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Women in labour are being refused epidurals in breach of official guidelines, a government inquiry has found. In findings reported by the Guardian, an investigation by the Department of Health and Social Care also found that women may not be being kept fully informed that if they choose to give birth at home or in a midwife-led unit they may have to be transferred if they want an epidural. Failing to make women aware of that possibility would also be in breach of National Institute for Health and Care Excellence (NICE) guidelines. As a result of the inquiry, the Health Minister Nadine Dorries will write to all heads and directors of midwifery and medical directors at NHS trusts this week to remind them of the NICE guidance regarding pain relief during childbirth and to ensure it is being followed. Clare Murphy, Director of external affairs at the British Pregnancy Advisory Service, said the “results of the government’s inquiry are sadly not surprising”. She added: “We have spoken with many women who have been so traumatised by their experience of childbirth that they are considering ending what would otherwise be wanted pregnancies. Pain relief is sometimes treated as a ‘nice extra’ rather than an integral part of maternity care, and women and their families can suffer profoundly as a result." Read full story Source: Guardian, 3 March 2020

There is always a lot happening with patient safety in the NHS (National Health Service) in England. Sadly, all too often patient safety crises events occur. The NHS is also no sloth when it comes to the production of patient safety policies, reports, and publications. These generally provide excellent information and are very well researched and produced. Unfortunately, some of these can be seen to falter at the NHS local hospital implementation stage and some reports get parked or forgotten. This is evident from the failure of the NHS to develop an ingrained patient safety culture over the years. Some patient safety progress has been made, but not enough when the history of NHS policy making in the area is analysed. Lessons going unlearnt from previous patient safety event crises is also an acute problem. Patient safety events seem to repeat themselves with the same attendant issues. Read full story Source: Harvard Law, 17 February 2020

A shortage of contraception is causing chaos and risks unplanned pregnancies and abortions, doctors are warning. Leading sexual health experts have written to ministers warning that the supply shortage of contraceptives is beginning to lead to serious problems across the UK. A number of daily pills and a long-acting injectable contraceptive are thought to be affected, including Noriday, Norimin and Synphase. The problem follows a shortage of hormone replacement therapy for menopausal women last year. It is unclear how many women use these types of contraception - overall around three million women take daily pills, and more than 500,000 use long-acting contraception, such as coils, implants and injections. The Royal College of GPs said its members were doing their best to help women find alternatives - there are many different types of daily pill available. Faculty president Dr Asha Kasliwal said; "We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system. This is causing utter chaos." The faculty has teamed up with the Royal College of Obstetricians and Gynaecologists and the British Menopause Society to write to ministers, asking them to set up a working group to address the problems. The letter warns women are becoming distressed by having to find alternative products that might not necessarily suit them or go without contraception altogether. It said this was affecting the "physical and mental wellbeing of girls and women" and could lead to a "rise in unplanned pregnancies and abortions". Read full story Source: BBC News, 7 February 2020

One in six women who lose a baby in early pregnancy experiences long-term symptoms of post-traumatic stress, a UK study suggests. Women need more sensitive and specific care after a miscarriage or ectopic pregnancy, researchers say. In the study of 650 women, by Imperial College London and KU Leuven in Belgium, 29% showed symptoms of post-traumatic stress one month after pregnancy loss, declining to 18% after nine months. The study recommends that women who have miscarried are screened to find out who is most at risk of psychological problems. "For too long, women have not received the care they need following a miscarriage and this research shows the scale of the problem," says Jane Brewin, Chief Executive of miscarriage and stillbirth charity Tommy's. "Miscarriage services need to be changed to ensure they are available to everyone and women are followed up to assess their mental wellbeing with support being offered to those who need it, and advice is routinely given to prepare for a subsequent pregnancy." Read full story Source: BBC News, 15 January 2020

Sick newborns in some areas of the UK are dying at twice the rate of seriously ill babies in other areas, a new report has revealed. The findings raise serious questions about the quality of care in some neonatal units, with experts warning action needs to be taken to tackle the “striking variation”. Across the country neonatal units are also short of at least 600 nurses with four in five failing to meet required safe staffing levels for specialist nurses. The regions with the highest mortality rate at 10 per cent were Staffordshire, Shropshire and the Black Country, where 107 babies died. This compared with a rate of 5 per cent in north central and northeast London. The Shropshire region includes the Shrewsbury and Telford Hospitals Trust, which is at the centre of the largest maternity scandal in the history of the NHS, with hundreds of alleged cases of poor care now under investigation. Dr Sam Oddie, a consultant neonatologist at Bradford Teaching Hospitals Trust and who led the work for the Royal College of Paediatrics and Child Health, said he was “surprised and disappointed” by the differences in death rates between units. “The mortality differences are very striking, with some units having a mortality rate twice that of the lowest. This variation in mortality is a basis for action by neonatal networks to ensure they are doing everything they can to make sure their mortality is as low as possible,” he said. Read full story Read MBBRACE-UK report Source: The Independent, 18 December 2019