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Found 810 results
  1. News Article
    A report highlights that maternity and neonatal services are often regular agenda items at board meetings, but the quality and quantity of information that is presented and the subsequent discussion (or lack thereof) doesn’t lead to effective oversight. The shocking and distressing stories emerging from the Lucy Letby case in August 2023 shone a light on the “cover-up culture” in the NHS. Although deliberate harming of babies is thankfully exceedingly rare, some of the issues raised in this case echo concerns that trusts are failing to react to signs of poor performance in maternity and neonatal services. Responsibility ultimately lies with trust boards which have a statutory duty to ensure the safety of care. However, the actions (or inactions) of leadership have come up frequently in inquiries and reviews. Read full story (paywalled) Source: HSJ, 7 November 2023
  2. Content Article
    Trust boards’ regular oversight of the quality and safety of maternity and neonatal services has been the subject of successive inquiries and reviews. In this report, the Sands and Tommy’s Joint Policy Unit review publicly available board papers and minutes for seven NHS Trusts in England. They analyse whether the information presented to boards, the process for review, and actions taken enabled boards to deliver effective oversight over the safety and quality of maternity and neonatal services.
  3. News Article
    Maternity services at Hull Royal Infirmary have recently been described in a damning report by the health watchdog as chaotic, unsafe and not fit for purpose. Three mothers, who claim staff missed signs of life-threatening conditions that could have killed them or their babies, have spoken to the BBC about their harrowing experiences at the hospital. One woman, a BBC journalist who does not want to be named, said she knew her newborn son was seriously ill within minutes of giving birth at the infirmary in 2021. "As soon as they handed him to me, I noticed something was wrong. He was panting and his breathing wasn't right," she said. Over the course of an hour, she said her concerns were dismissed by the newly-qualified midwife who said his breathing was "completely normal". "She kept reassuring me over and over that's how babies breathe. I felt like I was drowning surrounded by lifeguards," she said. But after being examined by a more experienced midwife, the baby was rushed to intensive care and diagnosed with potentially fatal sepsis. "It was like time stood still. The midwife ripped him off me and she slammed an oxygen mask on his face, called the crash team and he was taken away to the neonatal intensive care unit. "The anger I felt was overwhelming because I'd been saying for nearly an hour he was seriously ill. I was right and he had sepsis." A few months after her son's birth, she read about an inquest into the death of a four-day-old baby who had sepsis and was born at Hull Royal Infirmary. A coroner found that midwives had failed to respond to his infection quickly enough. "My blood ran cold because it was exactly the same circumstances that happened to me and that baby died. I thought they clearly haven't learned anything," she said. Read full story Source: BBC News, 6 November 2023
  4. News Article
    Pregnant women across the Democratic Republic of the Congo are to be offered free healthcare in an effort to cut the country’s high rates of maternal and neonatal deaths. Women in 13 out of 26 regions in the country will, by the end of the year, be entitled to free services during pregnancy and for one month after childbirth. Babies will receive free healthcare for their first 28 days under the scheme, which the government plans to extend to the rest of DRC – although there is no timetable for that yet. However, health workers have raised concerns that hospitals and medical centres are ill-equipped to cope with any increased demand on services. Some told the Guardian there were not enough staff, facilities or equipment to successfully introduce the $113m (£93m) programme, which is supported by the World Bank. The rollout of the programme comes amid nationwide strikes by nurses, midwives, technicians and hospital administrative staff, who are calling for higher pay and better conditions. Congo has one of the highest number of maternal and neonatal deaths in the world. Latest figures record the maternal morality ratio at 547 deaths for every 100,000 live births, and its neonatal rate – the number of babies dying before 28 days of life – at 27 per 1,000 live births. The minister of public health, Roger Kamba Mulamba, said the programme would free women from a “prison sentence”. He said: “Mothers today get healthcare without fear when they are pregnant. Babies today do not die because they have no access to antibiotics. Mothers today do not die because they cannot afford to pay for a caesarean delivery.” Read full story Source: The Guardian, 6 November 2023
  5. News Article
    Pregnant women are being forced to wait days longer than expected for “urgent” inductions of labour as NHS staff shortages and a lack of beds lead to severe delays. New mothers told i the delays, which the health watchdog has found can last up to five days, increased the anxiety they felt during labour. One first-time mother, who wanted to remain anonymous, said that her ordeal has put her off having any more children. The woman, who gave birth to a son in August, said she was “pushed” to book an induction when her waters broke and her baby was almost two weeks overdue. Despite being told by multiple healthcare professionals she needed to “give birth within 24 hours” due to a risk of infection, she did not end up delivering her baby for another 49 hours – without being induced. A birthing expert told i she has “never seen a crisis in maternity” like it during her almost 10 years working in the sector. It comes after it was revealed that the Care Quality Commission (CQC) watchdog has issued warnings to seven hospitals due to delays to the induction of labour since last year. Read full story (paywalled) Source: inews, 5 November 2023
  6. Content Article
    Sussex Community NHS Foundation Trust share their patient safety newsletters with the hub.
