Widespread maternity issues laid bare in new report

Preventable harm in maternity units across the country is at risk of being “normalised”, a new report has revealed.

Issues with staffing, leadership, how safety is managed, and problems with equipment and buildings are present in many of the 131 NHS units included in the CQC review.

While previous investigations into scandal-hit Trusts – such as East Kent and Shrewsbury and Telford – have revealed failings and poor standards of care that have played a role in babies’ deaths, this new review reveals the problems are far more widespread.

And the CQC warned that the scale of the problems in maternity care across the NHS meant that the risk to mothers and babies was in danger of becoming “normalised”.

Health Secretary Wes Streeting said the findings are a “cause for national shame”.

The new findings are the latest damning indictment of the standards of maternity care within the NHS, building on the recent Birth Trauma Report which laid bare how mothers felt dismissed and their concerns not taken seriously.

The CQC's 16-month investigation targeted maternity units not inspected and rated since March 2021.

Overall, 48 per cent were rated as inadequate or requiring improvement with around a quarter receiving a lower overall rating than when last inspected. On the single issue of safety, 65 per cent were judged to be failing.

While there were examples of good practice found, CQC’s report expressed concerns around staffing shortages and newly-qualified nurses taking on tasks beyond their experience; poor leadership and morale; inconsistences in the way safety incidents are monitored and recorded; and a lack of operating theatres resulting in delays to emergency Caesareans.

It also highlighted problems in triage, with expectant mothers facing delays in being assessed and not prioritised properly – an issue at the forefront of the Birth Trauma Report, and further highlighted in a recent paper by the Sands and Tommy’s Policy Unit.

Katie Fowler and Robert Miller’s daughter Abigail died at two days old due to failings in triage by the Maternity Assessment Unit (MAU) at the Royal Sussex County Hospital.

"When I was in the early stages of labour with Abigail, my husband and I phoned our MAU four times,” Katie says.

“A subsequent HSIB (now MNSI) investigation into Abigail's death found that three out of four of the calls were mishandled and her inquest found that her life would have been ‘significantly prolonged’ if we'd been invited into hospital when we should have been.”

Nisha Sharma, clinical negligence specialist principal lawyer at Slater and Gordon, who is handling growing numbers of maternity cases, again called for urgent action.

“While this latest CQC review is of course shocking, its content in many ways tells us nothing new,” she says.

“We know the problems that exist – they have been highlighted in previous reports on many occasions, and we hear about them first-hand from mothers who have suffered huge trauma because of these widespread issues in maternity care.

“The Health Secretary rightly calls it a ‘cause for national shame’, but I would again ask what are we doing about it? When are we going to make the wholesale deep-rooted change to maternity provision across the NHS that is so badly needed, that increasing numbers of traumatised parents have been calling for?

“We can only hope that this latest report is the catalyst for urgently-needed action – we cannot wait any longer.”