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Found 459 results
  1. News Article
    Hepatitis B transmission from mothers to babies has been eliminated in England, according to the World Health Organisation (WHO). The WHO elimination target is that less than 2% of babies born to mothers with hepatitis B go on to develop the infection. And data from the UK Health Security Agency (UKHSA) shows the figure for England currently stands at 0.1% The UKHSA said progress had been made in tackling the viral infection, which can cause liver damage, cancer and death if left untreated. A six-in-one vaccine is offered to all babies on the NHS when they are eight, 12 and 16 weeks of age. Health and Social Care Secretary Steve Barclay said: “We are paving the way for the elimination of hepatitis B and C, with England set to be one of the first countries in the world to wipe out these viruses.” Read full story Source: The Independent, 2 February 2023 .
  2. News Article
    The UK is facing a “crisis point” in abortion provision, experts say, with rising demand and restricted access to care in many areas putting unprecedented pressure on struggling NHS services. Healthcare professionals described a “terrifying” state of affairs in which women are travelling hundreds of miles for appointments or waiting several weeks before they are seen. Dr Jonathan Lord, the director of MSI Reproductive Choices UK, a major provider of abortion services, told the Guardian’s Today in Focus podcast: “There is no doubt we are seeing absolutely unprecedented levels of demand at the moment. All providers are reporting they are busier than they have ever been.” Lord, who is also an NHS consultant gynaecologist, said the rise was being driven by “the economic downturn, the cost of living crisis and the ability to access good quality contraception” via GPs and sexual health services, which have been affected by the wider NHS crisis. Clare Murphy, the chief executive at the British Pregnancy Advisory Service (BPAS), previously said: “The pandemic, and the policies adopted by the government, have had a clear impact on women’s pregnancy choices.” Faced with “economic uncertainty and job insecurity”, women had been forced to make tough decisions, she said. Read full story Source: The Guardian, 26 January 2023
  3. Content Article
    The Health and Social Care Select Committee have published a new report reviewing the progress that the UK Government has made in implementing the recommendations of the Independent Medicines and Medical Devices Safety Review, sometimes referred to as the Cumberlege Review. This blog sets out Patient Safety Learning’s reflections on this report.
  4. Content Article
    This Health and Social Care Select Committee report reviews the progress that the UK Government has made in implementing the recommendations of the Independent Medicines and Medical Devices Safety Review, sometimes referred to as the Cumberlege Review. You can read Patient Safety Learning’s reflections on this report here.
  5. News Article
    Fewer women who gave birth in NHS maternity services last year had a positive experience of care compared to 5 years ago, according to a major new survey. The Care Quality Commission’s (CQC) latest national maternity survey report reveals what almost 21,000 women who gave birth in February 2022 felt about the care they received while pregnant, during labour and delivery, and once at home in the weeks following the arrival of their baby. The findings show that while experiences of maternity care at a national level were positive overall for the majority of women, they have deteriorated in the last 5 years. In particular, there was a notable decline in the number of women able to get help from staff when they needed it. Many of the key findings from the survey include a drop in positive interactions with staff and lack of choices about the birth. Just over two-thirds of those surveyed (69%) reported 'definitely' having confidence and trust in the staff delivering their antenatal care. Results were higher for staff involved in labour and birth (78%). In addition, while the majority of women (86%) surveyed in 2022 said they were 'always' spoken to in a way they could understand during labour and birth, this was a decline from 90% who said this in 2019. The proportion of respondents who felt that they were 'always' treated with kindness and understanding while in hospital after the birth of their baby remained relatively high at 71%, however had fallen from 74% in 2017. Just under a fifth of women who responded to the survey (19%) said they were not offered any choices about where to have their baby. Also, less than half (41%) of those surveyed said their partner or someone else close to them was able to stay with them as much as they wanted during their stay in hospital. Read full story Source: Medscape, 13 January 2023
  6. Content Article
    This survey from the Care Quality Commission (CQC) looked at the experiences of women and other pregnant people who had a live birth in early 2022.
