Is this the turning point for maternity care?

Concerns over NHS maternity care are very sadly seldom out of the news. As a lawyer who has specialised in birth injury claims over many years, it has been all too clear to me for a long time, that far too many women and babies, fail to receive anywhere close to adequate maternity care leading in some instances to devastating outcomes.
 

The breaking news is that Health and Social Care Secretary, Wes Streeting, has ordered a wide-ranging national investigation into NHS maternity and neonatal services. It follows a series of meetings between the Secretary of State and bereaved families and is said to come alongside a package of immediate actions to boost accountability and safety.

The Government says that the investigation will provide 'truth and accountability', drive urgent improvements and address systemic problems said to have been ongoing for more than 15 years. This investigation follows years of independent reviews into maternity services at individual trusts which have found many similar failings – including issues of safety and leadership, and culture, along with not listening to women.

I would however ask the question many families will also be asking –  will this new “rapid” investigation finally lead to meaningful change?

The investigation is to take place in two parts, with the first urgently looking at the ‘worst performing’ maternity and neonatal units in the country, including Sussex. The second part will look at the ‘entire maternity system’ with the aim of producing ‘one clear national set of actions’, bringing together the learning from previous inquiries.

Earlier independent reviews have included the Ockenden review in 2022, which found serious failings at Shrewsbury and Telford NHS Trust. In the same year a damning report was published relating to failures in maternity care at East Kent Hospitals University NHS Foundation Trust. This year Nottingham University NHS Trust was fined over £1.6 million for safety failings in relation to three mothers and their babies.

The new national effort will include liaising with clinicians, experts and – in my view crucially – families who have been harmed by failures in care. A National Maternity and Neonatal Taskforce has been set up, chaired by Wes Streeting, to include a panel of experts and bereaved families. The Nursing and Midwifery Council has said it looks forward to working with the independent taskforce to ‘drive forward urgent improvements, and tackle the scourge of health inequalities’.

Wes Streeting has been meeting affected families and forcefully comments: ‘What they have experienced is devastating – deeply painful stories of trauma, loss and a basic lack of compassion – caused by failures in NHS maternity care that should never have happened.’ Further, in a speech at the Royal College of Obstetricians and Gynaecologists on Monday, Mr Streeting is reported as saying that families ‘describe being ignored, gaslit, lied to, manipulated and damaged further by the inability for a trust to simply be honest with them that something has gone wrong’.

Tackling racial inequalities in care
 

The inequalities faced by women from black, Asian and deprived backgrounds is to be an area of focus. An anti-discrimination programme to tackle these inequalities has been announced by Wes Streeting as part of a series of immediate measures. Racial disparities in maternity care are already well documented, with black women being almost four times more likely to die during pregnancy or childbirth than white women. Black babies are more than twice as likely to be stillborn than white babies.  

Surprisingly, it was recently reported that data is not being collected by the NHS with regard to the ethnicity or nationality of people bringing maternity claims of clinical negligence. I consider that it is vital that this data is properly collected to enable this shocking disparity in care to be better understood and addressed. However, I do question if in fact it is this very same cohort of women, (who are so frequently unseen and unheard) who do not have the resources, information, or support, to pursue a clinical negligence claim in the first place.

The national investigation is to begin this summer and is expected to report by Christmas. Given the length of time such investigations can take I very much hope that this short 5-6 month “rapid” investigation will be of sufficient detail and content to lead to workable, practical changes and will not simply end up on the shelf after a short-lived period of nationwide publicity. 

I have previously blogged on various NHS initiatives with the aim of learning from mistakes, with the goal of achieving maternity improvements, more swift access to justice, and a reduction in the costs associated with medico-legal claims. There has been a great deal done already, with all good intent, to identify failings and to address areas for improvement. However, the catalogue of poor care across the UK sadly continues and there can be no doubt that each and every pregnant woman deserves a far better service than is currently being delivered.