Continuing Concerns Over Maternity Services: CQC

Nicky Broyd

September 21, 2021

The Care Quality Commission (CQC) says disparities still persist in maternity services in England 18 months after it made a series of recommendations to improve safety.

In the regulator's latest report, Safety, equity and engagement in maternity services, it says: "Despite the greater national focus on maternity in recent years and the welcome improvements it has led to, the pace of progress has been too slow and action to ensure all women have access to safe, effective, and truly personalised maternity care has not been sufficiently prioritised to mitigate risk and help prevent future tragedies from occurring."

According to the latest CQC figures, as of July 31 a total of 41% of maternity services were rated as either “inadequate” (4%) or “requiring improvement” (37%).

Continuing concerns remain in several areas, the CQC said:

  • Leadership and oversight of risks, team working, and culture

  • Engagement and listening to women

  • Inequalities in outcomes for Black and Minority Ethnic women and babies

  • Poor incident reporting data

Minimum Expectation

CQC Chief Inspector of Hospitals, Ted Baker, said in a statement: "This report is based on a small sample of inspections carried out in response to evidence of risk so does not present a national picture. But we cannot ignore the fact that the quality of staff training; poor working relationships between obstetric and midwifery teams, and hospital and community-based midwifery teams; a lack of robust risk assessment; and a failure to engage with and listen to the needs of local women all continue to affect the safety of some hospital maternity services today."

He continued: "Safe, high-quality maternity care should be the minimum expectation for all women and babies, and it's what staff working in maternity services across the country want to deliver. We have seen good progress in some services, but we must now accelerate the pace of change across all services to prevent future tragedies from occurring and ensure that women and babies get consistently safe care every time."

Dr Edward Morris, president at the Royal College of Obstetricians and Gynaecologists, commented: "It’s discouraging to see that the issues highlighted in this report are ones we are all too familiar with - staff not having the right skills or knowledge; poor working relationships; poor risk assessments; and not learning from things going wrong. While the report acknowledges that progress is being made, the speed at which change is happening is far too slow. It’s tragic that these reoccurring failures are seriously impacting the health and wellbeing of the mothers and babies we healthcare professionals are trying to protect."

He continued: "The past 18 months have put additional strain on a healthcare system that was already struggling. It’s vital we urgently put into practice these learnings and join up current programmes and resources within the maternity system to help the Government deliver on its manifesto promise to make the UK the best place in the world to give birth."

James Titcombe, patient safety and policy consultant, Baby Lifeline, commented: "Since the Morecambe Bay report was published in 2015, improving the quality and safety of maternity care has been a national priority. Despite this, today's report highlights that in too many maternity units, concerns around leadership, oversight of risk, teamwork and culture are still negatively impacting the care of women and families.”

The latest report follows the Government's Ockenden report last December into the Shrewsbury and Telford NHS Hospital Trust scandal, which made 27 safety recommendations.

"It's particularly disappointing to see that in some services, staff weren’t fully supported to develop skills and competencies through multidisciplinary team training and learning and that a shared purpose and sense of a united 'maternity team' was lacking."

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