  7. News Article
    Parents of babies who have died or been harmed as a result of poor care are demanding that ministers order a public inquiry into repeated failings in NHS maternity units. They want Steve Barclay, the health secretary, to set up a judge-led statutory inquiry to investigate recurring problems in maternity services, which cost the NHS in England £2.6bn a year in damages. Babies are still being damaged and dying, despite previous inquiries into maternity scandals at the Morecambe Bay, Shrewsbury and Telford, and East Kent NHS trusts recommending changes. The NHS’s failure to improve maternity safety is so alarming that a public inquiry is needed to finally ensure that women and babies no longer come to harm, the families say. The Maternity Safety Alliance, a group of relatives of newborns who have died due to lapses in NHS childbirth, warned that scandals will continue unless such an inquiry is held. “Our babies are too precious to keep on ignoring the reality that despite a raft of national initiatives and policies implemented in the wake of investigations and reports, systemic issues continue to adversely impact on the care of women and babies. “Far too much avoidable harm continues to devastate lives in circumstances that could and should be avoided. Fundamental reform is needed,” they said in a letter urging Barclay to intervene. Read full story Source: The Guardian, 31 October 2023
  8. News Article
    The parents of a baby boy who died at seven weeks old after a hospital did not give him a routine injection have described the failure as “beyond cruel”. William Moris-Patto was born in July 2020 at Addenbrooke’s hospital in Cambridge, where it was recorded in error that he had received a vitamin K injection – which is needed for blood clotting. The shot is routinely given to newborns to prevent a deficiency that can lead to bleeding. His parents, Naomi and Alexander Moris-Patto, 33-year-old scientists from Chatteris, Cambridgeshire, want to raise awareness about the importance of the vitamin after a coroner concluded William would not have died had the hospital administered the injection. On Friday, the coroner Lorna Skinner KC described the omission as “a gross failure in medical care amounting to neglect”. Alexander Moris-Patto, a researcher at the University of Cambridge who recently co-founded William Oak Diagnostics to test for deficiencies in babies, said: “What’s come out of the inquest for me is that the systems they [the trust] put in place to try to prevent this happening again are not satisfactory.” He stressed the importance of the vitamin K injection, adding that about 1% of the UK population opt out of it. “We want people to know more about it, to understand how critical it can be, and for hospitals to take seriously the responsibility they have in those first precious hours of a baby’s life,” he said. Read full story Source: The Guardian, 29 October 2023
  9. Content Article
    The Children and Young People’s Mental Health Coalition (CYPMHC) and the Maternal Mental Health Alliance have launched ‘The Maternal Mental Health Experiences of Young Mums’ report, which includes both a literature review and first-hand insights from young mums impacted by maternal mental health problems.