  7. Content Article
    Recording of the Health and Social Care Committee meeting held on Tuesday 13 December 2022. Meeting started at 10.03am, ended 11.45am.
  8. Content Article
    This policy paper, published by the Department of Health and Social Care, provides an update on the UK Government’s progress in implementing the recommendations of the Independent Medicines and Medical Devices Safety (IMMDS) Review, sometimes referred to as the Cumberlege Review.
  9. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the issues associated with the assessment of risk factors for venous thrombosis in pregnancy and the first six weeks after birth. Venous thrombosis occurs when a blood clot forms and causes a blockage in a person’s vein. This can lead to venous thromboembolism (VTE), when part of the clot breaks off and travels through the bloodstream, blocking a blood vessel elsewhere in the body. Pregnant women and pregnant people are at greater risk of developing a venous thrombosis than those who are of the same age and not pregnant. Because of the increased risk, healthcare staff assess a pregnant woman’s risk factors for VTE at key stages before and after the birth, so that they can be given preventative treatment if necessary. While rare, in the UK venous thrombosis and VTE is the leading direct cause of death of pregnant women during pregnancy or up to six weeks after the end of pregnancy. Reference event The reference event for this investigation was the case of Alice, who was 26 years old and was pregnant with her second child. A VTE risk assessment was completed for Alice at her first antenatal appointment, when she was admitted to hospital for the birth of her child, and 24 hours after admission. Her score was zero each time, meaning no risk factors were identified for VTE. During her pregnancy Alice reported experiencing some pain in her calf; she was examined by a doctor who referred her for a scan. This ruled out a deep vein thrombosis (DVT). After giving birth by caesarean section, Alice's risk assessment was repeated, and as it indicated that medication was required, a preventative dose of low-molecular-weight heparin was prescribed and Alice was discharged. Eleven days after the birth of her baby, Alice was taken by ambulance to the emergency department with chest pain, shortness of breath and leg cramps. She was diagnosed with a pulmonary embolism (PE) and was started on a treatment dose of blood-thinning injections. Following investigation, it was found that Alice may not have received an appropriate preventative dose of low-molecular-weight heparin to help prevent the VTE.
  10. 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
  11. News Article
    Mothers are being offered water injections by the NHS to relieve pain during childbirth, while in some hospitals midwives are burning herbs to encourage breech babies to turn in the womb. Safety campaigners have dubbed the practices dangerous and say that they amount to “pseudoscience” being offered by the health service. They have called on the chief executive of NHS England, Amanda Pritchard, to ban their use in a letter published over the weekend. At least three trusts in England offer water injections for pain relief, including Newcastle upon Tyne Hospitals Trust, United Lincolnshire Hospitals Trust and North Tees and Hartlepool Trust. Information on the Newcastle trust’s website describes the injections as an “alternative form of pain relief” while in Lincolnshire patients are told the body’s response to the injections “prevents pain signals from reaching the brain.” The National Institute for Health and Care Excellence (NICE), which is responsible for setting out which treatments patients should receive, has said the NHS should not use injected water for pain relief. Read full story (paywalled) Source: The Times, 27 November 2022
  12. 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
  13. News Article
    Contrary to current advice, getting pregnant within a few months of an abortion or a miscarriage does not appear to be extra risky for the mum and baby, say researchers who have looked at recent real-life data. The World Health Organization (WHO) recommends at least a six-month gap to give the woman time to recover. However, a study in PLoS Medicine, analysing 72,000 conceptions, suggests couples might safely try sooner for a baby. The baby loss support charity Tommy's says women who feel ready to try again immediately after a miscarriage should do so if there is no medical reason against it. The WHO says more research into pregnancy spacing is already under way and would inform any future updates to the advice. The research from Norway, spanning eight years from 2008 to 2016, found no major differences in outcomes when a new pregnancy happened sooner than a six-month delay. That is a different finding to earlier work in Latin America that - along with other studies - informed the WHO recommendations on pregnancy spacing. The authors of the latest Norwegian analysis say the advice needs reviewing so that couples can make an informed decision about when to try for a baby. Read full story Source: BBC News, 23 November 2022
  14. 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
  15. 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.
