The Health and Social Care Committee's report on the safety of maternity services in England makes recommendations in respect of funding, learning and clinical negligence claims arising out of maternity care.
The report released this week follows on from previous reviews which have looked at ways in which to improve safety and learning within maternity services; including the Kirkup review, Better Births and the recent interim Ockenden report.
The committee's report continues the focus on improving safety of maternity services and the ongoing National Maternity Safety Ambition to half the number of stillbirths, neonatal deaths, brain injuries and investigations by 2025. The government's progress as against the four key commitments for maternity services has been reviewed and CQC style ratings applied by the committee, with an overall verdict of 'requires improvement' being applied.
Recommendations are offered under three main themes:
- Improving support for maternity services in the delivery of safe maternity care;
- Improved learning from patient safety incidents; and
- Provision of personalised care for all mothers and babies.
Key recommendations/findings from the report include:
- An immediate increase in funding to address maternity training and staffing shortfalls in the nursing, obstetrics and anaesthetic workforce.
- The independence of HSIB investigations was welcomed. Going forward, there should be a continued focus on collaboration with families and clinicians at all levels, and learning should be shared in a systematic and accessible manner.
- HSIB investigations should be concluded within six months of inception.
- Reform of the clinical negligence process is required to move away from an adversarial approach and to support a culture of learning. The report endorses the recommendations within Better Births concerning a Rapid Resolution and Redress scheme and a test of 'avoidability' rather than 'negligence' to access compensation.
- The report recommends reform to the current system for quantification of damages which permits the recovery of private care costs when NHS care is available. It recommends that compensation for loss of earnings be standardised for all claimants to prevent unjust variability.
- Provision of personalised care for all mothers and babies with improved training to address the inequality in women and babies from minority ethnic and socio-economically deprived backgrounds at comparatively greater risk.
- Removal of caesarean section percentages as a metric for maternity services.
Ultimately, the committee concluded maternity safety to have improved since 2015 but that there was still work to be done. While increased financial investment is always welcome, the committee argues that a systemic investment in improving the culture of learning from patient safety incidents will yield the greatest potential return on investment. This may well be tied in to further reform of the clinical negligence process for the management of maternity claims in future.
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