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Found 810 results
  1. News Article
    A maternity unit criticised for the preventable stillbirth of a baby is under investigation after the unexpected death of a second baby. The newborn baby died in December last year after her birth at the standalone midwifery-led unit (MLU) at Lagan Valley Hospital in Lisburn. Despite this, the unit continued to operate as normal for another three months when the South Eastern Trust temporarily paused births at the MLU. The second tragedy came four years after Jaxon McVey was stillborn when his delivery at the unit went catastrophically wrong. A post-mortem found he died as a result of shoulder dystocia – an obstetric emergency where the head is born but the shoulder becomes trapped behind the pubic bone. Jaxon’s mum, Christine McCleery, has hit out at the South Eastern Trust and raised concerns over the measures put in place following his stillbirth on Mother’s Day 2017. “I feel like they didn’t learn from Jaxon,” she said. “I don’t know if any other babies died before Jaxon, but I know one died afterwards. Read full story (paywalled) Source: The Independent, 23 November 2022
  2. News Article
    Nearly a fifth of trusts providing maternity care have been red rated for their infant mortality rates in a national audit. Twenty-three trusts were flagged for their perinatal mortality in the latest Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries audit for maternity services. Trusts with mortality rates more than 5% higher than an average of peer group providers are given a red rating. The report was published last month and looked at data for 2020. Average perinatal mortality rates have been falling across England since 2013, although there is significant variation across England. Six trusts in the latest audit were red rated for both stillbirths and neonatal mortality; Buckinghamshire Healthcare; Gloucestershire Hospitals; University Hospitals Dorset; Sandwell and West Birmingham Hospitals; University Hospitals Coventry and Warwickshire; and University Hospitals of Leicester. Twenty-three trusts rated red on a combined perinatal mortality indicator (including the six listed above). For 17 of them, their mortality rates were not high enough on one of the stillbirth or neonatal measures to be red rated, but sufficiently high enough on both indicators to tip their overall extended overall perinatal rating into the red. Andrew Furlong, medical director of University Hospitals Leicester, said: “Where learnings have been identified from reviews of care, we have developed robust action plans and strengthened care practice to shape and improve future services.” These include aiming to improve access to interpreters, provide clearer medical review guidelines, and update ultrasound scanning processes, he added. Read full story (paywalled) Source: HSJ, 21 November 2022
  3. Content Article
    On 1 November 2022, Dr Bill Kirkup, HSIB's Clinical Director of Maternity Investigations, and lead investigator for the investigation into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust, presented the investigation report: 'Reading the signals' in a seminar delivered to HSIB staff.
  4. News Article
    Women are four times as likely to die after childbirth in Britain as in Scandinavian countries, a study published in the BMJ has found. Researchers analysed data on the number of women who die because of complications during pregnancy in eight high-income European countries. They found that Britain had the second-highest death rate, with one in 10,000 mothers dying within six weeks of giving birth, only slightly less than in Slovakia, the worst performing. The study found that rates of “late” maternal death — when women die between six weeks and a year after giving birth — were nearly twice as high in Britain as in France, the only other country for which data was available. Heart problems and suicide were the main causes of death. Professor Andrew Shennan, an obstetrician at King’s College London, said: “Any death relating to pregnancy is devastating. Equally shocking are the avoidable discrepancies in worldwide maternal mortality. “Causes of [maternal] death are relatively consistent across the world, and largely avoidable. Most deaths are due to haemorrhage, sepsis and hypertensive disorders of pregnancy. “In Europe, non-obstetric causes of death have become proportionately more common than obstetric causes, including deaths from cardiovascular disease (23%) and suicide (13%); these should be prioritised.” Read full story (paywalled) Source: The Times. 17 November 2022
  5. Content Article
    Women are four times as likely to die after childbirth in Britain as in Scandinavian countries, a study published in the BMJ from Diguisto et al. has found. The authors compared maternal mortality in eight countries (France, Italy, UK, Denmark, Finland, the Netherlands, Norway, and Slovakia) with enhanced surveillance systems. They found that UK had the second-highest death rate, with one in 10,000 mothers dying within six weeks of giving birth, only slightly less than in Slovakia, the worst performing. Norway has the lowest maternal death rates in Europe, at one in 37,000. In Denmark, the second-best performing country, one in 29,000 died. In-depth analyses of differences in the quality of care and health system performance at national levels are needed to reduce maternal mortality further by learning from best practices and each other. Cardiovascular diseases and mental health in women during and after pregnancy must be prioritised in all countries.
