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Found 820 results
  1. News Article
    One in five recent inspections of maternity services have raised concerns over “essential” breathing equipment for newborn babies, HSJ has found. Care Quality Commission (CQC) inspectors have flagged fears over shortages and overdue maintenance of resuscitaire, a device commonly used by midwives if babies require additional support with breathing. Experts say the equipment should be immediately available to ensure safe resuscitation. The CQC itself said the lack of such equipment was impacting patient safety at some hospitals. Read the full story (paywalled) Source: HSJ, 31 May 2024
  2. News Article
    Having an epidural during labour can reduce the risk of serious childbirth complications by 35%, according to research that suggests expanding access to the treatment may improve maternal health. An epidural is an injection in the back to stop someone feeling pain in part of their body. Making them more widely available and providing more information to those who would benefit from one was even more important than previously thought, researchers said. The study by the University of Glasgow and the University of Bristol involved 567,216 women who were in labour in Scottish NHS hospitals from 2007 and 2019, and went on to give birth vaginally or by an unplanned caesarean section. Of the total, 125,024 of the women had an epidural. Researchers analysed the rate of serious complications, including heart attacks, eclampsia, and hysterectomies during childbirth. Having an epidural cut the risk of these events by 35%, the study found. The lead author, Prof Rachel Kearns, of the University of Glasgow, said: “This finding underscores the need to ensure access to epidurals, particularly for those who are most vulnerable – women facing higher medical risks or delivering prematurely. “By broadening access and improving awareness, we can significantly reduce the risk of serious health outcomes and ensure safer childbirth experiences.” Read full story Source: The Guardian, 22 May 2024
  3. Content Article
    The Safe Learning Environment Charter supports the development of positive safety cultures and continuous learning across all learning environments in the NHS. It is underpinned by principles of equality, diversity and inclusion. It has been developed by over 2482 learners, educators and key stakeholders in health education. The Charter was created by NHS England in response to healthcare learners’ feedback on their clinical experiences in maternity services, set out in the Kirkup (2015 and 2022) and Ockenden (2020 and 2022) reports. The Charter is designed for learners and those responsible for supporting placement learning across all learning environments and all professions within them. It is aligned to the NHS People Promise in recognition that learners are vital to the workforce and are included in the promises NHS staff and leaders must all make to each other, to improve everyone’s experience of working in the NHS. The Charter sets out the supportive learning environment required to allow learners to become well-rounded professionals with the right skills and knowledge to provide safe and compassionate care of the highest quality.
  4. Content Article
    This is the second ‘saving babies’ lives’ progress report from the Joint Policy Unit. When the first report was published in May 2023, the Unit committed to reassessing progress each year. Through this process it aims to hold government and decisionmakers to account, helping to ensure that saving babies’ lives and tackling inequalities in pregnancy and baby loss are the political priorities they deserve to be. This years report highlights that maternity services need a much more transformative approach from government, that matches the scale and impact of the issue. Maternity services are not on course to meet government ambitions to reduce rates of stillbirth, neonatal death or preterm birth, and there continue to be stark and persistent inequalities in rates of pregnancy and baby loss by ethnicity and deprivation. View a summary version of the report
  5. Content Article
    On 9 January 2024, the All-Party Parliamentary Group (APPG) on Birth Trauma established the first national inquiry in the UK Parliament to investigate the reasons for birth trauma and to develop policy recommendations to reduce the rate of birth trauma. Seven oral evidence sessions took place on consecutive Mondays between 5 February and 18 March 2024 in the House of Commons. The Inquiry was also informed by written submissions which were received following a public call for evidence. The inquiry received more than 1,300 submissions from people who had experienced traumatic birth, as well as nearly 100 submissions from maternity professionals. It also held seven evidence sessions, in which it heard testimony from both parents and experts, including maternity professionals and academics.
