Mothers and babies have been put at risk because steps to improve maternity care have been ‘too slow’, the CQC has warned.
A report, published by the health inspectors on Tuesday, found the ‘pace of progress has been too slow’ despite a push to improve maternity services. This follows a string of high-profile scandals at trusts such as Morecambe Bay, East Kent and Shrewsbury and Telford.
It said that while many maternity units in England were providing good care, it had concerns about leadership, risk assessment, teamworking, culture and community engagement among some teams.
And ethnic inequalities in outcomes among women and babies have been ‘exacerbated’ by the Covid-19 pandemic and must be tackled immediately. Black women are four times more likely to die in childbirth than white women, and Asian women twice as likely, it added.
Ted Baker, CQC chief inspector of hospitals, said: ‘The death or injury of a new baby or mother is devastating and something that everyone working in the health and care system has a responsibility to do all they can to prevent.
‘It is essential that we have a system that is open, and that recognises, investigates, and learns when things go wrong, so that so that families get the truth, and safety continually improves,’ he added.
Looking at nine sample maternity safety inspections between March and June 2021, the inspectors who wrote the report found:
- A lack of consistent and clear leadership, management, governance and assurance processes. This included a lack of oversight of services and problems in them.
- Poor working relationships between obstetric and midwifery teams, and hospital and community-based teams
- Some staff feel unsupported, not confident enough to seek support from senior colleagues or too afraid to challenge decision-making.
- Some staff were unengaged with training, and the quality of training and support for staff varying between trusts. Poor incident reporting was a further theme and staff did not always recognise what constituted an incident or how to grade incidents correctly.
In June 2020, the chief midwifery officer wrote to all NHS midwifery services calling on them to take action to minimise the impact of Covid-19 additional risks faced by women and babies from black and minority ethnic communities.
But the authors warned that in many cases the actions – including offering increased support, tailoring communications, ensuring risk factors are discussed with women, and recording the ethnicity of every woman and other risk factors – had been ‘interpreted quite narrowly’.
Mr Baker continued: ‘We also must do more to tackle the disparities in outcomes that exist for black and minority ethnic women. Addressing inequalities and tailoring maternity services to best meet the needs of the local population is a critical area for action.’
In 2018, the CQC revealed it had rated 50% of maternity units as either ‘requires improvement’ or ‘inadequate’. The proportion had fallen to 39% by March 2020 – but has risen since to 41% this July.
And in April this year, the NHS invested £95m from 2021/22 to make maternity units in England safer after the care scandal at Shrewsbury and Telford Hospital Trust.
NMC director of professional practice Geraldine Walters outlined how the NMC is laying the groundwork for the future of midwifery in a blog for Nursing in Practice this week.
To complete CPD modules on women’s health on Nursing in Practice Learning, click here.