  6. News Article
    Doctors have warned of "unsafe" maternity services at a Sussex hospital in emails seen by the BBC. In the email chain between senior staff at the Royal Sussex County Hospital in Brighton, consultants wrote of "compromises" to patient care. One doctor said during a birth "we were one step away from a potential disaster". One senior doctor wrote in the exchange that "increasing workforce issues" had contributed to making the situation in the maternity unit "almost unmanageable at times". They added: "We are making compromises to patient care every day as a result." Another wrote that their workload was often "unmanageable, and obviously impacted by the staffing issues". A senior member of maternity staff said "we are delivering suboptimal care" and "we are one step away from potential disaster". A doctor also said staff were being "stretched", and that there were delays to women's care. Another consultant wrote: "We have an unsafe service and we have to strive for better than that." Read full story Source: BBC News, 16 November 2022
  7. Content Article
    Published on 19 October 2022, the report of the investigation into maternity and neonatal services at East Kent Hospitals NHS Foundation Trust revealed a series of serious patient safety failings between 2009 and 2020, which resulted in avoidable harm to patients and deaths. The investigation found that if nationally recognised standards had been followed, the outcome could have been different in 97 of the 202 cases reviewed. In this article, Patient Safety Learning analyses the findings of this report from a broad patient safety perspective, focusing on five key themes that are consistent with many other serious patient safety inquiries and reports in recent years. It sets these in their wider context and highlights the need for a fundamental transformation in our approach to patient safety if similar scandals are to be prevented in the future.
  8. Content Article
    Established in 2006, the National Neonatal Audit Programme (NNAP) is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Paediatrics and Child Health (RCPCH). It assesses whether babies admitted to neonatal units receive consistent high-quality care in relation to the NNAP audit measures that are aligned to a set of professionally agreed guidelines and standards. The NNAP also identifies variation in the provision of neonatal care at local unit, regional network and national levels and supports stakeholders to use audit data to stimulate improvement in care delivery and outcomes. This report summarises the key messages and national recommendations developed by the NNAP Project Board and Methodology and Dataset Group, based on NNAP data relating to babies discharged from neonatal care in England and Wales between January and December 2021.
  9. News Article
    A new report has highlighted for the first time an apparent rise in the suicide rate for pregnant or newly postpartum women in 2020, citing disruption to NHS services due to Covid-19 as a likely cause. According to the review of maternal deaths by MBRRACE-UK, 1.5 women per 100,000 who gave birth died by suicide during pregnancy or in the six weeks following the end of pregnancy in 2020, which is three times the rate of 0.46 per 100,000 between 2017 and 2019. The number of deaths by suicide within six weeks of pregnancy in 2020 was numerically small – 10 women – but this was the same as the total recorded across 2017 to 2019. This is also despite Office for National Statistics figures showing a year-on-year fall in suicides in the population overall in 2020. In relation to the rise in suicides during pregnancy and up to a year after birth, the report states: “During the first year of the covid-19 pandemic, very rapid changes were made to health services… Mental health services were not immune from this and there was a broad spectrum of changes from teams where some staff were redeployed to other roles, through to teams that were able to operate relatively normally… “All of this occurred on a background of a recent huge expansion in specialist perinatal mental health services." Read full story (paywalled) Source: HSJ, 11 November 2022
  10. Content Article
    The MBRRACE-UK collaboration, led from Oxford Population Health's National Perinatal Epidemiology Unit (NPEU), has published the results of their latest UK Confidential Enquiry into Maternal Deaths and Morbidity. These annual rigorous reports are recognised as a gold standard in identifying key improvements needed for maternity services. The latest Saving Lives, Improving Mothers' Care analysis examines in detail the care of all women who died during, or up to one year after, pregnancy between 2018 and 2020 in the UK. This is the first report to include data that demonstrates the impact of the COVID-19 pandemic on maternal deaths.
