Damning report on England maternity care ‘watershed moment’, health secretary says | Health policy

Valerie Amos’ devastating accusation about maternity care should be a “turning point” in how the NHS treats pregnant women and babies, the health secretary has said.

James Murray promised that Lady Amos’s report would lead to significant improvements and the elimination of “toxic dynamics” that were damaging relationships between hospital staff providing maternity care.

A powerful maternity commissioner will be appointed to deliver an urgent transformation of maternity care in England.

The Amos report found that maternity care in England has failed to keep pace with major changes, including older maternity and a dramatic increase in the rate of women having caesareans.

Speaking in the House of Commons on Tuesday, Murray also took aim at a “culture” that means maternity units put their reputation above their duty of openness to families when mistakes are made, and called on NHS bosses to help ban this culture.

In his speech to MPs, he said: “A big part of the responsibility is culture. This culture is the most fundamental cause of the failures we see and the most fundamental thing we need to change.”

“We will eliminate toxic dynamics, improve staff morale and support better teamwork between midwives, doctors and other clinicians.

“Not only do we need the right policies, procedures and processes in place, we also need a fundamental reset in the culture of a service that puts its desire to protect itself above its duty to protect women and babies.”

In her 181-page report, Amos identified a number of “shocking” failures in maternity care; these include ignoring women, poor prioritization of expectant mothers, putting lives at risk and chronic understaffing of services.

“This culture change must come from the top. It is now time for trust leaders, managers and senior clinicians to pay attention to what is happening under their care. Put professional tribalism aside, abandon the shelter mentality when things go wrong and ensure the safety of women and babies always comes first.”

Murray continued: “This must be a turning point. We must break the cycle of recommendations sitting on the shelf gathering dust.”

The new maternity commissioner will play a key role in transforming maternity services. Whoever is elected will chair, along with the health minister, the government’s national maternity and newborn task force, which is preparing an action plan for safer and better care. It is planned to be released in December.

“Their role will be to support the voices of women, babies and families to ensure these voices are heard within government as decisions are made and implemented,” Murray said.

Ministers bowed to mounting pressure by agreeing to appoint the UK’s first maternity and newborn care commissioner. They will monitor hospitals for failures in care, push for far-reaching improvements and seek to restore families’ trust in the UK’s maternity system, which has been rocked by a series of scandals.

Lady Amos’s report is the second in less than a week to recommend ministers launch a dramatic overhaul to reduce the risk of mothers and babies being harmed or killed by errors and receiving inadequate care from the NHS. Donna Ockenden, author of last week’s inquiry into the maternity scandal in Nottingham, is expected to become the new commissioner.

“I still find it shocking that women and babies are harmed or killed, sometimes as a result of failures in the maternal and newborn care provided. We are a rich country. This should not happen,” Amos said in the 181-page report of her nine-month investigation.

“Having a baby should be one of the happiest moments in a family’s life. For most women in the UK it is. But for many women – depending on where they live, who they are or simply the day they give birth – the care they receive is not good enough and can result in preventable harm.

Labor leader and former cabinet minister Amos said: “Every example of avoidable harm is too many. The emotional toll and cost to families is indescribable. We cannot go on like this as a country and a society.”

Murray promised that Amos’s “landmark” report would be “a turning point” in efforts to ensure every woman receives safe, high-quality care during pregnancy, labor and delivery.

“The appointment of the UK’s first maternity and newborn commissioners will drive lasting change and ensure women and families are never overlooked again,” he added.

The report says the maternity system in England is “confusing, inflexible and insensitive to women and families”. Mothers described how they were dismissed when they voiced their concerns to Amos, “leading in some cases to preventable harm or unsafe care” and treated with a lack of compassion. Lack of pain relief meant that some experienced pain and distress during caesarean section or assisted vaginal birth.

Women of color experienced racism or discrimination. This led to them being “treated unfairly or unequally, leading to delays, unsafe care and sometimes devastating consequences” and a reluctance to participate in maternity services.

Amos said during her investigation she was asked whether women and families should rely on local maternity services. However, she did not answer and only said that she did not want to deter anyone from getting pregnant and having a baby.

He made eight main recommendations to improve care:

• Maternity triage services, the maternity equivalent of A&E, need an urgent overhaul, including deploying more staff so women’s concerns can be addressed more quickly.

She added that maternity care has not kept pace with major changes in recent years, such as the shift toward older women giving birth, more expectant mothers having an underlying health condition, and a recent dramatic increase in medical interventions such as induction of labor and caesarean sections.

Amos emphasized that many of the numerous recommendations made in a series of previous reviews to improve maternity care were not implemented or were short-lived. Some maternity units are so old they are now “unsafe”. Widespread understaffing was compromising the quality of care and causing maternity staff to suffer “trauma and moral injury from failures in care.”

Stillbirths and neonatal deaths are near record levels, he said, a rare positive finding, but added that progress on both fronts has stalled since 2020.

The report came from one of Amos’ clinical advisors, renowned birth safety expert Dr. It was overshadowed by Bill Kirkup’s resignation on Monday over the “normal birth ideology” episode, hours before the report was published. Amos said Kirkup disagreed with the statements.

But the Health Service Journal reported that she resigned “over a disagreement of principle” over this belief that women should have vaginal births without intervention whenever possible.