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Health secretary vows to make maternity care safer

Extra funding for services and training, and greater transparency, will make birth safer

Louise Prime

Tuesday, 18 October 2016

The health secretary has vowed to dramatically improve NHS maternity care with a series of new measures including extra funding to support safe maternity provision and better staff training, encouraging a culture of transparency and learning from mistakes, and a new public health campaign to raise awareness of key issues that can lead to stillbirth. Obstetricians and midwives have largely welcomed Jeremy Hunt’s announcement, but the Royal College of Midwives cautioned that implementing the plans and achieving the ambitious targets within could be challenging given the current huge pressures on maternity services.

Mr Hunt said his safer maternity care action plan includes “comprehensive” measures to provide resources for trusts to improve their approach to maternity safety, including £8 million for multi-disciplinary training, with at least £40,000 available to each NHS trust in England; and encourage lessons to be learned from mistakes and shared openly and transparently across the NHS. The plans include:

  • a £250,000 maternity safety innovation fund to help create and pilot new ideas for improving maternity care
  • publishing new maternity ratings for every clinical commissioning group (CCG) across the NHS to improve transparency and raise standards
  • a new national Maternal and Neonatal Health Quality Improvement Programme for all trusts to exchange ideas and best practice – a similar scheme in Scotland was linked to a 19% decrease in stillbirths over a 3-year period
  • a consultation to develop a ‘safe space’ to allow clinicians to speak openly about things that go wrong without fear that information they disclose may be used against them in court or professional misconduct hearings
  • the Healthcare Safety Investigation Branch, modelled on the highly successful Air Accident Investigation Branch, which will begin in April 2017.

Mr Hunt said the current ‘litigation culture’ can prevent openness and transparency, and the government is considering a new voluntary compensation scheme as an alternative to costly legal processes. Families currently wait an average 11½ years for resolution of a case., but the rapid resolution and redress (RRR) scheme could investigate and learn lessons from more than 500 incidents a year, and in cases where it found harm was avoidable would offer timely access to financial support without the current obligation on families to launch a formal legal process.

The health secretary also announced a partnership with Sands and Best Beginnings aimed at halving by 2030 rates of neonatal death, stillbirth, maternal death and brain injuries caused during or shortly after labour. The Our Chance public health campaign aims to raise awareness of factors that can lead to stillbirth, such as reduced foetal movement, itching, and smoking; and advise women on lifestyle changes that can improve their likelihood of a better pregnancy outcome.

The Royal College of Midwives said it welcomed and fully supported the “ambitious” plan, in particular the focus on transparency and learning from mistakes, public health and increased funding. But chief executive Cathy Warwick warned: “I do, however have concerns about the ability of maternity services to fully implement the plan and achieve the ambitious targets in the current climate … heads of midwifery are having to make significant savings. They believe these are starting to have a negative impact on the care women and babies receive.”

She pointed out that there is already a shortage of 3,500 midwives in England, and warned that as birth rates are rising and births becoming increasingly complex: “It is essential that staffing numbers are optimal if safety is not to be compromised.”

Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists said the College also welcomed the government’s commitment and investment, but was concerned that growing pressures on maternity services and stretched and understaffed services are affecting the quality of care provided to mothers and babies. She added that the RRR scheme has the potential to save lives and improve outcomes for both mothers and babies and said there is “a continued need to build a culture of openness, honesty and transparency in order to prevent past mistakes being repeated”.

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