Failings in NHS maternity services are so ‘widespread’ they risk becoming ‘normalised’, a damning report warns today.
As a major review found that dire care is ‘not isolated’ to high-profile scandals like East Kent and Shrewsbury and Telford, where hundreds of babies and mothers died or suffered preventable harms, Wes Streeting described the situation as a ‘national shame’.
The Care Quality Commission (CQC) said two-thirds of the services either ‘require improvement’ or are ‘inadequate’ for the safety of mothers and babies.
It stressed that many are not learning from mistakes, instead choosing to treat incidents as ‘inevitable’ rather than accept accountability.
In an unprecedented move, the regulator called for ‘increased national action’ and ring-fenced investment to tackle the shortfalls.
Health Secretary Wes Streeting speaks at an Institute for Public Policy Event on September 18
Mr Streeting described a report into the failings of NHS maternity services as a ‘national shame’ (Stock Image)
But campaigners say the recommendations do not go far enough, warning ‘countless lives are being forever torn apart’ in the meantime.
Last night, Mr Streeting vowed to fix maternity services, insisting that the current state of affairs keeps him ‘awake at night worrying’.
The Health Secretary said: ‘These findings are cause for national shame.
‘Women deserve better – childbirth should not be something they fear or look back on with trauma.
‘It is simply unacceptable that nearly half of maternity units the CQC reviewed are delivering substandard care.’
NHS maternity care has been under increased scrutiny following several high-profile inquiries, including more than 200 baby deaths at the Shrewsbury and Telford Hospital NHS Trust, and the investigation into maternity services in East Kent.
Inspectors visited 131 units between August 2022 and December 2023 as part of a national programme to reverse the trend.
The report blamed poor management of incidents with limited learning when things go wrong, failure to ensure safe and timely assessment at triage, unsuitable estates and access to essential equipment, a lack of oversight from trust Boards and significant challenges in recruiting and retaining staff.
It concludes: ‘Without action, the danger is that poor care and preventable harm will become normalised. We cannot and must not let that happen.’
Last night, Mr Streeting vowed to fix maternity services, insisting that the current state of affairs keeps him ‘awake at night worrying’ (Stock Image)
Almost half (48 per cent) were rated as requires improvement or inadequate while only four per cent were classed as outstanding and 48 per cent were rated good.
The CQC said the safety of maternity care ‘remains a key concern’ with no services rated outstanding, 47 per cent requiring improvement, 18 per cent rated inadequate and only 35 per cent, good.
Incidents are poorly managed and not learned from, with the potential to normalise serious harm in maternity, it said.
Not all patients received a safe and timely assessment when being triaged, with instances of triage phones going unanswered and some women discharging themselves before being seen by a midwife or doctor as delays were so severe.
While complications such as postpartum haemorrhages are well recognised by maternity staff, the ‘significant impact’ on women is often overlooked.
Some NHS estates were described as ‘not fit for purpose’, lacking the ‘space and facilities and, in a small number of cases, appropriate levels of potentially life-saving equipment’.
There are also concerns about how maternity staff communicate and engage with women and their families.
A damning inquiry found hundreds of avoidable baby deaths and brain damage cases at the maternity ward at Royal Shrewsbury Hospital (pictured)
More than 1,400 cases at the Royal Shrewsbury Hospital (pictured) have been reviewed – with most taking place between 2000 and 2019
Nicola Wise, director of secondary and specialist care at the CQC, said: ‘Although we’ve seen examples of good care and seen hardworking, compassionate staff doing their best, we remain concerned that key issues continue to impact quality and safety.
‘Disappointingly, none of those issues are new.’
The report makes a number of recommendations to NHS trusts, NHS England and integrated care boards including better data collection and letting affected parents have more involvement in any care reviews.
It also called for the Department of Health and Social Care (DHSC) to invest more in maternity services and work with NHS England to ensure this is ring-fenced.
But James Titcombe, whose son Joshua’s avoidable death in 2008 prompted the Morecambe Bay Inquiry, said they do not go far enough.
He told the Mail: ‘We urgently need a national process that looks at the system as a whole, including an honest analysis of why previous attempts to reform maternity safety have fallen short.
‘This work is badly needed, otherwise the forthcoming 10 year plan for the NHS developing by our new government risks being yet another missed opportunity for maternity safety – and the cost will be measured by more avoidable tragedy and lives forever shattered.’
James Titcombe (pictured) urged the government to take action, saying ‘the cost will be measured by more avoidable tragedy and lives forever shattered’
His son Joshua Titcombe (pictured) died after suffering pneumococcal septicaemia and a lung haemorrhage on November 5 2008, nine days after he was born at Furness General Hospital in Cumbria
Kate Brintworth, NHS chief midwifery officer, admitted large numbers of women and families are still being let down.
She said: ‘We know there is much more we need to do to drive up standards of care and build on improvements already made, and we will continue to provide intensive support to the most challenged trusts and support a growth in the maternity workforce.’
