of the 10,284 negligence claims last year, 12% (1,243) were for maternity. Maternity negligence claims cost the NHS more than any other medical specialty. This is because they tend to be an initial lump sum. This is followed by payments annually for the rest of the mum or baby’s life.
The NHS expects that 60% of the money it will pay out for last year will be for maternity negligence.
Health and Social Care Secretary to Set Out New Plan
In the wake of the recent statistics regarding the safety standards in the NHS, health and Social Care Secretary and Deputy Prime Minister, Thérèse Coffey, will set out ‘Our plan for patients.’ This will see patients receive easier access to NHS and social care this winter and next.
The new plans are set to:
- Build on the NHS winter plan. TThérèse Coffey will outline measures across the priorities that matter most to patients – ambulances, backlogs, care, and doctors and dentists
- Create a package of measures that will improve access to general practice. Therefore all patients who need an appointment can get one within 2 weeks. Additionally, plans are set to free up over one million appointments per year.
- Call on the public to do their bit as part of a ‘national endeavour’ to support the NHS and social care.
Nimish Patel, Medical Negligence Solicitor at AWH
Nimish Patel states “The news today that the reported incidents are worse than pre-pandemic are disappointing particularly as there has been a spotlight on maternity care and early reporting of incidents which was meant to lead Trusts to learn from the previous mistakes. The Ockenden review highlighted that as resources were scarce, there was a tendency to blame individuals for not following guidelines whereas there has been a failure to look at the underlying factors across the Trusts which have led to problems such as the nationwide lack of midwives in the service.”
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