Widespread maternity failings uncovered by CQC are a "cause for national shame"
Almost half of maternity services are failing mothers and babies, a new report by the Care Quality Commission has found. These figures should be shocking, but to those of us who strive to improve standards in the NHS through lessons learnt from clinical negligence claims, it is not at all surprising.
The CQC inspected 131 locations providing maternity services in England from August 2022 to December 2023 and the findings make for depressing reading. Almost half – 48% - were found to be either "inadequate" or "requiring improvement". Just 4% were rated as "outstanding".
When inspectors looked specifically at patient safety, not a single unit was outstanding - 47% locations required improvement and 18% were inadequate.
Health Secretary Wes Streeting said the current state of care for mothers and babies keeps him "awake at night." He added: "These findings are cause for national shame. Women deserve better - childbirth should not be something they fear or look back on with trauma. It is simply unacceptable that nearly half of maternity units the CQC reviewed are delivering substandard care."
Many Trusts are not learning from mistakes, the CQC found, and are instead choosing to treat incidents as "inevitable" rather than accept accountability. It warned that failings in NHS maternity services are so "widespread" they risk becoming "normalised".
The report stresses that more work needs to be done to improve the way incidents are reported, learned from and communicated, that risk needs to be better assessed and triaged, that there can be no place for inequality and racism in maternity services and that women are given adequate information in order that they can make informed decisions and consent to treatment.
These concerns have been raised before, yet little progress has been made. As highlighted by Nicola Wise, the CQC director of secondary and specialist care, none of the issues cited in the report are new.
These include poor management of incidents with limited learning when things go wrong, a failure to ensure safe and timely assessment, unsuitable estates and access to essential equipment, a lack of oversight from trust Boards, varied efforts to tackle inequalities in outcomes for Black and ethnic minority women, chronic staffing shortages and a need for better engagement with families.
Calling for government money to be "ring-fenced" for safer maternity services, Nicola Wise said: "We cannot allow an acceptance of shortfalls that are not tolerated in other services. Collectively, we must do more as a healthcare system.
"This starts with a robust focus on safety to ensure that poor care and preventable harm do not become normalised, and that staff are supported to deliver the high-quality care they want to provide for mothers and babies today and in the future."
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