NHS’s blockbuster maternity plan to stop more tragedies like Shrewsbury and East Kent warns sites could be unsafely staffed for FIVE YEARS
- NHS England has published its delivery plan for maternity and neonatal services
- But plan allows NHS trusts until 2027/2028 to meet its safe staffing criteria
- Read more: Fascinating charts lay bare the changing face of British mums
Tragedy-stricken NHS maternity units face being unsafely staffed for another five years, officials admitted today.
Damning inquiries into devastating scandals, which saw hundreds of mothers and babies harmed, partly blamed a lack of midwifery staff.
Yet NHS bosses have given hospitals until 2027/28 to ensure they meet workforce requirements.
The target was unveiled in a plan today, published exactly a year after a shocking report into the catalogue of failures at Shrewsbury and Telford NHS Trust.
Some 201 babies and nine mothers died in the biggest ever maternity scandal to strike the NHS.
Rhiannon Davies from Ludlow, Shropshire with her daughter Kate moments after she was born on March 1, 2009 at Shrewsbury and Telford NHS Trust. Kate died just hours later
Since then, other tragedies have come to light at East Kent Hospitals Trust and the Nottingham University Hospitals Trust, confirming safety problems are not isolated to just one area.
NHS bosses acknowledged the need to ensure safe staffing in maternity services in today’s Three Year Delivery Plan for Maternity and Neonatal services.
‘Trusts will meet establishment set by midwifery staffing tools and achieve fill rates by 2027/28, with new tools to guide safe staffing for other professions from 2023/24,’ the report reads.
But this suggests that for the next four to five years, NHS England cannot guarantee maternity units in the UK will be safely staffed.
‘Deplorable and harrowing’: The maternity scandals that rocked the NHS last year
The findings come in the wake of multiple damning reports into poor maternity care in England.
In October, a review into serious failings at East Kent Hospital Trust found that at least 45 babies died unnecessarily due to ‘catastrophic’ and ‘deep-rooted’ failures in care.
Affected families described being ‘disregarded, belittled and blamed’, with mothers left feeling like they were to blame for tragic incidents.
Dr Bill Kirkup, who led the inquiry, called for a new law so that organisations can be prosecuted if they stage cover-ups in future tragedies.
Meanwhile, a five-year inquiry, published in March last year, revealed 201 babies and nine mothers died needlessly during two decades of appalling care at the Shrewsbury and Telford Hospital NHS Trust.
The inquiry examined cases involving 1,486 families, mostly from 2000 to 2019, and found ‘repeated errors in care’ had led to injury to either mothers or their babies.
Findings from another NHS maternity scandal are also likely be published in the next 18 months.
Ms Ockenden, the midwife behind the scathing report into Shrewsbury and Telford, is currently leading an investigation into reports of poor care of mothers and babies at Nottingham University Hospitals NHS Trust.
The new investigation launched in September and will examine events from April 2012 to the present day.
At least nine babies and three mothers are believed to have died over the past three years at the trust, which runs 15 hospitals in the Midlands.
Fill rates represent whether wards are adequately staffed.
The key problem, as the report explains, is that even with millions being spent to boost the NHS maternity workforce, services are still struggling to both attract and retain staff.
‘Despite significant investment leading to increases in the midwifery, obstetric, and neonatal establishment, NHS maternity and neonatal services do not currently have the number of midwives, neonatal nurses, doctors, and other healthcare professionals they need,’ it reads.
‘This means existing staff are often under significant pressure to provide the standard of care that they want to. We need to change that.’
The report does not give a figure for the number of maternity staff needed.
Last year, the Royal College of Midwives warned that NHS services in England were missing about 2,500 midwives.
Despite the admission that not all maternity services in England can be assured to be safely staffed, the NHS insisted the majority of women enjoyed a safe birth in the health service.
‘Most women have a positive experience of NHS maternity and neonatal services, and outcomes have improved with over 900 more families welcoming a healthy baby each year compared to 2010,’ they said.
However, they also acknowledged that ‘there are times when the care we provide is not as good as we want it to be’.
In a letter to NHS trusts, directors and senior maternity staff today, NHS England’s chief nursing office, Dame Ruth May, its chief operating officer, David Sloman and national medical director Sir Stephen Powis, wrote: ‘Our three-year delivery plan sets out that the NHS will make care safer, more personalised, and more equitable for all women, babies and families.’
They added: ‘While most women have a positive experience of NHS maternity and neonatal services in England, independent reports show that some families have experienced unacceptable care, trauma and loss, and with incredible bravery have challenged us to improve.
‘This plan aims to deliver change rather than set out new policy.’
Among the report’s other recommendations include establishing a new national maternity and neonatal taskforce to ensure digital tools and data are used more effectively to track outcomes for mothers and babies.
Dr Edile Murdoch, consultant neonatologist and clinical director for maternity services in NHS Lothian, has been appointed its chair.
She will be supported by Dr Bill Kirkup – who led the review into East Kent Hospital Trust – will act as a special adviser.
Rhiannon Davies (left) embraces Kayleigh Griffiths (whose daughter died on April 27, 2016 after midwives failed to recognise a deadly infection) following the release of the final report into Maternity Services at the Shrewsbury and Telford Hospital NHS Trust
The report found that at least 45 babies died unnecessarily due to ‘catastrophic’ and ‘deep-rooted’ failures in care.
Speaking at an NHS England board meeting this afternoon, deputy chair Sir Andrew Morris, told attendees: ‘I welcome this report. I think we’ve made some really really strong progress.’
But, he added: ‘Ultimately it is the responsibility of our trust boards to implement this.
‘We are asking all boards to give attention to this and focus on the must-do – the key changes.
Read more: Even more mothers and babies will be harmed unless failing NHS maternity services are rapidly overhauled, damning report warns
‘It’s around culture, it’s around staffing, it’s around speaking up.’
Meanwhile, NHS England’s chief nursing officer, Dame Ruth said: ‘Improving maternity services continues to be a priority for the whole NHS and the implementation of the actions has been a key focus for us all.
‘Services have asked for this plan and we’ve listened.’
Senior midwife Donna Ockenden, who led last year’s report into Shrewsbury and Telford NHS Trust, is currently leading an investigation into reports of poor care of mothers and babies at Nottingham University Hospitals NHS Trust.
At least nine babies and three mothers are believed to have died over the past three years at the trust in the Midlands.
Among the ‘immediate and essential’ findings of last year’s Ockenden report into Shrewsbury was the need to ensure maternity services could maintain minimum staffing levels.
Staff quizzed in the inquiry warned of suboptimal staffing levels and unsafe inpatient-to-staffing ratios, claiming they often felt fearful and stressed at work due to poor staffing levels.
The 250-page report also said an obsession with ‘normal births’ contributed to the biggest maternity scandal in NHS history.
Ms Ockenden warned childbirth in England will be unsafe until all recommendations made are implemented in full.
Responding to today’s plan, James Titcombe, whose baby died at a scandal-hit maternity unit at Morecambe Bay NHS Trust said: ‘I’m pleased to see today’s 3 year delivery plan, particularly the focus on staffing levels, retention, cultural change and better use of data.
‘However, in the past, progress in maternity safety has been held back by a failure to turn words into real change on the ground.’
He added: ‘We can’t afford for this to be the case this time – so it’s crucial that these plans are backing up with the funding needed to make change happen – and that progress isn’t taken for granted – rather it needs to be carefully evaluated at regular intervals, and if necessary – revisited if we don’t start to see real changes and better outcomes for women and babies.’
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