Troubled maternity wards still put patients at risk, watchdog warns | NHS

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Babies and mothers are at risk of injury and death because too many maternity wards have failed to improve care despite a number of birth scandals, the NHS watch dog has warned.

In a very critical report released Tuesday, the Care Quality Commission (CQC) raised serious concerns that lessons are being learned and that many incidents involving patient safety are still not being recorded.

Despite multiple inquiries, reports and recommendations, some hospitals are “too slow” to take the necessary steps to make labor and delivery safer, it said.

The CQC also noted other persistent weaknesses in maternity care, including tension and difficulties between obstetricians and midwives and poor monitoring of risks to patients during an in-depth inspection of maternity care at nine hospitals in England. The NHS has been criticized for major maternity scandals involving poor care, sometimes lasting for many years, at trusts like Morecambe Bay, East Kent and Shrewsbury and Telford.

The government, NHS leaders and patients have urged the NHS in England to revise maternity security to reduce the number of babies injured or died due to poor care during childbirth.

The watchdog also criticized hospitals for doing too little to catch the views of blacks, ethnic minorities and poorer communities on how to improve their birthing experience. Black women are four times more likely to die in childbirth than white women and Asian women are twice as likely to die.

“We know that many maternity services provide good care, but we remain concerned that we haven’t learned enough from good and excellent performance,” said Ted Baker, chief inspector of hospitals for the regulator.

He stressed that the CQC’s results were not representative of the quality and safety of obstetrics across England, as the nine hospitals visited were selected because of evidence suggesting that patients were at risk.

However, he added, “But we cannot ignore the fact that the quality of employee training; poor working relationships between obstetrics and midwifery teams and hospital and community midwifery teams; a lack of solid risk assessment; and failure to address and address the needs of local women continues to affect the safety of some hospital delivery services today. “

Baker also castigated employees in some units for a lack of transparency when things go wrong, which makes families withheld explanations and makes necessary changes less likely. “The death or injury of a new baby or mother is devastating and everyone who works in the health and care system has an obligation to do everything possible to prevent it.

“It is important that we have an open system that recognizes, investigates and learns when things go wrong so that families can learn the truth and safety is continuously improved,” he said.

In the report, a woman known only as Tinuke explains how she was diagnosed with preeclampsia – dangerously high blood pressure – very late in pregnancy.

After I was hospitalized as an emergency, “My labor was going very quickly, but the midwife refused to believe I was actually in labor. I was left alone for hours with no pain relief whatsoever.

“When I was told I could push, I was so exhausted that I had to be given obstetrics. That’s not how I wanted to give birth to my son. The whole experience was extremely traumatic and could have been avoided if I had been listened to, ”she added.

The report states that, despite a renewed focus on maternity care in recent years, “the pace of progress has been too slow and that measures to ensure that all women have access to safe, effective and personalized maternity care is not a priority was granted to mitigate risks and help prevent future tragedies ”.

In 2018, the CQC announced that it had classified 50% of maternity wards as either “needing improvement” or “inadequate”. Although that percentage had fallen to 39% by March 2020, it has since increased back to 41%, the new report says.

The Royal College of Midwives said it supports efforts to ensure safer care. But dr. Mary Ross-Davie, her director of professional midwives, pointed out the serious NHS-wide shortage of midwives.

“We also have to be realistic and make sure there are enough midwives to do this [personalised care] secure. At the moment most services across the UK are understaffed with some shifts barely 50% busy. It is for this reason that the RCM has urged the government to ensure that we have enough midwives so that women can get the maternity care they need and deserve, ”she said.

An NHS spokesperson said: “The NHS is committed to providing safe, compassionate maternity services and has invested an additional £ 95 million in staff and training programs to improve leadership.

“We continue to face poorer outcomes, including by introducing our new equality strategy and rapidly pursuing our care continuity program, which has been shown to significantly improve your overall care experience.”


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