Scott Haslam, Director in the Clinical Negligence Team at Wake Smith discusses recently reported statistics regarding safety in maternity services in England.
As I drove my children to school and nursery this morning, my attention was drawn to the radio when the 8am news bulletin included a section on, as the newsreader put it “The ongoing maternity crisis in the NHS in England”.
As a Clinical Negligence Solicitor, such stories often resonate as we tend to see the worst examples of clinical care, but what I found most staggering were the figures being reported, particularly as the analysis seemed to be based on data provided by the Care Quality Commission (CQC) – the body responsible for assessing the quality and safety of care provided.
Upon reaching my desk, I located the relevant article on the BBC’s website. Those wishing to consider the BBC’s article for themselves can find it here: https://www.bbc.co.uk/news/health-62569344
It appears that the BBC’s analysis that “More than half of maternity units in England fail consistently to meet safety standards” is based on all currently reported CQC inspections of maternity units across England.
It is therefore important to understand that not all inspections take place at the same time.
There are currently 137 maternity units across England. Some of them were last inspected a number of years ago and so the standards may have changed within that time (and particularly during the COVID-19 pandemic), however, the data does provide a snapshot of the current situation as last assessed by the CQC.
Based on the data available on the CQC’s website (freely accessible to anyone at: https://www.cqc.org.uk/), it is clear that the current CQC inspection findings have assessed:
- 6 maternity units as outstanding;
- 77 units as good;
- 45 units as requiring improvement; and
- 9 maternity units as inadequate.
It is important to note that these ratings are the ‘overall’ scores or ratings given to maternity units which take a number of factors into account. There are, however, separate ratings given for each of the constituent parts, including safety.
The CQC’s assessments for safety confirm that as of September 2022, 9 (approx. 6.5%) out of the 137 maternity units in England are rated as inadequate for safety which essentially means that urgent action is required to prevent avoidable harm to mothers and babies.
A further 66 maternity units (48%) ‘require improvement’ on safety issues. These improvements are required to reduce the risk to mothers and babies and ensure legal requirements on safety are met, such as safe staffing levels.
62 maternity units in England (45%) currently have a ‘good’ rating for safety, recognising that they are taking steps to reduce the risk of avoidable harm to mothers and babies and that legal requirements on safety are being met.
Currently, none of the 137 maternity units in England have an ‘outstanding’ rating for safety. This would only be awarded where there is a comprehensive safety system in place.
Clearly there are ongoing issues with maternity care and services across England, but these figures are particularly concerning for two reasons.
The first is that the assessment suggests that less than 50% of maternity units have good safety ratings. The second is that this seems to have fallen since a similar assessment of the data in 2016, when 50% of units had good safety ratings.
I find the timing of the BBC’s assessment of the CQC’s data of particular interest because 30 September 2022 will mark the six-month anniversary of the Ockenden review of maternity services at Shrewsbury and Telford Hospital NHS Trust being published.
Whilst that review largely focused on the maternity services provided at one NHS Trust, the subsequent report also identified 15 key Immediate and Essential Actions to improve all maternity services in England, including financing a safe and sustainable maternity and neonatal workforce and ensuring training for the whole maternity team meets the needs of today’s maternity services.
The Government had already announced plans for additional funding for maternity services, and to significantly increase staffing levels in maternity units across England.
What is clear is that failures in safety do not appear to be isolated to a handful of units, but appear to be much more widespread within maternity units across England.
This is also not a new issue. Recent years have included:
- A report of the investigation in maternity services at Morecambe Bay in 2015;
- This led to the publication of Better Births in 2016 which sort to ensure safer and more personalized care across England and to halve the rates of stillbirths, neonatal mortality, maternal mortality and brain injury by 2025;
- The Ockenden Review of Maternity Services at Shrewsbury and Telford Hospital NHS Trust, published in 2022;
- An ongoing Independent Investigation into East Kent Maternity Services, which is expected to report in the coming months; and
- The recently announced Independent Review of Maternity Services at Nottingham University Hospitals.
Those of us working within Clinical negligence know that, in reality, birth injuries make up a small percentage of claims against the NHS, but they account for a much greater proportion of the cost of clinical negligence claims to the NHS.
Damages in such cases are often significant, and so improving safety within maternity services in England would potentially save the NHS considerable sums in compensation and legal costs.
More importantly, there are mothers and babies at the heart of these statistics and surely one thing everyone can agree on is that one mother or baby experiencing genuinely avoidable harm, is one too many.
To discuss a clinical negligence issue call Scott Haslam at Wake Smith Solicitors on 0114 224 2127 or at [email protected]
