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Found 810 results
  1. Content Article
    Poster presentation from Dr Felicity Brokke and Ken Spearpoint at the recent GOSH Patient Safety and Human Factors Conference.
  2. Content Article
    Women should be able to have confidence that they will receive safe, effective, compassionate maternity care that focuses on their individual needs. That is the experience of many people. But too many families still face care that puts the safety and wellbeing of women and babies at risk. This Parliamentary and Health Service Ombudsman (PHSO) report looks at themes from maternity complaints families have brought to us, to shine a light on their experiences and encourage others to let their voices be heard. It shares case summaries and guidance to help families complain and help NHS organisations understand the issues.
  3. Content Article
    Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, Korstjens et al. examined their interactions in the clinic, looking for “good practice”.
  4. Content Article
    In this Guardian article, Sarah Kendell describes her experience of maternity care in Australia, highlighting the stark difference in care offered before and after a woman has given birth. She says "at the most difficult transition of our lives–after childbirth–the healthcare system leaves us to fend for ourselves," and argues that the impact this can have on the health and wellbeing of women and their babies needs to be considered. She asks whether reallocating some resource from antenatal care to postnatal care would produce health benefits for new mothers and babies.
  5. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Isabela shares how her experience of losing her baby daughter to avoidable harm in 2006 led to her involvement in patient safety advocacy. She talks to us about the vital role of patient campaigners in driving the movement to reduce avoidable harm, and why we need to shift from patient inclusion to belonging in order to improve patient safety.
  6. Content Article
    In this blog, Sonia Barnfield, Clinical Adviser for Maternity Investigations at the Healthcare Safety Investigation Branch (HSIB), looks at risk assessments during the maternity care pathway, following HSIB's recent national learning report on the same subject. Sonia outlines the need for change in the way that risk during pregnancy is assessed and managed, highlighting that there is currently no single national guidance and that HSIB identified repeated examples of insufficiently robust, continuous risk assessment in the maternity pathway. She lays out six key themes highlighted in HSIB's report and looks at how risk assessments should change to improve safety for pregnant women and their babies.
  7. Content Article
    At least 1 in 5 mothers experience a perinatal mental health (PMH) problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period. This resource was produced by the Institute of Health Visiting (iHV) in partnership with the Maternal Mental Health Alliance (MMHA). It draws together principles collated from a comprehensive desktop evidence review of current policy, research, reports and literature on what good PMH care looks like. It aims to support individuals, services, pathways, multiagency groups and networks across health, public health, social care and non statutory services to consider: Where are we now? Is the care we currently provide good enough? What do families want mental health care in the perinatal period to look like?
  8. Content Article
    A recording of the conference from Midwifery Conversation on ‘action to reduce the disparate deaths and damage to Black mothers and babies in England.'
  9. Content Article
    Statement from Maria Caulfield, Parliamentary Under Secretary of State (Minister for Mental Health and Women's Health Strategy) on the Government’s initial response to the report of the independent review into the maternity and neonatal services at East Kent University NHS Foundation Trust that was published on the 19 October 2022. NHS England commissioned Dr Bill Kirkup to undertake this review following concerns about the quality and outcomes of care.
  10. Content Article
    The Scottish Patient Safety Programme (SPSP) is a national quality improvement programme that aims to improve the safety and reliability of care and reduce harm.  Since the launch of SPSP in 2008, the programme has expanded to support improvements in safety across a wide range of care settings including Acute and Primary Care, Mental Health, Maternity, Neonatal, Paediatric services and medicines safety. Underpinned by the robust application of quality improvement methodology SPSP has brought about significant change in outcomes for people across Scotland. 
  11. Content Article
    Risk assessment during the maternity pathway relies on healthcare professionals recognising a change in a pregnant woman/person’s circumstances that may increase the level of risk. Risk assessments are undertaken during the numerous contacts pregnant women/people have with a team of healthcare professionals throughout the maternity pathway. This thematic review draws on findings from the Healthcare Safety Investigation Branch's (HSIB's) maternity investigation programme to identify key issues associated with assessing risk during pregnancy, labour and birth (known as the ‘maternity pathway’). It examined all reports undertaken by the HSIB maternity investigation programme from April 2019 to January 2022, with the aim of identifying key learnings about risk assessment. A total of 208 reports that had made findings and recommendations to NHS trusts about risk assessment during the maternity pathway were included. The review identified an overarching theme around the need to facilitate and support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, seven specific ‘risk assessment themes’ within the maternity care pathway were identified as commonly appearing in HSIB reports. These seven themes require a focus from the healthcare system to help mitigate risks and enable NHS trusts and clinicians to deliver safe and effective maternity care to pregnant women/people.
