Maternity services under scrutiny with many in crisis

When the Ockenden review into the maternity services at the Shrewsbury and Telford Hospital NHS Trust highlighted that inadequate care had led to 300 babies dying or being left with brain damage, it was clear that steps would need to be taken to ensure that such a tragedy did not happen again. Urgent guidance was provided to maternity services across the country advising that improvements to safety must be made.

The Ockenden review has now moved on to Nottingham University Hospitals NHS Trust and it has been revealed this week that it is set to be the largest review of maternity services in the UK with 1700 families’ cases to be examined.

Healthcare Safety Investigation Branch (“HSIB”) are also involved in considering maternity care, recently they were commissioned to undertake a review surrounding a number of maternal deaths and maternal collapse events in 2021/2022 at University Hospitals of Derby and Burton NHS Foundation Trust. The maternity learning review highlighted a number of safety recommendations together with noting delays in care, staff shortages and bullying. In early 2023 UHDB engaged with the NHSE Maternity Improvement team with the aim to improve their maternity provision. We are acutely aware that there are ongoing issues with the maternity services provision in Derby. We are currently acting on behalf of 26 patients who have been directly impacted by the treatment they received at UHDB and feel in light of the increased spotlight upon maternity services across the country that this figure will likely increase.

With maternity services across the country clearly facing significant challenges, the Care Quality Commission (“CQC”) commenced a maternity inspection programme. The aim of such programme was to improve the quality and safety of maternity care across England. They pledged to inspect all NHS acute hospital maternity services that had not been inspected and rated since April 2021.

Analysis carried out by the Observer newspaper shows that of the 45 maternity services that have been inspected by the CQC to date as part of the inspection programme nearly half are substandard, with six having been declared as inadequate and 15 have been rated as “requires improvement”.

We have reviewed a number of the inspection reports produced by the CQC and there are trends appearing across the NHS. Staffing within maternity services is often below planned numbers. Such shortages can lead to the safety of women and babies being put at risk. Delays in access to triage services and fetal monitoring is a further problem area, again such delays can put the safety of patients at risk. When incidents are happening there appears to be inconsistency as to how they are reported. Whilst often they are reported in accordance with policy, there have been instances found by the CQC where significant harm has occurred and yet they have only been graded as “No harm” or “Low harm”.

Carolyn Jenkinson, the CQC’s deputy director of regulatory leadership, said: “Many women and people using NHS maternity services receive good, safe care during pregnancy, labour and postnatally, but sadly that’s not everyone’s experience".“At some NHS trusts we have found that issues such as the quality of staff training, a lack of robust risk assessment and a failure to engage with, and listen to, the needs of women and their families are impacting on the safety of services. We have been clear with those hospitals where action must be taken and clear that there must be sufficient investment to ensure that services have the right numbers of staff, with the right training, to enable them to deliver consistently high quality, safe and personalised maternity care for all".“In recent years there has been an increased national focus on maternity safety which is welcome and crucial to improvement, but the pace of change needs to be accelerated”.

NHS England are alert to the issues surrounding maternity services and understand that the provision needs to be safer. Earlier this year they published their three year delivery plan for maternity and neonatal services in the hope that this will lead to safer care for babies and their families.

Karen Reynolds, Partner within the Clinical Negligence team said: “Whilst the Ockenden reviews, HSIB findings and CQC reports are shining a light on the failures of maternity services across the country, these are all issues I have sadly dealt with many times before. Freeths are acting for a great number of people who have suffered a poor experience in their maternity care. Hospital Trusts must ensure they take on board all recommendations provided to them, to enable urgent improvements to be made to obstetric care, thus resulting in greater patient safety for the future.”

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Our clinical negligence team across Freeths has years of experience in dealing with the effects of poor maternity care, birth injuries to mother and baby and stillbirth. If you think that you, or a loved one, may have been affected by negligent medical care during pregnancy or birth, you are welcome to contact our team to discuss how we can help and support you:-

• Karen Reynolds, Partner on 0345 272 5677 or by email to karen.reynolds@freeths.co.uk
• Jane Williams, Partner on 0345 272 5724 or by email to jane.williams@freeths.co.uk
• Carolyn Lowe, Partner on 0186 578 1019 or by email to carolyn.lowe@freeths.co.uk