This week’s share is the Care Quality Commission's report on maternity services (https://lnkd.in/eJvspZRp). It builds on previous reports in 2020 and 2022, shining a further spotlight on the state of maternity care today. This subject matters really deeply to me: I was privileged to be an obstetric anaesthetist for twenty years, and counselled numerous women who had experienced poor care which was impacting their decision making about how (and in some cases if ) they should give birth in the future, and their stories shaped my practice. The report makes difficult reading. It’s not describing anything new, and there is good progress in some areas, but overall the pace of change is slow. Today, no English maternity service is rated as outstanding, and two thirds ‘require improvement’ or worse. It describes that, in some units, poor care has become normalised, with incidents under-reported. This misses the opportunity to learn and institute training. Alongside this is a normalisation of potentially serious incidents when these have been managed effectively, not asking if the whole event was avoidable. Birth can still be psychologically very traumatic even when care is safe. This contributes to the long term impact giving birth can have on mental health even when physical trauma has resolved. The report states that 4 to 5% of women develop PTSD as a result of giving birth a year. I did the maths, and that’s 25 to 30 000 women a year. Other areas of focus include lack of consistent triage, poor data, estates that don’t support delivering safe care, communication challenges both with clients and between staff, and deep seated health inequalities. Addressing these issues is hard, and made harder by the long standing staffing challenges in maternity services. Shortages, and the pressure staff feel under to go the extra mile contribute to risking sickness rates and retention challenges that perpetuate the cycle. And care needs are getting more complex, with rising rates of obesity and other medical conditions and a continuing rise in the proportion of babies born by caesarean section. At CF I’ve worked with a number of systems and ICBs to set out the specific challenges faced by local maternity services, develop care models that tackle these, set a strategic direction for the future, and prioritise what needs to be done to deliver this. I’m invariably blown away by the passion and commitment of staff to deliver better care, their willingness to work in partnership across systems to do so, and to combine their knowledge with the data to develop compelling solutions. My fervent hope is that more systems set out the transformation of maternity services needed to deliver the care women and families deserve, and that the NHS 10 year plan when it comes enables delivery. Thoughts welcome, and if you’d like to talk about any of this, message me… #NHS #maternitycare