  10. News Article
    To new parents processing the shock of delivery and swimming in hormones, newborns can feel like a tiny, terrifying mystery; unexploded ordinance in a crib. “We were totally unprepared,” says Odilia. Neither she or her husband had ever changed a nappy and had no idea the baby needed feeding every three hours. “If you’re a new mum or dad, you have no idea,” recalls Anouk, a new mother. “I’m a doctor,” says Zarah, another new mother, incredulously. “So, you would expect that I’d know something, and I knew some things, but you really don’t have any clue.” The difference for these new parents, compared to the rest of us, is that they gave birth in the Netherlands. That meant help was instantly at hand in the form of the kraamzorg, or maternity carer. Everyone who gives birth in the Netherlands, regardless of their circumstances, has the legal right – covered by social insurance – to support from a maternity carer for the following week. These trained professionals come into your home daily, usually for eight days, providing advice, reassurance and practical help. It’s a different role to midwives, who continue to monitor women and babies after the birth in the Netherlands; the maternity carer updates the midwife on the mother and baby’s health and progress as well as supporting the parents as they come to terms with their new child. A maternity carer in the Netherlands, explains Betty de Vries of Kenniscentrum Kraamzorg, the organisation that registers maternity carers, “takes care of the woman the first week, advises her on breastfeeding and bottle feeding, hygiene, gives advice … everything to do with safe motherhood and a safe baby. She is there for the whole day most of the time so she can see how they are doing.” Her colleague, director Esther van der Zwan, adds: “It’s a lot of responsibility.” To prepare, maternity carers train for three years – a combination of academic and on-the-job placements – and have regular refresher training in everything from CPR to breastfeeding support.
  11. Content Article
    Reducing inequalities in maternal healthcare in England is an important policy aim. One part of achieving that is to ensure that women from Black, Asian and minority ethnic communities, as well as women from the most deprived areas, see the same midwife or midwifery team throughout their pregnancy and postnatal period. Emma Dodsworth takes a closer look at the data to reveal what progress is being made on this.
  12. News Article
    Almost two-thirds of maternity units provide dangerously substandard care that puts women and babies at risk, the NHS watchdog has said in a damning report. The Care Quality Commission (CQC) has rated 65% of maternity services in England as either “inadequate” or “requires improvement” for the safety of care – up from 54% last year. Services are beset by a host of problems, including serious staff shortages and internal tensions, which mean that too many mothers and their babies receive care that is not good enough, it said. Women too often face delays in accessing care, do not receive the one-to-one care from a midwife to which they are entitled or experience communication problems with staff looking after them, including being shouted at by midwives. The CQC judged overall quality of care to be inadequate or require improvement at 85 maternity units, almost as many at which it rated it to be either good or outstanding – 87. The number of units offering substandard care has soared by 30 in the last year, from 55 to 85. It said that, having inspected 73% of all maternity units, “the overarching picture is one of a service and staff under huge pressure. People have described staff going above and beyond for women and other people using maternity services and their families in the face of this pressure. “However, many are still not receiving the safe, high-quality care that they deserve.” Read full story Source: The Guardian, 20 October 2023
  13. News Article
    A coroner has found neglect contributed to a baby's death at the hospital where he was born. Jasper Brooks died at the Darent Valley Hospital in Kent on 15 April 2021. The coroner found gross failures by midwives and consultants at the hospital and says Jasper's death was "wholly avoidable". Jasper was a second child for Jim and Phoebe Brooks. Due to a complication during pregnancy of her first child, Phoebe was booked in to have an elective Caesarean section to deliver Jasper. But in April 2021 those plans changed overnight. A check-up found Phoebe had raised blood pressure. She was told to remain in hospital and that the C-section would happen the following morning - nine days earlier than planned - when there were more staff on duty. Jasper's parents say the midwives caring for Phoebe repeatedly failed to listen to her and Jim's concerns - that she was shaking violently, feeling sick, and thought she was bleeding internally. "We felt like an inconvenience - no-one wanted to deal with me that night," Phoebe says. "The doctor didn't want to do my C-section, the midwife that's meant to be looking after me, she just doesn't really care. "I remember saying clearly to her, 'my whole body is shaking - something's happening, and no-one's taking the time to listen to what I'm saying or listen in on my baby'." At the inquest hearing, midwife Jennifer Davis was accused by the family's barrister, Richard Baker KC, of "failing to act on signs of blood loss, failing to determine if Phoebe was in active labour, and failing to call a senior doctor when necessary". Jasper was born without a heartbeat, so a resuscitation team was called. But during the inquest, the family learned that further errors were made because the correct people failed to attend the resuscitation. There was no consultant neonatologist on site - a doctor with expertise in looking after newborn infants or those born prematurely. Intubation, the process of placing a breathing tube into the windpipe - which should only take a few minutes - did not occur for 18 minutes. There was also a delay in administering adrenaline to try to stimulate Jasper's heart. Read full story Source BBC News, 24 October 2023
