Varied quality of maternity services in England

VARIATION in the quality and safety of England’s maternity services has been identified as an "ongoing concern" in a new report from the Care Quality Commission (CQC).

The Safety, Equity and Engagement in Maternity Services report draws on the findings from a sample of nine focused maternity safety inspections carried out between March and June 2021, along with insights gathered from interviews and direct engagement with various organisations representing women and their families.

The report found that many maternity units across the country are providing good care but there are "ongoing concerns about leadership and oversight of risk, team working and culture, and the extent to which services are engaging with and listening to the needs of their local population". It also highlights a "pressing need" to address inequalities in outcomes for Black and minority ethnic women and babies, which it says have been further exacerbated during the Covid-19 pandemic.

In particular, the CQC report noted variation in the "consistency and stability" of leadership teams in the services they inspected and that some services lacked a shared purpose and sense of a “united maternity team”. Poor incident reporting was a further theme, with staff not always recognising what constituted an incident or how to grade incidents correctly.

CQC inspections of maternity services as of 31 July 2021 found that four per cent were rated 'inadequate', 37 per cent were rated 'requires improvement', 58 per cent were rated as 'good' and one per cent were rated as 'outstanding' for the key question ‘are maternity services safe?’

Dr Edward Morris, President at the Royal College of Obstetricians and Gynaecologists, said: “We welcome this report by the CQC which acts to further identify the reason why just over 40 per cent of maternity units are now rated as either inadequate or requiring improvement.

“It’s discouraging to see that the issues highlighted in this report are ones we are all too familiar with - staff not having the right skills or knowledge; poor working relationships; poor risk assessments; and not learning from things going wrong. While the report acknowledges that progress is being made, the speed at which change is happening is far too slow. It’s tragic that these reoccurring failures are seriously impacting the health and wellbeing of the mothers and babies we healthcare professionals are trying to protect

"The past 18 months have put additional strain on a healthcare system that was already struggling. It’s vital we urgently put into practice these learnings and join up current programmes and resources within the maternity system to help the Government deliver on its manifesto promise to make the UK the best place in the world to give birth.”