Maternity care in ‘concerning decline’ across England, finds Care Quality Commission

Women’s experiences of maternity services are in “concerning decline”, a health watchdog has said, with a “deterioration” in the ratings given to care.

Fewer women feel they always got the help they needed during labour and birth and a significant number reported that they did not feel listened to when raising concerns, they raised concerns, the Care Quality Commission (CQC) said,

Maternity care in the NHS has been thrown into the spotlight after several scandals first highlighted by The Independent.

The CQC found care ratings tumbled over the past five years, with particular concerns raised about staff availability, confidence and trust, as well as kindness and understanding of staff.

Some 21,000 women across England who had received care at one of 121 NHS trusts took part in the national survey, which found:

Victoria Vallance, from the CQC, said: “These results show that far too many women feel their care could have been better.

“The trend analysis carried out this year reveals a concerning decline over time, particularly in relation to accessing information and support and getting help when it was most needed.

“This reflects the increasing pressures on frontline staff as they continue in their efforts to provide high-quality maternity care with the resources available.

“It also echoes what maternity staff attending CQC’s roundtable event last year told us about the exceptionally demanding circumstances in which they are operating and the need for greater support to help manage the challenges they face.”

Angela McConville, chief executive of the National Childbirth Trust (NCT), said: “A woman who gives birth today may have a worse experience of NHS maternity services than if she gave birth five years ago. Time usually leads to progress, but we’re seeing the opposite.

“Women are less likely to report getting the help they need during labour, birth and antenatally, to get information to make informed decisions about their care, and to feel that any concerns about their care are taken seriously.

“This is not all the impact of the Covid pandemic but is directly associated with long-term under-investment in the staffing of maternity services.”

An inquiry last year found poor care may have led to the deaths of 45 babies at East Kent Hospitals University Trust, where failures were part of a “pattern of recurring harm”. It was commissioned by the government after The Independent revealed more than 130 infants suffered brain injuries during birth at the trust over several years.

Another inquiry, led by maternity expert Donna Ockenden, last year found Shrewsbury and Telford Hospital Trust presided over failings that resulted in babies dying, suffering fractured skulls and other injuries, as well as causing harm to mothers. It also came after The Independent revealed more than a dozen women and more than 40 babies died during childbirth at the trust due to a culture that denied women choice.

And the NHS could be facing its largest maternity scandal to date as the review into services in Nottingham is now expected to exceed 1,500 cases. It began after The Independent revealed dozens of babies had died or been left with serious injuries or brain damage as a result of care at NUH, which runs Nottingham’s City Hospital and Queen’s Medical Centre (QMC).

Matthew Jolly, national clinical director for maternity and women’s health for the NHS in England, said: “The CQC survey results show the ongoing impact of the pandemic on maternity services, and while the majority of women were positive about their interactions with staff and the information provided, other findings show the implications of sustained workforce challenges and reinforce the need for further improvements to maternity services.

“We continue to take action to strengthen maternity services across the country – we’re investing £165m annually to grow our workforce, strengthen leadership and improve culture, while continuing to work closely with NHS trusts and our partners to make necessary improvements and ensure that we provide the best possible services for mothers, babies and their families.”