A major review of NHS maternity services is underway, with members of the public invited to share their experiences of maternity and obstetric care.
What is the review, and why does it matter?
The review follows the Morecambe Bay scandal in 2013, in which avoidable baby deaths spanning nearly a decade were found to be due to a 'lethal mix' of shortcomings at Furness General Hospital. Midwives were reported to have colluded to cover up failings, with attention finally being drawn to the unit in 2011 by campaigners.
The scope of the Morecambe Bay failings resonated on a national level. 'Geographical and professional isolation', suppression of potential whistleblowers and failure to carry out internal investigations are problems to which the whole of the NHS can be vulnerable; hospital trusts across the country are over-stretched and under-resourced, and finding a way to reinvigorate areas of NHS practice is a challenge that must be addressed proactively.
The review will scrutinise all current maternity care offered by the NHS. In its review document, NHS England has said that:
- Many women face significant risks, poor experiences and 'still too often, heartbreak and loss';
- Whilst 25% of women want to give birth in a hospital, over 85% actually end up doing so;
- Homebirths are a safe option, and should be made more readily available and presented as an appropriate option for pregnant women.
Many of those with an interest in the review are watching to see how these opening statements from NHS England are borne out by the results of the review. Some are surprised, for example, that NHS England has cited so many women wanting home births.
The relationship between patient choice and service provision is one of the key arguments in the maternity care debate, and it is hoped that the findings of the review will shed more light on the state of play in this area.
The cost of failings in maternity care
NHS England has confirmed that 35% of all clinical negligence claims are for injuries sustained during childbirth. The cost of maternity clinical negligence cover in 2012-2013 was £482 million – an unarguably worrying figure.
We hope that the review, which will be independently chaired by Baroness Julia Cumberlege, will promote positive changes that are felt at patient level. In addition, it is highly likely that there will be findings of clinical staff struggling to provide safe care under enormous pressure; we would want to see staffing and resourcing issues addressed, to provide maternity professionals with the environment they need to carry out their roles effectively.
NHS England has promised to produce new models of care and to improve professional culture and accountability in maternity and obstetrics.
This, hopefully, will put an end to the backs-to-the-wall atmosphere identified in the Morecambe Bay saga. NHS England has also pledged to make the procedure for the final review transparent and accessible.
Having your say
Anyone interested in maternity services is invited to take part in the survey, and there will be regional drop-in events where people can share their personal and professional views. An online survey, open until 31 October 2015, is also available for anyone to complete anonymously. Fathers and families are welcome to participate.
It is not often that a whole sector of the NHS receives an audit as searching as this.
We hope that as many people contribute to the review as possible, and that the results of the review are released in an open, frank and honest way.
This is an opportunity to take positive steps towards improving the childbirth experience and promoting safety for mothers and babies.