Maternity care in England ‘requires improvement’, according to the evaluation by the Health and Social Care Committee’s expert panel, published in July 2021 and which assessed the Government’s progress against its policy commitments.[1]

In introducing the report, the Committee said: “…there remains worrying variation in the quality of maternity care which means that the safe delivery of a healthy baby is not experienced by all mothers”.

This week, on the 17th, we recognise World Patient Safety Day; this year the theme is maternal and newborn safety.

Focus on maternal health and safety

For us in the UK, the focus is timely.  Currently patients in Nottingham are demanding an investigation into poor care at their local maternity unit, which the Care Quality Commission rated as ‘inadequate’ in December 2020.  

At University Hospitals of Morecambe Bay NHS Foundation Trust, the subject of a major investigation into failings of maternal and newborn safety in 2015,[2] the CQC has given the trust an overall rating of requires improvement.  This must be heart-breaking to the families who campaigned so hard to have the trust investigated and who had every right to believe things would improve permanently following the Kirkup investigation.[2]

While childbirth in the UK is generally a safe event, progress to improve safety seems to have stalled, and how safe mums and babies are depends on where you are and who you are.

Black women are four times more likely than white women to die in pregnancy or childbirth.[3] Asian heritage women have a twofold risk and women living in deprivation are almost three times more likely to die than those in the most affluent areas of the UK.[3] This week there was a debate in the House of Commons as part of Black Maternal Health Awareness Week, a weeklong campaign dedicated to raising awareness about the disparities in maternal outcomes for Black women and developed by the grassroots organisation, Five X More.

Patient Partnership

crying newborn in the arms of her motherFrom our perspective as champions of patient partnership, we were particularly interested in the panel’s ‘inadequate’ rating for personalised care. We firmly believe that involving patients in their care improves outcomes and safety. Mums-to-be developing plans with the midwives and obstetricians seems a perfect example of this.

And the expert panel agrees: “Personal care and support plans are critical for improving women’s experience and outcomes and to embed the legal principle of informed consent within maternity care.” But it found that only a very small percentage of women had such plans and there was no evidence to enable the panel to assess the extent to which the plans were used or if they improved care or outcomes. 

The expert panel’s report and our own research show that clinicians meaningfully partnering with patients is not mainstream practice.  It will take leadership, training and funding to make patient partnership in maternity care everyday practice.

This World Patient Safety Day we call on all those in a position to bring about change in how maternity care is delivered and to pledge to introduce true patient partnership.

[1] Health and Social Care Committee. The safety of maternity services in England: Fourth Report of Session 2021–22. 6 July 2021. Available at: https://committees.parliament.uk/publications/6578/documents/73151/default/. Last accessed September 2021.

[2] Kirkup, B. The Report of the Morecambe Bay Investigation. March 201. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/408480/47487_MBI_Accessible_v0.1.pdf. Last accessed September 2021.

[3] MBRRACE-UK. Saving lives, improving mothers’ care. Dec 2020. Available at: https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/MBRRACE-UK_Maternal_Report_Dec_2020_v10.pdf. Last accessed September 2021.