  6. Content Article
    This BMJ opinion piece highlights that seeing women’s health as synonymous with sexual, reproductive and maternal health means that gaps remain in health provision to meet the wider needs of women. The Government recently outlined its 2024 priorities that build on the 2022 Women’s Health Strategy for England. The authors welcome the focus on specific areas of need, but highlight that the priorities reinforce a traditional view of women’s health and miss an opportunity to encourage policymakers, healthcare providers and the public to take a broader view. They argue that a broader approach would reduce critical gaps in the evidence base and care and treatment relating to diseases and conditions that present only in women, disproportionately in women, and differently in women.
  7. Content Article
    In this opinion piece for the BMJ, Scarlett McNally looks at patient safety concerns relating to maternity care in the NHS. She considers the costs associated with additional spending in the sector intended to improve safety and emphases the need to train and retain more midwives.
  8. Content Article
    This report by the Maternity & Newborn Safety Investigations (MNSI) programme examines findings from 92 of their investigations where safety recommendations were made to midwife-led units in NHS hospital trusts in England. It highlights key learnings and prompts to help trusts to consider how safety risks can be mitigated and drive improvements in care.
  9. News Article
    NHS staff do not correctly monitor a baby’s heart rate during labour in almost half of cases where serious failings lead to tragedy, a review of maternity care has found. The Care Quality Commission identified that inadequate foetal monitoring occurred in 45 of 92 cases (49%) in which a baby died or suffered serious brain damage while being born in a midwife-led unit in England. The findings show that correct monitoring is “critically important” to ensure care is safe in all maternity units, said Sandy Lewis, the director of the CQC’s maternity and newborn safety investigations (MNSI) programme. It analysed four common failings in the 92 births in a report that is intended to help midwives and doctors improve the quality and safety of care. In one case the investigation team found that “there were likely to have been abnormalities in the baby’s heart rate which were ongoing for a prolonged period of time, which were not identified during intermittent auscultation [monitoring]”. In another, midwives were so busy dealing with a separate emergency on the unit that they failed to monitor the baby at the correct recommended intervals and the woman was left unattended. The 92 incidents involved 62 cases in which the newborn suffered a severe brain injury, 19 in which it was alive at the start of labour but was stillborn and 11 when it died within its first six days of life. Read full story Source: Guardian, 8 May 2024
  10. Content Article
    Abbie experienced a high-risk pregnancy with her twin girls. They were born at 27 weeks gestation and weighed in at just 677g and 500g. After 150 nights in Neonatal Intensive Care Unit (NICU), both of Abbie’s daughters came safely home.  In this blog, Abbie highlights the importance of building a trauma-informed, clinical network around women whose babies have spent time in NICU. Drawing on her own experience and insights, she offers suggestions for how midwives, GPs and health visitors can support their mental health postnatally. 
  11. Content Article
    This study aimed to assess perceptions of Covid-19 vaccines amongst pregnant or recently pregnant women in the US over two different time periods between November 2021 and February 2023. The results highlighted decreasing confidence in Covid-19 vaccine safety in a large, diverse pregnant and recently pregnant insured population, and the authors see this as a public health concern.
  12. News Article
    More than a dozen trusts have changed their maternity IT system – or are in the process of doing so – following a national patient safety alert. NHS England issued the alert in December, after a fault was discovered with the Euroking maternity EPR, supplied by Magentus Software. It said information recorded in the EPR could overwrite previously recorded data, meaning the system could mislead clinicians. While no cases of patient harm have been reported, NHSE instructed trusts using the system to “consider if Euroking meets their maternity service’s needs” and “ensure their local configuration is safe” by June. A spokesperson for Euroking said: “We have identified a solution to the issues raised in the NPSA [alert], which has been shared with NHSE and with our customers. We’re now meeting each customer and are working with them individually to support the changes that need to be made based on their local configurations. We will continue working with the trusts to support them meeting the deadline outlined in the NPSA. “As the NPSA outlined, it has been issued as a precautionary measure and there is no evidence of harm being caused to patients.” Read full story (paywalled) Source: HSJ, 12 April 2024 Related reading on the hub: NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn?
