NHS Care in Maternity Units Not Meeting Standards

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Maternity units forced to close across the UK 

In 2017, 11 NHS trust disclosed they had been forced to close maternity units more than 10 times during the year, due to shortage of staff. Freedom of Information (FOI) requests by Labour identified 300 occasions where maternity units were closed and mothers were sent elsewhere, due to lack of capacity, resourcing and staffing issues. 

Jonathan Ashworth Shadow of Heath Secretary stated there is an urgent need to improve resources, calling the statistic ‘a disgrace.’ 

The Royal College of Midwifery warned “NHS England remains 3500 midwives short of the number of midwives it needs to deliver a safe and high-quality maternity service.”

135 FOI requests were made to hospital trusts in England, asking how and why maternity units had been closed to new admissions during 2017. 89 trusts responded: 41 had experienced closures. In total, there were 287 occasions when maternity units closed their doors to expectant mothers, with 11 trusts stating they were forced to close more than 10 times during the year.

The Bristol NHS Unit closed 29 times during 2017-2018 New Year due to high demand. In Weston-Super-Mare Somerset, the unit was closed for 3 weeks, whilst another in Dorset closed 16 times during the year due to insufficient staff.

The figures show clearly that certain units across regions are unable to cope with the demand, lacking staff.  Ashworth stated maternity units are understaffed and under pressure; “It is a disgrace that almost half of maternity units in England had to close to new mothers at some point in 2017.” 

Department of Health and Social Care stated that maternity unit temporary closures are well rehearsed; and there are well established systems in place to redirect women to the next available unit. “To use these figures as an indication of safe staffing issues, particularly when a number of them could have been for a matter of hours, is misleading because maternity services are unable to plan the exact time and place of birth for all women in care.”

NHS leaves 1 in 4 women alone during childbirth or labour

Another in depth study found conducted by NHS Watchdog, Care Quality Commission, found that 1 in 4 women felt they were left alone during labour or birth. The survey revealed that most mothers were satisfied with the quality of care received, with women being offered where to give birth. 

However the NCT parenting charity and childbirth campaigners, found that CQC’s findings showed that 23% of 18,426 women surveyed were worried by being left alone without a midwife or doctor present during their labour or birth.

The number of women left alone in labour has reduced by 3% since the survey was last undertaken in 2015. Senior policy adviser for NCT Elizabeth Duff stated the statistic reinforces low staffing levels; midwives are stretched to the limit.  “Midwives end up looking after several women giving birth simultaneously – we continue to call on government to address the midwife shortage.”

  • Case Studies

    In an earlier published survey administered by CQC, of 23,000 women who gave birth in 2013 in NHS care, more than a third related to being left unattended too long, during delivery or postnatal stay.  Comments women made then suggested this was due to staff being too busy and not available and inattentive. 

    Women described being left unattended prior to and during labour, and immediately after the birth where they were left for long periods of time, often without access to working call buttons:

    • “Due to me not being listened to and being ignored when I was telling the midwives I felt labour had started. I was left in a room with other women and not checked for four and a half hours even though I went to them three times to tell them I felt my baby was coming.”
    • “I had stitches which I was told were dissolvable, a month later they were still there and my skin had covered them therefore I had to go to the hospital and have them removed, with gas and air.”
    • “It was a second pregnancy I was hardly seen by my midwife, often trying to contact her with concerns or to make an appointment was almost impossible I was fobbed off constantly.”
    • “We saw a different junior doctor in clinic every time and only saw the consultant once, which resulted in a lack of continuity.”
    • “The views of the midwives were so different which really messed with my mind. Some were dead against formula feeding which made me feel very guilty.”

NHS policy since 2010 has been that all women should have a midwife or doctor on hand during labour and birth to provide practical reassurance, help, and advice.  But shortages in midwife make this challenging to achieve. 

Although the current 2017 survey has seen the number of women left alone reduced- 23% is still occurring. The NCT research conducted last year found that half of all births in NHS involve at least one red flag event- these events lapse in safety and can threaten the health of the baby and mother or both. The potential issues that may arise in a lacking maternity care facility can have devastating adverse effects for both mother and child. 

NCT research found that half of the £4.37bn of medical negligence claims lodged against NHS trusts every year involve childbirth, with lifetime care costs of a brain-damaged baby often reaching £20m.

As a clinical negligence lawyer, some of the most devastating, life changing claims I deal with are when babies are seriously injured during birth.  Lack of close monitoring during labour can lead to a delay in delivery of the baby, causing harm to both baby and mother.  The baby may even require life-long care.  Closure of maternity units will inevitably increase the risk of childbirth and we are pleased this issue has been highlighted.  Every day we see the real impact of these injuries on the baby and its family. We therefore welcome any measures which could reduce the incidence of birth injuries which will, in turn, reduce the cost to the NHS.

If you believe you, or your child, have suffered as a result of clinical negligence you can contact me Anne Robertson, or a member of the team for free advice on 0113 284 5745 or email clinneg@isonharrison.co.uk  If we believe that there are sufficient prospects to pursue a claim, we will guide you through the process and ensure that you get the compensation you deserve to enable you to obtain support and assistance when you need it the most.

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