The Healthcare Commission has urged the NHS to redouble efforts to improve maternity services following a major review of 150 NHS Trusts. The watchdog requested the review after concerns were raised over the safety and quality of care. The regulator carried out three separate investigations into deaths at maternity units during a two-year period.
The review found that most women have a generally favourable view of services with, for example, 89% rating care during labour as good or better. But there were significant differences between Trusts, with this figure being 96% in one Trust and 67% in another.
The Commission called upon Trust boards to make maternity care a higher priority after finding that in some Trusts:
• Levels of staffing were well below average, indicating that they may not have been adequate.
• Consultant obstetricians did not spend the time on labour wards recommended by their professional body.
• Doctors and midwives did not attend in-service training courses.
• There was not adequate continuity of care.
• Recommendations for antenatal care were not adequately adhered to, particularly in the case of women whose pregnancies were likely to be more risky.
• There was poor communication, care and support after women had their babies.
• There were too few beds and bathrooms, particularly in labour wards.
Commenting on the release of the Commission’s report, Better Births – A Review of Maternity Services in England, Dame Karlene Davis, general secretary of the Royal College of Midwives, said: “The good news is that many women are happy with the service, and that many Trusts are making great efforts to further improve their maternity care. It is a great shame that the good examples are overshadowed by the bad ones.
“Trust bosses have got to take maternity services more seriously than they have in the past. I am concerned on the back of the Lord Darzi Review of the NHS, that the strategic health authority regional vision documents, released recently, show little evidence that maternity services are a priority. We expect it, the Government expects it, and most important of all, midwives and mothers expect it. This requires more staff, better facilities and a service that offers real choice.
“The Government has given a commitment to have 4,000 more midwives by 2012, yet I see no evidence to suggest we are anywhere near hitting that target. There is also no evidence that the promises in the Maternity Matters document for more choice for women are anywhere near being met.”
