Maternity care shows “substantial scope for improvement”, Watchdog reports

The NHS has been in the news yet again, following a report by the National Audit Office (NAO) which highlights continuing failings in the provision of maternity services.

Figures obtained from the NAO in a report on “Maternity Services in England“ prepared by the Comptroller and Auditor General [ which is responsible for auditing central government accounts and reporting on value for money], show that the number of medical negligence claims involving childbirth and maternity care rose by 80% over a five year period – necessitating the reserve of a staggering £482 million by the NHS to meet these potential birth injury negligence payouts in 2012/2013 alone.

The NAO say that this rise in claims “highlights the importance of improving risk management and the safety of care.” Mismanaged birth and related mistakes are now responsible for an incredible one third of the total annual sum of £1 billion which it costs the NHS in payouts as the result of medical negligence claims. Costs in settling claims arising out of poor maternity care are typically higher than claims arising out of other areas within the NHS, as the settlement figures often have to meet the considerable costs of providing lifelong care for the injured baby as it grows.

The current “baby boom” – the number of births has increased by almost a quarter in the last decade and is currently at its highest level for 40 years – and the general shortage of midwives are both significant factors, the watchdog’s report states. Maternity services are struggling as there is a shortage of 2300 midwives in England, and April – September 2012 saw 28% of units providing maternity services being forced to close for periods of time ranging from twelve hours to fourteen days – the reasons being a shortage of manpower in the form of midwives or capacity in terms of beds.

Despite guidelines provided by the Royal College of Obstetricians and Gynaecologists, a low level of consultant presence is also stated to be a factor in the rise in claims. Although the physical presence of consultants during labour has improved quite significantly – the watchdog reported that a consultant was on hand for 60 hours a week or more in 73% of maternity units – according to the figures 53% of maternity units, including the country’s biggest, were still failing to meet the presence level recommended by the Royal College.

The NAO’s report also reveals that in England, more babies are either stillborn or die within a week of being born than elsewhere in the UK – at one in 33 of all births.

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