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NAO: ‘Wide Variation’ In Quality And Safety Of NHS Maternity Care

Report Reveals ‘Unexplained Variations’ In Performance


A new report from the National Audit Office (NAO) has revealed concerns over ‘significant and unexplained’ variations in the performance of NHS maternity services across England, including in relation to issues including safety and quality.

The report revealed that while most women are provided with a positive experience and there have been improvements in services, there remains work to be done to address the differences which exist between trusts.

It also found that one in 133 babies was stillborn or died within several days of birth in 2011 and while the mortality rate has fallen over time, comparisons with other UK nations indicate there may be scope for improvement.

The most common reasons for medical negligence issues related to mistakes in labour management, caesarean sections and errors which led to cerebral palsy.

In conclusion, the NAO recommended increasing the presence of consultants on labour wards in an effort to improve decision making and outcomes, as well as to increase the number of midwives to ensure a widely recognised benchmark is being met.

It found that while 73 per cent obstetric units had consultants on duty for a minimum of 60 hours week – which was a significant increase from eight per cent – this cover did not meet recommendations set by the Royal College of Obstetricians and Gynaecologists.

Amyas Morse, head of the National Audit Office, said: “Since the Department of Health’s 2007 strategy, there have been improvements in maternity services, but the variation in performance across the country, and our findings on how services are being managed, demonstrate there is substantial scope for further improvement.”

Expert Opinion
While it is welcome that the NAO report suggests services are improving and the majority of NHS services are of a high standard, it remains clear that there is plenty to be done to address the continuing problems faced by NHS maternity services in England. The unacceptable truth is that mortality rates remain high when compared to other countries and everything possible needs to be done to tackle this issue.

"Through our work, we see numerous cases when families have been left devastated after losing a child due to preventable errors in care, as well as instances where child have suffered serious birth injuries which mean they need access to lifelong care and support to get the most from life.

"In all of these cases, those involved simply and rightly want answers over the ordeals they have faced, as well as reassurances that lessons will be learned which will ensure that no one else will face the heartache and difficulties they have suffered.

"Anyone being treated or cared for by the NHS deserves to receive the highest possible standard of care and there are too many occasions when this is not the case. We would urge the NHS and Government to thoroughly examine the findings of this report and determine what can be done to make further improvements to this area.

"Providing a high standard of support is vital if public confidence in the health service as a whole is to rise."
Lisa Jordan, Partner