  11. Event
    This Westminster Health Policy forum conference will discuss the next steps for improving care and support for pregnant women. Delegates will assess priorities for the safety and quality of maternity services moving forward following the release of the Final Ockenden review: Independent Review of Maternity Services, and for the Maternity and Newborn Safety Investigation Special Health Authority (MNSI) division of the Healthcare Safety Investigation Branch being established for April 2023. It will be an opportunity to assess priorities for the Secretary of State, and to examine the future outlook for supporting pregnant women following the publication of the Women’s Health Strategy for England, which highlighted a need for pregnant women to be listened to - and included the ambition for 4m people to receive personalised care by March 2024. Areas for discussion include: personalised care: assessment of individual needs - improving the access to mental health services - promoting healthy lifestyle choices during pre-conception, pregnancy, and early years workforce support: encouraging professional development, including funding and education - maternal workforce recruitment and retention - improving senior leadership improving patient safety ensuring strong communication in maternity teams providing appropriate pregnancy risk assessment recommendations and guidance for clinical decision making encouraging and delivering continuity of care progress and next steps for the Maternity Transformation Programme following the Better Births report investigation: priorities for the MNSI and ensuring safety concerns are investigated and addressed - learning from mistakes - listening to families quality of care: developing best practice guidelines - delivering high quality services - improving pregnancy outcomes - improving communication with pregnant women inequalities: addressing variation in service provision - tackling disparities in pregnancy outcomes, particularly for ethnic minorities. Register
  12. News Article
    The death of a three-day-old baby could have been avoided if medical professionals had acted differently, a coroner concluded. Rosanna Matthews died three days after being delivered at Tunbridge Wells Hospital in Kent in November 2020. The hospital trust apologised, saying the level of care for Ms Sala and her daughter “fell short of standards”. Ms Sala told the inquest midwives were "bickering" and appeared confused during her labour. She claimed that if she had been allowed to start pushing when she wanted to, instead of waiting as midwives advised, Rosanna would have lived. Rachel Thomas, then deputy head of gynaecology and midwifery, said there had been "errors in communication". Following the conclusion of the inquest, the coroner ruled Rosanna died following a “prolonged period of avoidable hypoxia”, which led to brain damage. The coroner, sitting in Maidstone, also found midwives at the hospital failed to recognise that Rosanna was already unwell with congenital pneumonia. Ms Sala said her daughter could have lived had medical professionals acted differently on the day of her birth. Read full story Source: BBC News, 8 November 2022
  13. News Article
    The proportion of newborn babies receiving a timely health visitor check-in has fallen sharply, with one in five missing out in the most recent statistics available. Official data reveals that only 82.6% of babies received a new birth visit within their first fortnight in 2021-22, as is recommended, and in the fourth quarter of the year it dropped as low as 79.3%. This is the lowest proportion recorded in recent years in the annual dataset on health visitor service delivery metrics, published by the Office for Health Improvements and Disparities. According to the NHS website, a health visitor new birth visit is supposed to take place between 10 and 14 days after birth and is designed to offer advice on issues including safe sleeping, vaccinations, infant feeding, infant development, and adjusting to life as a parent. Kate Holmes, head of support and information at charity The Lullaby Trust, said: “Safer sleep saves babies’ lives and all families should be given advice on how to reduce the risk of sudden infant death syndrome for their baby. The new birth visit is a key opportunity for health visitors to talk to families about safer sleep and to provide them with information and support that takes their individual and family circumstances into account.” Read full story (paywalled) Source: HSJ, 7 November 2022
  14. Content Article
    Maternal Mortality Review Committees (MMRCs) in the US are multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy. MMRCs have access to clinical and non-clinical information to more fully understand the circumstances surrounding each death, determine whether the death was pregnancy-related, and develop recommendations for action to prevent similar deaths in the future. This article summarises the data from MMRCs in 36 US states between 2017 and 2019, demonstrating variations in prevalence and cause of death according to race, ethnicity and geographical area. The data suggests that over 80% of pregnancy-related deaths examined were determined to be preventable.
  15. News Article
    A boss at a trust which was heavily criticised in a damning report says patients have lost confidence in the care they provide. Raymond Anakwe, executive director of East Kent Hospitals Trust, said regaining patient trust would be "possibly the largest challenge". He was speaking at a board meeting two weeks after a review found a "clear pattern" of "sub-optimal" care. Mr Anakwe said: "The reality is we have lost the confidence of our patients." He also said the trust has lost the confidence "of our local community and sadly also many staff". The trust's chief executive, Tracey Fletcher, told the meeting that she believed many staff thought "enough is enough", and that the trust has to be "brave" if it's to move forward. Stewart Baird, a non-executive director, said: "I think it's clear the buck stops here with the people sat round this table, and where there are bad behaviours in the trust, it's because we have allowed it. "Where people don't feel able to speak up, it's because we have not provided an environment for them to do that." Read full story Source: BBC News, 3 November 2022
  16. News Article
    Patients are not always getting the care they deserve, says the head of NHS England. Amanda Pritchard told a conference the pressures on hospitals, maternity care and services caring for vulnerable people with learning disabilities were of concern. She even suggested the challenge facing the health service now was greater than it was at the height of the pandemic. Despite making savings, the NHS still needs extra money to cope, she said. Next year the budget will rise to more than £157bn, but NHS England believes it will still be short of £7bn. Ms Pritchard told the King's Fund annual conference in London that demand was rising more quickly than the NHS could cope with. "I thought that the pandemic would be the hardest thing any of us ever had to do," she said. "Over the last year, I've become really clear.... it's the months and years ahead that will bring the most complex challenges." Read full story Source: BBC News, 2 November 2022
  17. Content Article
    On 19 October 2022, the long-awaited findings of Dr Bill Kirkup’s independent investigation into maternity services at East Kent were published. This blog outlines the response of the charity Birthrights to the investigation. It focuses on how breaches of mothers' human rights contributed to negative experiences of care and affected outcomes. Lack of informed consent, the use of disrespectful and discriminatory language and a failure to listen to mothers' concerns all contributed to many cases of avoidable harm. It argues that there is a desperate need for proper funding and real commitment to improving staff recruitment and retention, coupled with a culture shift in maternity care that embeds human rights at the centre of care.