  16. News Article
    Far too many women were rushed into mesh sling surgery for stress incontinence after birth when pelvic floor physiotherapy could have fixed or eased the problem. In France, women are offered pelvic floor physiotherapy after childbirth as standard. A recent question to the Secretary of State for Health and Social Care asked what assessment the Department has made of the potential benefits of offering new mothers pelvic floor physiotherapy. This question was answered on 15 November 2022: "The National Institute for Health and Care Excellence’s guidance recognises that physiotherapy is important for the prevention and treatment of pelvic floor problems relating to pregnancy and birth. The NHS Long Term Plan committed to ensure that women have access to multidisciplinary pelvic health clinics and pathways in England. NHS England is deploying perinatal pelvic health services to improve the prevention, identification and access to physiotherapy for pelvic health issues antenatally and postnatally. Two-thirds of local maternity and neonatal systems are expected to establish these services by the end of March 2023, with full deployment in England expected by March 2024." Source: Parallel Parliament, 15 November 2022
  17. 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
  18. 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.
  19. Content Article
    This survey by In-FACT (Independent Fetal Anti Convulsant Trust) is intended to provide patients, no matter what anti-epileptic drug (AED) they are prescribed or what condition the AED is prescribed for, the opportunity to report problems and worries about taking their medication during pregnancy. The results will be used to inform In-FACT's ongoing work to improve medication safety and their engagement with the Medicines and Healthcare products Regulatory Agency (MHRA).
  20. 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
  21. News Article
    Abortion access is a “fundamental” part of women’s healthcare the government’s women’s health ambassador has warned. Dame Lesley Regan, who was appointed as Women’s Health Ambassador by the Government in July, has said in answer to questions from The Independent about the voting records of ministers: “I think it’s really important that we never ever get complacent about freedom of choice. “Now what my view is about whether abortion is good or bad is really irrelevant. My job is to tell the Prime Minister if he’ll listen and the Secretary of State that it [abortion] is an absolutely fundamental part of women’s healthcare." “Because I’ve done so much work overseas during my career, what I know is that if you make it difficult to access, or you make it illegal, the problem doesn’t go away but women die as a result.” Her comments come after it was revealed this week that the prime minister and senior members of his government have voted against boosting access to abortions or have opted out of key votes. More than a third of the government’s current cabinet voted against early medical abortion at-home measures rolled out in the wake of the pandemic being made permanent. The Department for Health and Social Care’s minister for women, Maria Caufield, who has been granted responsibility for abortion care, has previously voted to curtail access rights. Earlier this year The Independent revealed women seeking abortions in the UK are having to travel hundreds of miles to access care as “untenable” waiting times put unsustainable pressure on services. Read full story Source: The Independent, 8 November 2022
  22. News Article
    A new pill that could prevent pre-eclampsia has become the first pregnancy drug to be fast-tracked for development by the UK’s drug regulator. Scientists at MirZyme Therapeutics, a biopharmaceutical company, believe they have developed a drug that when given to women from 20 weeks of pregnancy could stop them developing the condition. Pre-eclampsia endangers the lives of thousands of expectant mothers and their babies in the UK each year, and has no therapeutic options. Globally, it affects between 2% and 8% of pregnancies and kills up to half a million babies and 100,000 women a year. MirZyme Therapeutics has been awarded an innovative licensing and access pathway (ILAP), or so-called innovation passport, by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA). The passport was established in January 2021 to expedite access to essential new drugs at the height of the Covid pandemic. It is granted to medicines that address the needs of patients with life-threatening and unmet medical needs, with a view to getting the drug to the market as quickly as possible. Read full story Source: The Guardian, 8 November 2022
  23. 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.
  24. Content Article
    This is the transcript of a Westminster Hall debate in the House of Commons on Black Maternal Health Awareness Week 2022, dedicated to raising awareness about disparities in maternal outcomes.
  25. 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.
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