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Showing results for tags 'Obstetrics and gynaecology/ Maternity'.
Found 399 results
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News ArticleIn March 2015, the Morecambe Bay investigation, chaired by Dr Bill Kirkup, published its report into serious failures in care that led to the avoidable deaths of 11 babies and a mother at Furness General Hospital (FGH) between 2004 and 2012. One of the babies that died was James Titcombe's son, Joshua. The report described a seriously dysfunctional maternity unit where certain midwives pursued an “over-zealous” approach to promoting “normal” childbirth, relationships between doctors and midwives was poor, midwifery practice fell well below acceptable standards and, unforgivably, instances of avoidable harm and death were covered up – meaning lessons were not learned and similar failures were repeated year after year. The report detailed how opportunities to intervene at Morecambe Bay were missed at all levels and how the families who raised concerns were treated as problems to be managed, rather than voices that needed to be heard. More than four years later, it is both tragic and distressing to read about the litany of failures identified in the leaked interim report into care at Shrewsbury and Telford Hospital Trust (SaTH). Far from events at Morecambe Bay being a “one-off”, it is now painfully clear that not only have similar failures in care occurred elsewhere, but that they have happened on an even larger scale. James, speaking to The Independent, says "Worryingly, the reason why we are reading about these issues now isn’t because the regulatory system identified a problem and called for further scrutiny, but rather because of the extraordinary efforts of bereaved families." Read full story Source: The Independent, 21 November 2019
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News Article
West Suffolk Hospital's maternity services 'needs improvements'
Patient Safety Learning posted a news article in News
The Care Quality Commission (CQC) issued a warning notice to the West Suffolk Hospital in Bury St Edmunds, which must improve by 31 January. It has not released details but the hospital said inspectors flagged up how it recorded observations and monitored women in its care. A hospital spokeswoman said: "We have taken this feedback seriously and are acting accordingly." She added: "Concerns have been raised about how we record patient observations after we have taken them, which are currently not in line with national guidance". "The CQC also identified that we should make changes to the way we monitor women in our care, again to bring us in line with national guidance". "We are making the necessary changes and the CQC is satisfied with the plans we have in place to make the improvements required." Read full story Source: BBC News, 21 November 2019 -
News Article
Australian women win landmark vaginal mesh class action against Johnson & Johnson
Patient Safety Learning posted a news article in News
Hundreds of women left in debilitating pain by faulty transvaginal mesh devices have won a landmark case against multinational giant Johnson & Johnson. The Australian class action against companies owned by Johnson & Johnson was won on behalf of 1,350 women who had mesh and tape products implanted to treat pelvic prolapse or stress urinary incontinence, both common complications of childbirth. The devices all but ruined the lives of many. Women have been left in severe, debilitating and chronic pain, and often unable to have intercourse. The vast majority also suffered a significant psychological toll. The mesh eroded internally in many cases, has caused infections, multiple complications, and is near impossible to completely remove, Australia’s federal court has heard. The devices were not properly tested for safety before being allowed on to the Australian market, though Johnson & Johnson and the associated companies clearly knew the potential for serious complications. The companies were accused of launching a “tidal wave” of aggressive promotion at doctors, marketing the devices as cheap, simple to insert, and a relatively risk-free way to boost profits. All the while, their potential dangers were minimised, downplayed or ignored, both in communications to doctors and patients, the plaintiffs alleged. When patients complained of pain, they were frequently disbelieved. Read full story Source: The Guardian, 21 November 2019 -
News ArticleAs many as one in three women in the UK are traumatised by their birth experiences, and one in 25 of those will go on to develop full-blown PTSD. Following the most recent scandal at Shrewsbury, Milli Hill, the founder of the Positive Birth Movement, talks to The Independent about why we need to bring human connection back into maternity services, as well as continuing to invest in the research and technology that can save the lives of those most at risk and, why, above all, we need to start listening to women. If we don’t do these things, history will only repeat itself. Milli says: "We cannot continue to see scandals like Shrewsbury and Morecambe Bay as isolated, instead we must be brave enough to view them as symptomatic of a wider problem of a maternity system that has become completely dehumanised and unable to listen to women." Read full story Source: The Independent, 20 November 2019
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News Article
Shrewsbury and Telford Hospital: Babies and mums died 'amid toxic culture'
Patient Safety Learning posted a news article in News