  12. Content Article
    Victoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
  13. Content Article
    The OptiBreech project is a research study exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. About 1 in 25 babies are born bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice. In this video, Dr Shawn Walker explains why the combination of meconium and tachycardia, particularly in the first stage of labour, indicates increased risk in breech births.
  14. Content Article
    Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes. Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by 2030. This report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
  15. News Article
    NHS England is raiding a national fund earmarked for improvements in cancer, maternity care and other priority services by up to £1bn this year, to pay for deficits elsewhere, and will cut it by a similar amount in 2023-24, HSJ has learned. The “service development fund” is allocated at the beginning of the year for priority service areas also including primary care, community health, mental health, learning disabilities and health inequalities. Several NHSE directors said it was being tightly squeezed this year, amid major cost pressures from inflation, a pay deal unfunded by government, and higher than expected covid-related costs. One well-placed source said the fund this year was required to underspend by about £1bn against what had been planned, which will help balance overspends elsewhere in the NHS. The cuts are likely to be linked to ministers’ view that the NHS should focus on “core” priorities and cut other activities, including reducing NHSE national programme work which is typically linked to SDF budgets. Patricia Hewitt is looking into giving integrated care systems more “autonomy” from NHSE to set their own priorities. Read full story (paywalled) Source: HSJ, 8 December 2022
  16. News Article
    More than 1,000 referrals to admit very sick or premature babies to neonatal units were rejected in the last year due to a lack of beds, data obtained by HSJ has revealed. Nineteen trusts turned down a total of 2,721 requests to admit a baby to their level three neonatal intensive care unit – those for the most serious cases – specifically due to a lack of a bed, between 2019-20 and 2021-22, with 1,345 such refusals taking place in 2021-22. Experts told HSJ the issue – which appears to have led to families having to travel very long distances from their homes – was due to a shortage of staff, especially nurses, meaning insufficient beds (normally referral to as cots in neonatal care) can be opened. A British Association of Perinatal Medicine spokesperson told HSJ: “Neonatal intensive care units should run at less than 80% occupancy on average to allow for peaks and troughs in activity. There are a significant number which are having to run over that capacity limit which can cause flow problems – we’re a bit like an A&E that can’t stack the ambulances outside – once the baby is there, it has to come and we’re not able to control those admissions.” Read full story (paywalled) Source: HSJ, 1 December 2022
  17. News Article
    The NHS could be facing its largest maternity scandal to date as the review into services in Nottingham is now expected to exceed 1,500 cases, The Independent has learned. The probe began in 2021 after this newspaper revealed dozens of babies had died or been left with serious injuries or brain damage as a result of care at NUH, which runs Nottingham’s City Hospital and Queen’s Medical Centre (QMC). But the scope of the investigation has more than doubled, with Nottingham University Hospitals NHS Trust sending more than 1,000 letters to families to contact the independent inquiry, after 700 families previously came forward with their concerns. Of these, the number of families expected to be covered by the probe is more than 1,500 – surpassing the 1,486 examined during the UK’s current largest maternity scandal in Shrewsbury. Read full story Source: The Independent, 30 November 2022
  18. News Article
    The rising number of women who have caesarean sections instead of natural births is causing concern for the National Childbirth Trust (NCT). The trust, which supports women through pregnancy, childbirth and early parenthood, says it does not know why the rate of caesareans is increasing. One in four maternity services showed a caesarean rate of between 20% and 29.9%, and 2% of services had a rate of more than 30%, according to latest figures. The World Health Organization recommends that the acceptable rate is 10 to 15%. The maternity care working party, a multi-disciplinary group set up by the NCT, said there was an urgent need to address the problem. "A caesarean is major abdominal surgery," the working party said in a statement to a conference in London with the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists "Most women would prefer to give birth normally, provided that a normal birth is considered safe for them and their baby. It is important that health professionals' advice does not have the effect of denying them this opportunity without good reason." The working party is calling for data to be published on caesarean section rates and for obstetricians to justify in each case that the benefits outweigh the hazards. It also wants action to be taken to prevent any inappropriate use of caesarean sections. Belinda Phipps, chief executive of the NCT, said: "We know that in many cases caesareans are necessary for good clinical reasons. However, in our view rates have reached unacceptable levels and we want to know why." Read full story Source: The Guardian, 24 November 2022
  19. News Article
    Bosses at Nottingham's crisis-hit maternity units are set to miss a deadline for clearing a backlog of incomplete "serious incident" investigations. Nottingham University Hospitals Trust (NUH) has 53 outstanding maternity incidents yet to be investigated. The trust had said it aimed to complete investigations by December 23. But director of midwifery Sharon Wallis says they have not progressed as quickly as she had hoped. The Local Democracy Reporting Service said the trust has managed to clear a number of those incidents - but it declared another nine in September and October. An independent review team, led by senior midwife Donna Ockenden, is examining dozens of baby deaths at the trust. Read full story Source: BBC News, 25 November 2022
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
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