  13. Content Article
    The UK is suffering from a chronic shortage of midwives, a shortage that has had an inevitable impact on maternity safety. While services in Scotland, Wales and Northern Ireland certainly have their challenges, it is England where the problems have been most severe, with a current estimated shortage of 2,500 midwives. The result is that midwives and working an estimated 100,000 hours’ unpaid overtime every week— burnout is widespread and the NHS is struggling to retain staff. This report by the Royal College of Midwives makes several suggestions to recruit and retain midwives in our maternity services. These include improving the quality of midwifery education. paying student tuition fees and employers developing more flexible working practices.
  14. News Article
    Families have been told they will have to prove liability for the harm caused to mothers and children at East Kent Hospitals University Foundation Trust before getting compensation. This is despite the inquiry having examined each case in detail and concluding 45 babies could have survived, while 12 who sustained brain damage could have had a different outcome. It also determined 23 women who either died or suffered injuries might have had better outcomes had care been given to “nationally recognised” standards. However, NHS Resolution – which handles claims for clinical negligence – now says families must prove causation and a breach of duty of care before any compensation can be made. This stipulation has been made even in cases where the inquiry found different treatment would have been reasonably expected to make a difference to the outcome. The investigation into the trust’s maternity care led by Bill Kirkup reported 18 months ago. Speaking to HSJ, its author said: “I am disappointed that East Kent families are facing these problems after everything that has happened to them. Of course, it is true that the independent investigation panel was not in a position to rule on negligence, but we did provide a robust clinical assessment of each case. “I would have hoped that this could be taken into account in deciding to offer early settlement instead of a protracted dispute. It seems sad that a more compassionate approach has not been adopted.” Read full story (paywalled) Source: HSJ, 2 April 2024
  15. Content Article
    Drawing on insights from Maternal Mental Health Alliance (MMHA) Lived Experience Champions, member organisations and local contacts, this toolkit offers creative ideas and practical tools to empower individuals in shaping perinatal mental health care at a local level. The toolkit explores innovative examples of ongoing efforts to bring about this much-needed change. It contains resources relating to: Breaking barriers Demonstrating impact Making connections Sharing stories
  16. Content Article
    The purpose of this paper, published in the Annals of Internal Medicine, was to conduct a systematic review on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving maternal and infant health outcomes for those who are pregnant and postpartum, and strategies for implementation.
  17. Content Article
    When ECRI unveiled its list of the leading threats to patient safety for 2024, some items are likely to be expected, such as physician burnout, delays in care due to drug shortages or falls in the hospital. However, ECRI, a non-profit group focused on patient safety, placed one item atop all others: the challenges in helping new clinicians move from training to caring for patients. In an interview with Chief Healthcare Executive®, Dr. Marcus Schabacker, president and CEO of ECRI, explained that workforce shortages are making it more difficult for newer doctors and nurses to make the transition and grow comfortably. “We think that that is a challenging situation, even the best of times,” Schabacker says. “But in this time, these clinicians who are coming to practice now had a very difficult time during the pandemic, which was only a couple years ago, to get the necessary hands-on training. And so we're concerned about that.”
  18. Content Article
    Improving maternity care is a key Government and National Institute for Health and Care Research (NIHR) priority. In March 2024, an NIHR Evidence webinar showcased research from their recent Collection, Maternity services: evidence to support improvement.  This summary includes videos of researchers’ presentations and captures some of the points raised in the webinar Q&A. It highlights seven features of safety in the maternity units, kind and compassionate care around the induction of labour, and the role of hospital boards in improving maternity care.
