London maternity care under fire
Maternity services vary across England, Healthcare Commission says
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Friday, 25, Jan 2008 10:26
"Real concerns" have been raised about the standard of maternity care in London following the most comprehensive national review of maternity services.
The Healthcare Commission says some of the problems result from low staffing levels and calls for the capital's healthcare trusts to "rise to the challenges" they face.
Issues with care in London are part of the wider postcode lottery uncovered by the Healthcare Commission's review.
In the north of England, 33 out of 44 trusts were 'better performing' or 'best performing' (75 per cent), while 19 out of 27 London trusts were 'least well performing' (70 per cent).
The watchdog assessed all 148 trusts providing a full maternity service in England, looking at the period from when a pregnant woman first accesses care to her final contact with a midwife - usually ten days after a birth.
Concerns were raised about the number of trusts not meeting national guidelines on antenatal mental health checks; thorough foetal anomaly scans; and readmission rates.
An apparent increase in caesarean sections raised fears as the review suggests some trusts are not focussing on interventions to promote vaginal birth.
Not all trusts were able to meet guidelines on the ratio of midwives to pregnant women.
In the north, 33 out of 44 trusts were 'better performing' or 'best performing' (75 per cent), while 19 out of 27 London trusts were 'least well performing' (70 per cent).
Nationally, 22 per cent of maternity services were deemed to be 'fair performing'; 21 per cent as 'least well performing'; 26 per cent as 'best performing'; and 32 per cent were 'better performing'.
"Overall, it is positive that more than half of trusts were in the best or better performing categories," said Healthcare Commission chief executive Anna Walker.
"But those trusts that were least-well performing should as a matter of urgency take steps to improve and we shall be checking that they do so."
Seeking to reassure patients, Ms Walker added: "Being put in the least well performing category does not mean that a service is unsafe. If we believed any unit to be unsafe, we would take immediate action to ensure patients were protected. We would not hesitate.
"The purpose of the review is to encourage improvement and get all trusts performing to the standard of the best. We will repeat the assessment so that trusts have the opportunity to demonstrate improvement."
Dr Gill Morgan, chief executive of the NHS Confederation which represents over 95 per cent of NHS organisations, welcomed the study, saying it provides information about where trusts need to improve.
"We need to examine the reasons why clinicians are not following Nice [National Institute for Health and Clinical Excellence] and other guidance," she added.
"Managers and professionals need to work through the barriers and blocks to ensure mothers are given the service they need."