Maternity care issues
Maternity services are in the spotlight. In 2015, the Morecambe Bay investigation found serious failings in maternity care and neonatal (newborn) services, after one mother and 11 babies died.
Since then, maternity services have had more policy recommendations than any other health area. But there have still been major service failures in Shrewsbury and Telford Hospital NHS Trust (the Ockenden review) and East Kent Hospitals University NHS Trust (the ‘Reading the signals’ report). A further inquiry into maternity care at Nottingham University Hospitals NHS Trust began last year.
If we do not start tackling these issues differently, there will be more tragedies. The repeated failings have led to the Healthcare Safety Investigation Branch’s (HSIB) maternity investigation programme, which aims to work with families and Trusts to bring about lasting changes to maternity care.
The latest national maternity survey shows a decline in people’s positive experiences of using maternity services. The areas that need improvement include staff availability, confidence and trust, and communications and interactions with patients.
Another recent survey showed that 4 in 5 (84%) women have felt healthcare professionals were not listening to them. Women are not being listened to when they raise concerns about their pregnancies, babies or their own health. This risk is even higher for women who are Asian, Black or Mixed ethnicity. UK studies, including a recent Birthrights report, have shown these women often had worse maternity outcomes and experiences. They also expressed more worries about labour, birth, and possible medical interventions.
In a survey by Five X More, 43% reported feeling discriminated against in their maternity care, with the most common reasons being race and ethnicity. CQC’s most recent State of Care report says Black women are four times more likely to die in pregnancy and childbirth than White women. For Asian women it is two times more.
Complaints and failings
The Parliamentary and Health Service Ombudsman shares common themes from complaints we investigate to help NHS organisations improve their services.
We upheld or partly upheld 27 maternity complaints between 2020 and 2022. More than half (65%) of these involved communication issues. We also found failings relating to diagnosis, aftercare and mental health support.
These failings have led to injustices that have serious and long-lasting effects on families’ lives.
Investment and change
Many of the issues are well known, and there has been a significant investment of time, energy and money to improve maternity care.
We welcome the £127 million funding boost the Government announced on 24 March 2022 for maternity services across England. We also appreciate the hard work of healthcare staff to improve them, especially when the NHS is under such significant pressure.
We recognise that people working in maternity services want to provide high-quality care. Culture, systems and processes can get in the way of achieving that goal.
But improvements are not happening quickly enough, and we have not seen sustainable change. We must do more to make maternity services safer for everyone.
Listening to families
Families have explained that they want what happened to them to matter. They want to make sure voices like theirs are listened to and heard. They want NHS organisations to make meaningful and sustained changes so that what happened to them will not happen to others in future.
We hope the stories and guidance in this report will empower more people to share their experiences of maternity care and understand their right to complain. Complaints can make a real difference by showing how the issues are affecting people’s lives. They can help organisations to learn from mistakes and improve services for everyone.