The Care Quality Commission (CQC) has today published its National Review of Maternity Services in England, setting out thematic findings and recommendations arising from 131 inspections carried out between August 2022 and December 2023.
Responding to the publication, Dr Ranee Thakar, RCOG President, said:
“The government will have a long list of NHS priorities after last week’s Darzi Review but this CQC report should propel maternity care to the top. It signals loud and clear that urgent, multi-pronged action is needed to tackle the complex, deep-rooted issues facing maternity services.
“Everyone has the right to expect safe, personalised and compassionate care throughout their pregnancy and birth and our members are working flat out to deliver the best care they can, battling against years of chronic NHS underinvestment.
“Recent green shoots of improvement in staffing numbers now need to be nurtured. We must see investment in skills development, leadership, wellbeing support and modern facilities for long-term and lasting change. Listening to and involving women, families and staff in delivering improvement is also crucial.”
The review found continued concerns about the quality of NHS hospital maternity services, with common issues impacting safety. It warns that without urgent action and investment in services nationwide, there is a risk of poor care and preventable harm to women and babies becoming normalised.
The CQC analysed individual inspections and feedback from families to draw together common themes and areas of concern in NHS maternity services in England. While the CQC identified some good practice and improvements, areas such as managing and learning from safety incidents and addressing health inequalities were highlighted as needing urgent attention.
The need for timely and effective risk assessment at triage is highlighted, after finding that issues with staffing, systems and space could result in delays, calling on NHS England to oversee the performance of triage services to help them to benchmark and improve. This is in line with the RCOG good practice paper’s recommendation to introduce an agreed national standard and reporting tool for triage, similar to that used in emergency medicine.
Ranee Thakar added, “We’re pleased the CQC has echoed our calls for the national standardisation of maternity triage systems. As the emergency portal into maternity care, that many pregnant women access when they are worried or need quick action or assurance, it’s critical that triage systems are set up to provide timely and consistent advice and support, escalating urgent care when this is required.”
The College endorses the CQC call for additional government investment in maternity estates to make sure that they are fit for purpose, after finding that multiple units lacked space and adequate facilities or equipment for patients and staff.
We support the recommendation that NHS trusts and integrated care boards should improve data collection, including information on ethnicity and levels of deprivation, to better understand inequalities in outcomes and make sure data is always considered when reviewing patient safety incidents. Trusts should also ensure that women who do not have English as a first language have access to high quality interpreting services and clear information at every stage of pregnancy and birth.
We will also consider the CQC recommendation around findings in relation to the surgical first assistant role in maternity services, as we digest the review in detail to ensure that it informs our maternity safety programme moving forward.
The College is fully committed to supporting the delivery of safe, high quality maternity care through developing the curriculum and clinical guidance, and supporting the professional development of clinicians through exams, courses and events. The College also delivers research and quality improvement programmes that contribute to improvements in maternity safety and supports ensuring system wide improvements are identified and delivered.
- The full CQC report can be found here
- Information about the RCOG maternity safety programme can be found here