  19. News Article
    Norah Bassett was hours old when she died in 2019, after multiple failings in her care. What can be learned from her heartbreaking loss? The maternity unit at the Royal Hampshire county hospital in Winchester was busy the evening when Charlotte Bassett gave birth. When the night shift came on duty, a midwife introduced. “She was very brusque,” Charlotte, 37, a data manager, remembers. “She said, ‘We’ve got too many people here. I’ve got this and this to do.’” Charlotte tried to breastfeed Norah, but she wasn’t latching. The midwife told Charlotte to cup feed her with formula. She didn’t stay to watch. Charlotte poured milk from a cup into Norah’s rosebud mouth. Blood came out. It was staining the muslin. The midwife didn’t seem concerned. “I was drowning my child, who was drowning in her own blood. And there was no one there to say: this isn’t normal,” Charlotte says. The Health Services Safety Investigations Body (now HSSIB but at the time known as HSIB), which investigates patient safety in English hospitals, produced a report into Norah’s care in 2020. One sentence leaped out to Charlotte and her husband James. “An upper airway event (such as occlusion of the baby’s airway during skin-to-skin) may have contributed to the baby’s collapse.” In other words, it was possible that Charlotte might have smothered her daughter. “So Charlotte spent four years in agony,” says James, “thinking it was her.” Dr Martyn Pitman remembers the night Norah died, because it was unusual. A crash call, for a baby born to a low-risk mother. It played on his mind, because eight days earlier, on 4 April 2019, Pitman, a consultant obstetrician and gynaecologist, had presented proposals for enhanced foetal monitoring to a meeting of the maternity unit’s doctors and senior midwives. Pitman, 57, who is an expert in foetal monitoring, felt the proposals would prevent more babies suffering brain injuries at birth. “We’re not that good at detecting the high-risk baby, in the low-risk mum,” he says. Another doctor would later characterise the meeting as “hideous … hands down the worst meeting I’ve ever been to. Martyn … was being set upon.” A midwife felt the animosity in the room was “personal towards Martyn”, and was “appalled” by the “unprofessionalism that I saw from my midwifery colleagues”. James and Charlotte join an unhappy club: a community of parents whose children died young, after receiving poor care, and were told their deaths were unavoidable, or felt blamed for them. “I’ve spoken to so many families,” says Donna Ockenden, who authored a 2022 report into Shrewsbury’s maternity services, “who have been blamed for the eventual poor outcome in their cases. This has included being blamed for their babies’ death.” She has also met the families of women blamed for their own deaths. “This never fails to shock me,” she says. Read full story Source: The Guardian, 26 March 2024
  20. Content Article
    In this Guardian article, Theopi Skarlatos explains how she was making a documentary about the UK’s midwife crisis when she lost her baby. By then she had heard time and again about understaffing, depression, burnout …
  21. News Article
    The UK’s National Institute for Health and Care Research (NIHR) has launched a £50m “Challenge” funding call to tackle inequalities in maternity care. The funding call aims to establish a research consortium to deliver research and capacity building over five years. The call was announced as part of the Department for Health and Social Care’s women’s health priorities for 2024. Recent evidence suggests that Black women in the UK are almost three times more likely to die during pregnancy or up to six weeks after pregnancy compared to white women. Asian women are twice as likely to die during pregnancy or shortly after, compared to white women. The new consortium is hoped to bring together experts across the UK to help change numbers like these. The research aims to focus on inequalities before, during and after pregnancy. According to NIHR, a key aim is to identify specific areas where measurable improvements can be made. Relevant charities, patient groups, community groups and the life sciences industry will be involved in the research where appropriate. Professor Marian Knight, scientific director for NIHR Infrastructure, said: “I am hugely excited about what this research can achieve – funding truly innovative approaches to tackle maternity inequalities will save women’s and babies’ lives – this is a challenge the NIHR is ideally placed to deliver.” Read full story Source: FemTech World, 15 March 2024
  22. News Article