  14. News Article
    Derby and Burton’s maternity services are now among the “most challenged in England”, requiring national involvement to boost improvements. The University Hospitals of Derby and Burton NHS Foundation Trust joins 31 other NHS trusts across England which are now under closer scrutiny aimed at improving the quality of maternity services. A report from the trust details that it asked to be added to the national NHS England Maternity Safety Support Programme (MSSP) "voluntarily". Midwifery and obstetric improvement advisors have now been allocated to the trust to spend two days a week on the trust’s sites and also to provide “virtual” assistance. A letter to Stephen Posey, the trust’s chief executive, sent by Sascha Wells-Munro, the deputy chief midwifery officer for NHS England, details that the organisation’s addition to the national support programme comes after a number of concerning reports – not just its request. It references the Healthcare Safety Investigation Branch report, published in February, which highlighted the cases of seven women and their babies between January 2021 and May 2022, with three mothers and a baby dying and four mothers suffering extreme consequences. Read full story Source: Derbyshire Live, 13 September 2023
  15. News Article
    Leaders of two maternity services have been told to take urgent action, after inspectors found understaffing and declining levels of care, despite safety warnings from midwives. Maternity services at University Hospital North Durham and Darlington Memorial Hospital have been downgraded from “good” to “inadequate” in Care Quality Commission reports, published today. The CQC noted a “concerning deterioration” in the care the two services provided, despite midwives telling managers they felt the service was unsafe. Sue Jacques, chief executive of County Durham and Darlington Foundation Trust, which runs the hospitals, said the CQC’s findings would be taken “extremely seriously”. The reports also said staff reported “feeling ‘frozen out’ or that their concerns were ignored by leaders” and that staff felt “‘continuity of carer’ was the trust’s main focus, despite depleted safe staffing levels, skill mix, and staff being pulled in to cover acute areas on a frequent basis”. Last year, trusts were told not to pursue continuity of carer models – which were previously championed by NHS England – unless they had adequate staffing levels to do so safely. Read full story (paywalled) Source: HSJ, 15 September 2023
  16. News Article
    Women are being "failed at every stage" when it comes to maternity care, say campaigners, as they call for more support for those experiencing traumatic births. Mumsnet found 79% of the 1,000 women who answered their questionnaire had experienced some form of birth trauma, with 53% saying it had put them off from having more children. And according to the snapshot of UK mothers, 44% also said healthcare professionals had used language implying they were "a failure or to blame" for what happened. Conservative MP Theo Clarke is leading calls for more action after her own experience, where she thought she was "going to die" after suffering a third degree tear and needing emergency surgery. Now, she has set up an all party parliamentary group on birth trauma. She said: "[It is] clear that more compassion, education and better after-care for mothers who suffer birth trauma are desperately needed if we are to see an improvement in mums' physical wellbeing and mental health. "It is vitally important women receive the help and support they deserve." Chief executive of Mumsnet, Justine Roberts, said the trauma had "long-lasting effects", adding: "It's clear that women are being failed at every stage of the maternity care process - with too little information provided beforehand, a lack of compassion from staff during birth, and substandard postnatal care for mothers' physical and mental health." Read full story Source: Sky News, 15 September 2023
  17. Content Article
    This is the first report of a national confidential enquiry specifically focussed on child deaths. Confidential enquiries have already contributed to major improvements in obstetrics, neonatal, and perioperative care in the UK. However they are time consuming and require extensive collaboration between various professional groups as well as the attention of a dedicated full-time research team. Hence, when planning a confidential enquiry in a new patient group, it is pertinent to investigate both feasibility and utility at its outset. The aim of this enquiry was to evaluate the feasibility of using this methodology to reduce the number of child deaths and make a significant contribution to child health in the UK. The basic functions of a confidential enquiry are: To develop and maintain a register of the cases under scrutiny. To subject cases in the register (or a specific sample of them) to review by a panel of experts with a focus on identifying avoidable factors where there have been adverse outcomes. Subsequent recommendations are then derived from both the analysis of the register and the conclusions of the expert review panels. This report presents the findings of a feasibility study “The Child Death Review” in which confidential enquiry methodology was applied to child deaths (28 days to 17 years 364 days) occurring in three regions of England, all of Wales and Northern Ireland in the calendar year 2006. A surveillance programme was mounted in order to determine where and when deaths occurred. A comprehensive core dataset was developed and then collected on all deaths. A sample, designed to have an even spread across age groups and the geographical areas involved, was then subjected to more detailed enquiry. This involved scrutiny of the available records by a multidisciplinary panel in each case.
