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Thursday 10 Jul 2008 @ 12:54
Care Quality Commission
Care Quality Commission
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HEALTHCARE WATCHDOG URGES NHS TO SEIZE OPPORTUNITY TO IMPROVE MATERNITY
· Women positive about services with 89 percent rating care during birth and labour as good or better.
· Improvements still needed on pathway from antenatal to postnatal care
The Healthcare Commission will today (Thursday) urge the NHS to redouble efforts to improve maternity services by enhancing the quality of clinical care and the experiences of women.
It will publish a national report on maternity services, containing conclusions and recommendations from a major review involving 150 NHS trusts in England.
Sir Ian Kennedy, the Commission's Chairman, will launch the report at a conference on maternity services in Birmingham where he will address more than 200 managers and commissioners of services from around the country.
Sir Ian asked for the review after publicly highlighting his concern about the quality and safety of maternity services. The regulator had carried out three separate investigations into deaths at maternity units during a two-year period.
The investigations found recurring issues – such as inadequate staffing and poor teamwork – suggesting a systemic national problem. In addition, maternity services accounted for one in ten requests to the Commission to investigate particular trusts.
In compiling its report, the Commission has for the first time thrown a spotlight on services from the start of pregnancy, through labour and birth, to postnatal care.
It has drawn together information from all NHS maternity units in England and conducted surveys of some 5,000 maternity staff and more than 26,000 mothers. The survey of mothers was the largest ever carried out, making the experience of women central to the assessment.
The report says most women have a generally favourable view of services with, for example, 89 per cent rating care during labour as good or better. But there were significant differences between trusts, with this figure being 96 per cent in one trust and 67 per cent in another.
The report identifies aspects of care that were less good, with concerns in antenatal and postnatal services, as well as in hospitals. It points to significant weaknesses nationally that correspond with earlier investigations, particularly in relation to staffing and teamwork.
Sir Ian will tell his audience: "I want to start by paying tribute to you for your commitment and for all the good work that you do. Believe me, I am under no illusions about how tough and challenging your work is every day.
"And we have been hugely encouraged by the positive way in which you have both participated in our review and responded since we published scores on each trust’s performance in January. I know that many trusts are already working on the points that we then raised.
“Boards of trusts are now reviewing their performance and acting where necessary. This has moved maternity services up the trusts’ agenda and this is good news for women and their families.
“Indeed, since our investigations, there has been progress. We have seen recognition of a need to raise the quality of care, introduction of new standards, key improvements in services, and £330 million of government money with a commitment to recruit more midwives.”
He will add: "Our contribution is to paint the picture of what is happening. This report out today does that, I think, with forensic detail. It gives you comparative information on every aspect of maternity care, from the start of pregnancy to the early days of childcare.
"There is no doubt that the report contains some tough messages. There is clearly more to be done to improve the quality of clinical care as well as the experiences of women. The matters raised and the views expressed must not be ignored.
"So now it's over to you. We can paint a picture but only you can make a difference. I urge you to seize with both hands the opportunity that this review has created to push maternity services higher up the agenda and to make lasting improvements for women.
"I say this because of how all this started. Believe me, I don't ever again want to be reading another report into high death rates at a maternity unit. I don't want our investigators to be again describing to a young family what happened to their mum."
The report identifies key overall improvements that are still needed, saying that in some trusts:
· levels of staffing were well below average, indicating that they may not have been adequate
· consultant obstetricians did not spend the time on labour wards recommended by their professional body
· doctors and midwives did not attend in-service training courses
· there was not adequate continuity of care
· recommendations for antenatal care were not adequately adhered to, particularly in the case of women whose pregnancies were likely to be more risky
· there was poor communication, care and support after women had their babies
· there were too few beds and bathrooms, particularly in labour wards
· information was not always being compiled to assess services.
The report goes on to set out detailed findings at each stage of care: antenatal, postnatal and during labour and birth. It also examines the impact of resources and management, including staffing; facilities and information systems.
To bring about improvement, the Commission urges those commissioning care, those responsible for performance management (strategic health authorities and Monitor), and trusts’ boards to make maternity services a higher priority.
The report contains seven recommendations with a checklist for implementation. The recommendations relate to: monitoring standards of care; ensuring that there is sufficient staff; gathering and acting on the views of those using services; encouraging team working; training staff and keeping skills up to date; collecting information on outcomes; meeting the requirements of women from higher-risk groups.
Notes to editors
The Healthcare Commission’s conference on maternity services, called ‘Delivering the next generation’, will take place at Aston Villa Football Club in Birmingham on 10 July 2008.
As part of the review, the Commission published scores for all relevant NHS trusts in January 2008. A total of 26 percent were “best performing”, 32 percent were “better performing”, 22 percent were “fair performing” and 21 percent were “least-well performing”.
Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.
Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.
The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.
For further information contact the press office on 0207 448 0868 or on 07917 232 143 after hours.
· Improvements still needed on pathway from antenatal to postnatal care
The Healthcare Commission will today (Thursday) urge the NHS to redouble efforts to improve maternity services by enhancing the quality of clinical care and the experiences of women.
It will publish a national report on maternity services, containing conclusions and recommendations from a major review involving 150 NHS trusts in England.
Sir Ian Kennedy, the Commission's Chairman, will launch the report at a conference on maternity services in Birmingham where he will address more than 200 managers and commissioners of services from around the country.
Sir Ian asked for the review after publicly highlighting his concern about the quality and safety of maternity services. The regulator had carried out three separate investigations into deaths at maternity units during a two-year period.
The investigations found recurring issues – such as inadequate staffing and poor teamwork – suggesting a systemic national problem. In addition, maternity services accounted for one in ten requests to the Commission to investigate particular trusts.
In compiling its report, the Commission has for the first time thrown a spotlight on services from the start of pregnancy, through labour and birth, to postnatal care.
It has drawn together information from all NHS maternity units in England and conducted surveys of some 5,000 maternity staff and more than 26,000 mothers. The survey of mothers was the largest ever carried out, making the experience of women central to the assessment.
The report says most women have a generally favourable view of services with, for example, 89 per cent rating care during labour as good or better. But there were significant differences between trusts, with this figure being 96 per cent in one trust and 67 per cent in another.
The report identifies aspects of care that were less good, with concerns in antenatal and postnatal services, as well as in hospitals. It points to significant weaknesses nationally that correspond with earlier investigations, particularly in relation to staffing and teamwork.
Sir Ian will tell his audience: "I want to start by paying tribute to you for your commitment and for all the good work that you do. Believe me, I am under no illusions about how tough and challenging your work is every day.
"And we have been hugely encouraged by the positive way in which you have both participated in our review and responded since we published scores on each trust’s performance in January. I know that many trusts are already working on the points that we then raised.
“Boards of trusts are now reviewing their performance and acting where necessary. This has moved maternity services up the trusts’ agenda and this is good news for women and their families.
“Indeed, since our investigations, there has been progress. We have seen recognition of a need to raise the quality of care, introduction of new standards, key improvements in services, and £330 million of government money with a commitment to recruit more midwives.”
He will add: "Our contribution is to paint the picture of what is happening. This report out today does that, I think, with forensic detail. It gives you comparative information on every aspect of maternity care, from the start of pregnancy to the early days of childcare.
"There is no doubt that the report contains some tough messages. There is clearly more to be done to improve the quality of clinical care as well as the experiences of women. The matters raised and the views expressed must not be ignored.
"So now it's over to you. We can paint a picture but only you can make a difference. I urge you to seize with both hands the opportunity that this review has created to push maternity services higher up the agenda and to make lasting improvements for women.
"I say this because of how all this started. Believe me, I don't ever again want to be reading another report into high death rates at a maternity unit. I don't want our investigators to be again describing to a young family what happened to their mum."
The report identifies key overall improvements that are still needed, saying that in some trusts:
· levels of staffing were well below average, indicating that they may not have been adequate
· consultant obstetricians did not spend the time on labour wards recommended by their professional body
· doctors and midwives did not attend in-service training courses
· there was not adequate continuity of care
· recommendations for antenatal care were not adequately adhered to, particularly in the case of women whose pregnancies were likely to be more risky
· there was poor communication, care and support after women had their babies
· there were too few beds and bathrooms, particularly in labour wards
· information was not always being compiled to assess services.
The report goes on to set out detailed findings at each stage of care: antenatal, postnatal and during labour and birth. It also examines the impact of resources and management, including staffing; facilities and information systems.
To bring about improvement, the Commission urges those commissioning care, those responsible for performance management (strategic health authorities and Monitor), and trusts’ boards to make maternity services a higher priority.
The report contains seven recommendations with a checklist for implementation. The recommendations relate to: monitoring standards of care; ensuring that there is sufficient staff; gathering and acting on the views of those using services; encouraging team working; training staff and keeping skills up to date; collecting information on outcomes; meeting the requirements of women from higher-risk groups.
Notes to editors
The Healthcare Commission’s conference on maternity services, called ‘Delivering the next generation’, will take place at Aston Villa Football Club in Birmingham on 10 July 2008.
As part of the review, the Commission published scores for all relevant NHS trusts in January 2008. A total of 26 percent were “best performing”, 32 percent were “better performing”, 22 percent were “fair performing” and 21 percent were “least-well performing”.
Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.
Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.
The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.
For further information contact the press office on 0207 448 0868 or on 07917 232 143 after hours.
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