Babies and mothers died amid a "toxic" culture at a hospital trust stretching back 40 years, a report has said. The catalogue of maternity care failings at Shrewsbury and Telford Hospital NHS Trust are contained in a report leaked to The Independent. It reveals that some children were left disabled, staff got the names of some dead babies wrong and, in one case, referred to a child as "it". The trust apologised and said "a lot" had been done to address concerns. In 2017, then Health Secretary Jeremy Hunt announced an investigation into avoidable baby deaths at the trust, which runs Royal Shrewsbury Hospital and Telford's Princess Royal. It is being led by maternity expert Donna Ockenden, who authored the report for NHS Improvement. Its initial scope was to examine 23 cases but this has now grown to more than 270 , covering the period from 1979 to the present day. The cases include 22 stillbirths, three deaths during pregnancy, 17 deaths of babies after birth, three deaths of mothers, 47 cases of substandard care and 51 cases of cerebral palsy or brain damage. The interim report said the number of cases it is now being asked to review "seems to represent a longstanding culture at this trust that is toxic to improvement effort". Read full story Source: BBC News, 20 November 2019 -
News Article
NHS health board Cwm Taf Morgannwg 'prioritised targets over safety'
Patient Safety Learning posted a news article in News
A health board criticised for severe maternity failings put too much emphasis on targets instead of patient safety, according to a new review of quality governance arrangements at Cwm Taf Morgannwg University. It found wider failings in Cwm Taf Morgannwg health board's governance. Healthcare Inspectorate Wales (HIW) and the Wales Audit Office (WAO) also found a high level of risk to patient safety was accepted as the norm in some departments. The health board said work was under way to address the issues raised. The report was not an assessment of frontline care, but spoke to staff about procedures for reporting and learning from problems. It found Cwm Taf Morgannwg health board had not given enough attention to the safety of its services, in contrast to a strong focus on targets and financial controls. Read full story Source: BBC News, 19 November 2019 -
Content ArticleThe Department for Health and Social Care (DHSC) launched a call for evidence in March 2021 to inform the first-ever government-led Women’s Health Strategy for England. This report focuses on the survey component of the consultation. Nearly 100,000 people in England got in touch to share: their personal views and experiences as a woman the experiences of a female family member, friend or partner their reflections as a self-identified health or care professional. The results highlight priority areas for action and further research and underpin DHSC’s vision statement for England’s Women’s Health Strategy (published in December 2021). The full strategy will be published in spring 2022.
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Content ArticleThe Ockenden review of maternity services at Shrewsbury and Telford NHS Trust uncovered the biggest maternity scandal in the NHS’s history. The report concludes that 201 babies and nine mothers might have survived if they had received better care and raises serious questions about how avoidable deaths and injury to so many mothers and babies could have happened Staffing pressures, training gaps, and overstretched rotas all contributed. But so did a failure to follow clinical guidelines or to investigate and learn from mistakes. Staff did not listen to patient experience, women were blamed or held responsible for poor outcomes—even their own deaths—and there was a lack of compassion in how patients were treated and responded to. Inadequate leadership and a bullying culture left staff feeling unable to raise concerns or escalate problems Is there a failure to listen to women across the NHS? Why are women’s voices ignored and their health concerns brushed aside?
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Content ArticleFollowing the Shrewsbury maternity scandal where "at least 201 babies would have survived with better care", outgoing CQC chief inspector of hospitals Ted Baker said the NHS should listen to criticism to be able to change. Ted Baker said the NHS faced a resistance to being challenged and "for anyone to refuse to listen to criticisms of what the NHS does I think is a big mistake." Listen to Ted Baker's, CQC's outgoing chief inspector, full interview on Times Radio.
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Content ArticleIn this article, the first in a series of two on pelvic mesh and its medicolegal challenges, Dr Ivan Ramos-Galvez, Consultant in Pain Medicine and expert witness, explores the uses of pelvic mesh and the complications that can arise. The second in the series focuses on the physical and psychological effects pelvic mesh implants can have on claimants.
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Content ArticleThis investigation by the Healthcare Commission examined the cases of ten women who died during pregnancy or within 42 days of delivery at Northwick Park Hospital, North West London Hospitals NHS Trust, between April 2002 and April 2005. This number of maternal deaths was significantly higher statistically when compared with other trusts that serve similar populations.
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Content ArticleIn the 1790s, François Marie Prevost, a young French surgeon fresh from his medical training in Paris moved to Port-de-Paix, Haiti. “Of course at that time Haiti was France's most economically valuable colony”, says historian Deirdre Cooper Owens. “So there he began some experimental work on enslaved Haitian women, trying to perfect the caesarean section.” Prevost's sojourn coincided with the leadership of Toussaint Louverture, who had been born a slave, the fight for Haitian independence, and the abolition of slavery. And so Prevost left Haiti for Louisiana. “He moved to a little town outside of Baton Rouge, and began experimental surgery on enslaved women there, perfecting the caesarean section, and he did this in the 1830s, the era before the civil war that ends slavery.” It was also an era in which Louisiana surgeons were reluctant to attempt the experimental surgery on white women. Of the 15 caesarean sections done by Prevost and others in Louisiana between 1820 and 1861, all were performed on enslaved women. “At the time, in the 19th century, during the time of slavery, they couldn’t consent”, she explains. “But this is the really interesting thing: from the 1830s all the way to the 21st century, Louisiana has been in the top three states with the most caesarean sections on Black women patients…So what's going on, did all of these women need to have caesarean sections?”