  18. Content Article
    The Care Quality Commission (CQC) State of Care is an annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve.
  19. Content Article
    This is the tenth MBRRACE-UK annual report and details the care of 572 women who died during pregnancy, or up to one year after pregnancy between 2019 and 2021 in the UK. The report also includes confidential enquiries into the care of women who died between 2019-2021 in the UK and Ireland from haemorrhage, amniotic fluid embolism, anaesthetic causes, sepsis, general medical and surgical disorders, epilepsy and stroke. By global standards, giving birth in the UK is safe, but the data reported this year should be taken as a warning signal concerning the state of maternity services and the consequences of increasing inequalities and social complexities. While Covid-19 is a significant feature of the deaths reported this year, the pandemic must not distract from wider trends. The Government’s ambition in England was to reduce maternal mortality by 50% between 2010-2025. This target is unlikely to be met. Since 2009-11, maternal mortality has increased by 15%. Crucially, the figures detailed in this report are from before the cost-of-living crisis of 2022-23. When the deaths due to Covid-19 are excluded, maternal death rates are very similar to those in 2016. There is concern that we risk losing the gains made in previous decades. Downloads Lay summary Full report Infographics Themed Surveillance Report Themed Maternal Morbidity Report Themed Maternal Mortality Report
  20. Event
    until
    The Maternity Consortium is hosting a free virtual event sharing examples of good practice from Local Maternity and Neonatal Systems (LMNS) working in partnership with Voluntary Community and Social Enterprise (VCSE) organisations and Maternity and Neonatal Voices Partnerships (MNVPs) to implement their equity and equality plans. The event will also include a national update on the equity and equality plans from NHS England and an opportunity to network with colleagues in breakout rooms. Who should attend? The event is open to anyone working in the maternity and neonatal space, including in LMNSs, Trusts, regions, specialist perinatal/maternal mental health services, the VCSE sector, local authorities, MNVPs, service user voice representative roles, other frontline services, and academia. Agenda Introduction from the Maternity Consortium Presentation from NHS England Presentation from North East and North Cumbria LMNS Presentation from Suffolk and North East Essex LMNS Breakout rooms About the Maternity Consortium Tommy’s and Sands are co-leading the Maternity Consortium as members of the VCSE Health and Wellbeing Alliance. The Maternity Consortium includes: National Maternity Voices, Pregnancy and Baby Charities Network, Five X More, Muslim Women’s Network UK and LGBT Mummies. The Maternity Consortium's aim is to use our collective expertise to join up national and local voices behind a common agenda: to reduce health inequalities for families throughout the whole pregnancy journey from pre-conception and through the first year of a baby’s life. Contact: Celeste Pergolizzi, Maternity Consortium Coordinator and Engagement Lead, celeste.pergolizzi@sands.org.uk Sign up for the event
  21. Content Article
    This study aims to explore minority ethnic women’s experiences of perinatal mental health services during COVID-19 in London. Methods: Eighteen women from ethnic minority backgrounds were interviewed, and data were subject to a thematic analysis. Results: Three main themes were identified, each with two sub-themes: ‘Difficulties and Disruptions to Access’ (Access to Appointments; Pandemic Restrictions and Disruption), ‘Experiences of Remote Delivery’ (Preference for Face-to-Face Contact; Advantages of Remote Support); ‘Psychosocial Experiences’ linked to COVID-19 (Heightened Anxiety; Social Isolation). Conclusions: Women from ethnic minority backgrounds experienced disrupted perinatal mental health care and COVID-19 restrictions compounding their mental health difficulties. Services should take women’s circumstances into account and provide flexibility regarding remote delivery of care.