  18. Content Article
    Inflammatory rheumatic disease (IRD), such as rheumatoid arthritis, can cause poor outcomes in pregnancy, and the health of the mother and developing foetus must be balanced when making decisions about medication. This updated guideline from the British Society for Rheumatology contains evidence and best practice for prescribing rheumatology medications during pregnancy and breastfeeding. It includes a table that summarises information about drug compatibility in pregnancy and breastfeeding.
  19. News Article
    A baby was left "severely disabled" after a delay during his delivery by Caesarean section, a High Court judge has been told. Betsi Cadwaladr health board will pay £4m in compensation after a negligence claim was brought by one of the boy's relatives. He has required 24-hour care since his birth in 2018 at Glan Clwyd Hospital in Denbighshire. The hospital apologised, saying doctors are "working hard" to learn lessons. "We are extremely sorry," barrister Alexander Hutton KC, representing the health board, told Mr Justice Soole. "[Betsi Cadwaladr] is working hard to learn lessons from this case," he added. Read full story Source: BBC News, 2 November 2022
  20. Content Article
    Maternity costs make up the largest cost to the NHS in value of claims. The Early Notification Scheme provides a faster and more caring response to families whose babies may have suffered severe harm. 'The second report: The evolution of the Early Notification Scheme' provides an overview of progress made since the report into the first year of the scheme, which was published in 2019. The report updates on the progress of the key recommendations which were made in the first report and reflects on modifications and improvements made to the scheme since its launch five years ago. It provides an analysis of the main clinical themes, based on a small cohort of cases, and makes recommendations to further improve outcomes for affected families.
  21. Content Article
    In this article for The Times, Deborah Ross describes her negative experience of NHS maternity care during and after labour, and how this has put her off having more children. During her 72-hour labour and subsequent hospital admission, she was denied pain relief, did not feel listened to and was not informed as to why her baby had been transferred to NICU.
  22. Content Article
    Appreciative Inquiry (AI) is a research approach that aims to create practical and collaborative change by taking participants through an in-depth exploration of their organisation, team or role. This article in the European Journal of Midwifery reflects on the process of using AI in a study that explored staff wellbeing in a UK maternity unit. The authors share key lessons to help others decide whether AI will fit their research aims, and highlight issues in its design and application.
  23. Content Article
    The Healthcare Safety Investigation Branch (HSIB) third annual conference took place on 21 September 2022. Presentations and videos from the day are now available to view and download below. Although it tied in with the World Health Organization’s World Patient Safety Day theme of medication safety, our speakers also covered: how we can drive system level change practical sessions based on our HSIB investigation education courses maternity safety insights themed around inclusivity of care opportunities for sharing and learning from Norway’s healthcare safety investigation body, UKOM.
  24. Content Article
    In this blog, The Patients Association's Chief Executive Rachel Power argues that the findings of the independent investigation into maternity and neonatal services at East Kent Hospitals NHS Foundation Trust demonstrate the repeated failure of maternity services in England to offer safe and compassionate care to families. She outlines the key findings of the report, including catastrophic failures in the organisation's culture, team working and professionalism, and failure to listen to patients. She highlights that the lack of honesty shown by the Trust to individuals and families harmed by the hospitals' failures is shocking, and compounded the suffering felt by each family.
  25. Content Article
    In this BMJ feature, journalist Emma Wilkinson looks at how a shortage of health visitors in England is leaving babies and children exposed to safeguarding risks, late diagnosis and other problems. An estimated third of the health visitor workforce has been lost since 2015, and research by the Parent-Infant Foundation suggests that 5000 new health visitors are needed. Families are not getting the minimum recommended number of contacts with health visitors during the first three years of life, and research into the impact of this on children's outcomes is ongoing. Emma speaks to different mothers, including Phillippa Guillou, who had a baby in 2020 and struggled to breastfeed. Philippa felt unsupported and ignored by her local health visiting service, who only saw her once by videocall when her baby was one year old.
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