Improving the safety of maternity care in the NHS
New measures to make giving birth safer, including maternity safety funding and publishing maternity ratings, have been announced.
The safer maternity care action plan, designed to dramatically improve the safety of maternity care in the NHS, was announced by the Health Secretary today (17 October 2016).
The new measures will provide resources for trusts to improve their approach to maternity safety, including an £8 million fund for maternity safety training, with at least £40,000 available to each NHS trust in England. They also will make sure lessons are learned from mistakes and shared openly and transparently across the NHS. We will also consult on how to change the litigation culture, which can prevent openness and transparency, by taking views on a new voluntary compensation scheme as an alternative to costly legal processes.
The safer maternity care action plan also includes:
- a £250,000 maternity safety innovation fund to help create and pilot new ideas for improving maternity care, like the successful PROMPT scheme pioneered by Professor Tim Draycott, a consultant obstetrician, and Cathy Winter, a midwife, at Southmead Hospital in Bristol, where they have seen a 50% reduction in babies born with a low oxygen and a 70% reduction in babies born with a paralysed arm
- publishing new maternity ratings for every clinical commissioning group (CCG) across the NHS to improve transparency, raise standards and give families better information about the quality of local maternity services
- a new national Maternal and Neonatal Health Quality Improvement Programme for all trusts to exchange ideas and best practice – a similar scheme in Scotland was linked to a 19% decrease in stillbirths over a 3 year period
- a consultation to develop a ‘safe space’ to allow clinicians to speak openly about things that go wrong without fear that information they disclose may be used against them in court or professional misconduct hearings
- the Healthcare Safety Investigation Branch, modelled on the highly successful Air Accident Investigation Branch, which will be up and running from April 2017
There will also be a consultation on a new rapid resolution and redress (RRR) scheme. The RRR scheme could investigate and learn lessons from more than 500 incidents a year. In cases where harm was avoidable this would offer timely access to financial support without the current obligation on families to launch a formal legal process. At present, the average time families have to wait for resolution of a case is 11.5 years.
Eligible families would be given the option to join an alternative system of compensation that offers support and regular payments without the need to bring a claim through the courts and the scheme would ensure families receive personalised support including counselling, case management and legal advice. A similar scheme operating in Sweden has reduced serious avoidable birth injuries by around 50% in the last 6 to 7 years.
Health Secretary Jeremy Hunt said:
Our NHS maternity staff do a fantastic job under huge pressure. But even though we have made much progress, our stillbirth rates are still amongst the highest in Western Europe and many on the frontline say there is still too much of a blame culture when things go wrong - often caused by fear of litigation or worry about damage to reputation and careers.
These comprehensive measures will give practical support to help trusts improve their approach to safety – and help to foster an open and transparent culture so that the courts become a last resort not an automatic first step. By learning from proven methods in countries like Sweden we hope to achieve a dramatic reduction in the number of tragedies where babies are lost or injured for life.
As part of the ambition to halve the rates of stillbirths, neonatal deaths, brain injuries that occur during or soon after birth and maternal deaths by 2030, we’ve launched “Our Chance”, a new public health campaign in partnership with Sands and Best Beginnings. It aims to raise awareness of key issues that can lead to stillbirth, such as reduced foetal movement, itching and smoking, and highlight lifestyle changes women can take to improve their likelihood of having better pregnancy outcomes.