  22. News Article
    Women have faced delays in giving birth due to the ongoing strikes, a major trust’s chief executive has said. Matthew Hopkins, who joined Mid and South Essex Foundation Trust last month, told a board meeting on Thursday that industrial action was having a “significant and growing” impact on patients. He added that this extended beyond delays to outpatient appointments and elective operations, saying: “It is also delaying mums giving birth, because we are seeing delays now in being able to conduct our elective Caesarian sections.” Mr Hopkins said the impact was also “really significant” on staff, with those covering for colleagues “very, very tired”. “It is important we give a very clear message to the two sides of the argument – government and the [British Medical Association] – that we need a light at the end of the tunnel, and staff need a light at the end of the tunnel. “Going into winter, with this continuing disruption for our patients and our staff, is in my view unacceptable.” Read full story (paywalled) Source: HSJ, 28 September 2023
  23. News Article
    A consultant obstetrician has claimed he was sacked from his hospital for raising whistleblowing concerns about patient safety over fears they would cause “reputational damage”. Martyn Pitman told an employment tribunal in Southampton that managers dismissed his concerns and he was “subjected to brutal retaliatory victimisation” after he criticised senior midwife colleagues. He said: “On a daily basis there was evidence of deteriorating standards of care. We were certain that the situation posed a direct threat to both patients’ safety and staff wellbeing. Concern was expressed that there was a genuine risk that we could start to see avoidable patient disasters.” Rather than addressing these, Pitman said the trust had considered it “the path of least resistance to take out [the] whistleblower”. Pitman was dismissed this year from his job at the Royal Hampshire County hospital (RHCH) in Winchester, where he had worked as a consultant for 20 years. He is claiming he suffered a detriment due to exercising rights under the Public Interest Disclosure Act. He said he “fought against [an] absolute barrage of completely unprofessional assaults on me” after he raised concerns about foetal monitoring problems that resulted in the death of a baby and the delivery of another with severe cerebral palsy. Read full story Source: The Guardian, 26 September 2023
  24. Content Article
    The well-being of Black mothers during and after pregnancy has been disproportionately affected by cultural barriers that hinder access to adequate mental health care. Addressing and breaking these barriers is essential to ensuring the well-being of Black mothers and promoting healthy outcomes for their children. Black Maternal Mental Health Week is led by The Motherhood Group and the theme for 2023 is Breaking Cultural Barriers.
  25. News Article
    Hospitals are still promoting a “natural birth is best” philosophy – despite a succession of maternity scandals highlighting the dangers of the approach. A Telegraph investigation has found a number of trusts continuing to push women towards “normal” births – meaning that caesarean sections and other interventions are discouraged. On Saturday, the Health Secretary has expressed concern about the revelation, vowing to raise the matter with senior officials. Guidelines for the NHS make it categorically clear that a woman seeking a caesarean section should be supported in her choice, after “an informed discussion about the options”. Maternity services were last year warned by health chiefs to take care in the language they used, amid concern about “bias” towards natural births. The warning from maternity officials followed concern that women were being left in pain and fear, with their preferences routinely ignored. The findings come 18 months after Dame Donna Ockenden published a scathing report into maternity care at Shrewsbury and Telford NHS Trust, which warned that a focus on natural birth put women in danger. Read full story (paywalled) Source: The Telegraph, 23 September 2023
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