    Alice and Lewis Jones were forced to watch their 18-month-old baby die in front of them after a failure by a scandal-hit NHS trust left him with a “catastrophic brain injury” following his birth. Their son Ronnie was one of hundreds of babies who have died following errors by Shrewsbury and Telford Hospital, where the largest NHS maternity scandal to date was previously uncovered by The Independent. Two years later, Mr and Mrs Jones are calling for the Supreme Court to overturn a controversial decision in February which ruled bereaved relatives could not claim compensation over the psychological impact of seeing a loved one die, even if it was caused by medical negligence. It comes after the trust admitted to failings in a letter to the parents’ lawyers. Ronnie’s birth in 2020 fell outside of the Ockenden review and his parents have warned it showed failures were still occurring despite warnings made during the inquiry. Within the Ockenden inquiry, multiple cases of staff failing to recognise and act upon CTG training were found, and the final report recommended all hospitals have systems to ensure staff are trained and up to date in CTG and emergency skills. The report also said the NHS should make CTG training mandatory and that clinicians must not work in labour wards or provide childbirth care without it. A CTG measures a baby’s heart and monitors conditions in the uterus and is an important measure before birth and during labour to observe the baby for any signs of distress. Ms Jones said: “We knew about the Ockenden review, but everything at Telford was new and so I think we just assumed that lessons had been learned, the same thing wouldn’t happen to us.” Ronnie’s parents are campaigning to reverse the Supreme Court which ruled that “secondary victims” – including parents who are not directly harmed by the birth – are not eligible to bring claims for psychiatric injury following medical negligence. Read full story Source: The Independent, 14 March 2024
  23. News Article
    Almost £35 million will be invested to improve maternity safety across England with the recruitment of additional midwives and the expansion of specialist training to thousands of extra healthcare workers. The investment, which was announced as part of the Spring Budget 2024, will be provided over the next 3 years to ensure maternity services listen to and act on women’s experiences to improve care. The funding includes: £9 million for the rollout of the reducing brain injury programme across maternity units in England, to provide healthcare workers with the tools and training to reduce avoidable brain injuries in childbirth investment in training to ensure the NHS workforce has the skills needed to provide ever safer maternity care. An additional 6,000 clinical staff will be trained in neonatal resuscitation and we will almost double the number of clinical staff receiving specialist training in obstetric medicine in England increasing the number of midwives by funding 160 new posts over 3 years to support the growth of the maternity and neonatal workforce funding to support the rollout of maternity and neonatal voice partnerships to improve how women’s experiences and views are listened to and acted on to improve care. Health and Social Care Secretary Victoria Atkins said: "I want every mother to feel safe when giving birth to their baby. Improving maternity care is a key cornerstone of our Women’s Health Strategy and with this investment we are delivering on that priority - more midwives, specialist training in obstetric medicine and pushing to improve how women are listened to in our healthcare system. £35 million is going directly to improving the safety and care in our maternity wards and will move us closer to our goal of making healthcare faster, simpler and fairer for all." Read full story Source: Gov.UK, 10 March 2024
  24. Content Article
    This annual report from ECRI and the Institute for Safe Medication Practices (ISMP) presents the top 10 patient safety concerns currently confronting the healthcare industry. It is a guide for a systems approach to adopting proactive strategies and solutions to mitigate risks, improve healthcare outcomes and enhance the well-being of patients and the healthcare workforce. Drawing on ECRI and ISMP’s evidence-based research, data and insights, this report sheds light on issues that leaders should evaluate within their own institutions as potential opportunities to reduce preventable harm. Some of the concerns represent emerging risks, some are well known but still unresolved, but all of them pertain to areas where organisations can make meaningful change.
  25. News Article
    The NHS paid out tens of millions of pounds over maternity failings at a hospital trust which is the subject of a major inquiry. Including legal fees, £101m was paid in claims against Nottingham University Hospitals (NUH) between 2006 and 2023. NUH is facing the UK's largest-ever maternity review, with hundreds of baby deaths and injuries being examined. Experts say lives could be saved if the trust invested more in learning from its mistakes. The NHS paid the money in relation to 134 cases over failings at the Queen's Medical Centre (QMC) and City Hospital. The majority - £85m - was damages for families who were successful in proving their baby's death or injury was a result of medical negligence. Read full story Source: BBC News, 28 February 2024
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