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Content ArticleThis World Health Organization (WHO) guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognises a “positive postnatal experience” as a significant end point for all women giving birth and their newborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognises the needs of women and babies, and respects their cultural context. This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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Content ArticleThe concept of woman-centred care is at the core of midwifery care and midwives have a key role as advocates and facilitators of women’s choices. This briefing from the Royal College of Midwives provides guiding principles and support for midwives in facilitating personalised care and women’s choices, including when those fall outside clinical recommendations.
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Content ArticleA patient satisfaction survey for outpatient hysteroscopy for patient's to share their comments on the service they received.
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Content ArticleThis report highlights the importance of embracing a culture of change in the design and delivery of women’s health to achieve national systems and local services fit to meet the expectations and needs of the 21st century woman. It describes the many failings of health services across the world whose default position is to treat women as second-class citizens and place unnecessary barriers to the delivery of high-quality accessible care. The report sets out recommendations, founded on common sense and rooted in the belief that women should be in control of their own bodies.
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Content Article
Misogyny is a safety issue: a blog by Saira Sundar
SairaS posted an article in Women's health
In this opinion piece, hub topic lead Saira Sundar looks at the culture of misogyny we have inherited in the medical profession, particularly in the obstetrics and gynaecology area of medicine. We hear time and time again women speaking up about being mistreated and/or disbelieved by medical professionals, resulting in delays in diagnosis and serious harm. However, there is a real change being forced by women themselves, with the public increasingly questioning and insisting on improvement and the right to be heard. -
Content ArticleThis article by the National Institute for Health Research (NIHR) summarises recent evidence about the information and support pregnant women need to make decisions about their maternity care, and any interventions they may need. It discusses the following areas: The importance of continuity of carer and personalised care in maternity services Women need clear information and better access to mental health care Helping women with complicated pregnancies make informed decisions about their care Supporting shared decision-making when there are problems with the baby
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Content ArticleThe Royal College of Obstetricians and Gynaecologists (RCOG) is undertaking a project to look at the impact of the pandemic on gynaecology waiting lists. The work will look at the size and scale of waiting lists and at the impact this is having on those who are waiting longer for diagnosis and treatment, and on the wider health service. The College would like to hear from people whose gynaecology care has been affected by the pandemic. This might mean you have struggled to get an appointment with or a referral from your GP to see a gynaecologist, waited longer for tests or a scan to receive a diagnosis of a gynaecological condition, or waited longer for treatment or surgery. The College wants to understand your experiences of having a suspected or diagnosed gynaecological condition that isn’t cancer, as ‘benign’ gynaecological conditions are managed differently in the NHS. This could be for conditions such as endometriosis or fibroids, heavy periods, incontinence or recurrent urinary infections – anything you’d be referred to a gynaecologist for. You can access the survey through the link below.
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Content ArticleThis report from the National Maternity and Perinatal Audit assesses care inequalities using data from births between 1 April 2015 and 31 March 2018 across England, Scotland and Wales. The National Maternity and Perinatal Audit (NMPA) is led by the Royal College of Obstetricians and Gynaecologists (RCOG) in partnership with the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine (LSHTM).
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Content ArticleIn this article, Dr Ivan Ramos-Galvez, Consultant in Pain Medicine at the Royal Berkshire Hospital, discusses the physical and psychological issues that can arise following surgery for pelvic mesh implants. Dr Ramoz-Galvez highlights that around a third of reported complications are systemic symptoms such as runny nose, muscle pain, brain fog and lethargy, which may be the result of a chronic inflammatory state within the body. Their link to pelvic mesh implants is suggested by the fact that many women report that these symptoms resolve after their implant is removed. He also discusses the wide-ranging impact of pelvic mesh side effects for women who experience them, highlighting that the consequences are not only physical, but also psychological, social and financial. He calls for the medical profession to recognise this and develop treatments that cover all aspects of pelvic mesh complications.
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Content ArticlePoppy Harris was born at Milton Keynes University hospital on 23 November 2020. Following a protracted labour, she was delivered using Kielland's forceps. She was transferred to John Radcliffe Hospital in Oxford where it was discovered that she had suffered a spinal cord injury and despite all efforts and care she died on 24 March 2021.
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Content Article
RCOG: Recurrent miscarriage guidelines (19 October 2021)
Patient Safety Learning posted an article in Maternity
A new medical guideline has been released for consultation by the Royal College of Obstetricians and Gynaecologists, bringing together all the available evidence on possible risks and causes of recurrent miscarriage, potential treatment options, management of subsequent pregnancies and best practice in supportive care. The new draft Recurrent Miscarriage guideline – last published in 2011 – supports a move towards a graded model of care where women are provided with individualised care earlier. In the UK, women can only access support after they have experienced three miscarriages in a row. The new approach would see women offered information and guidance to support future pregnancies after one miscarriage, an appointment at a miscarriage clinic for initial investigations after two miscarriages, and a full series of evidence-based investigations and care – as described in this guideline - after three miscarriages. -
Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
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Content ArticleOn Friday 17 September 2021 the World Health Organization (WHO) held their World Patient Safety Day 2021 Virtual Global Conference, focused on the theme of ‘Safe maternal and newborn care’. This page contains links to a number of presentations from the event.
