Throughout England, the importance of high-quality maternity care is taking center stage. After an extensive review of care received by expecting patients through NHS trusts, it was found that an advanced initiative to increase the quality of health care was a necessary next step. The Safer Maternity Care action plan was published in October of this year as part of the national discussion surrounding the need to increase the care quality with the underlying purpose of reducing countrywide stillbirths, maternal and neonatal deaths. In response to the new call to action, seven cities have recently been selected as early adopters for new NHS services. The trial systems will focus their efforts on enhancing the care given to expectant mothers, based on recommendations brought forward by the Better Births report.
In an effort to push forward the level of maternity care in England, suggested changes to the care plans for expectant mothers incorporates significant shifts, including:
- The provision of dedicated resources for NHS trusts to improve the safety of maternity care
- Maternity safety training funding totaling £8 million with £40,000 made available to each NHS trust throughout the country
- Maternity safety innovation fund of £250,000 to encourage brainstorming new paths toward improving maternity care
- Publication of maternity ratings for all clinical commissioning groups throughout the NHS, meant to increase transparency and provide clear information about the quality of care available
- A national program allowing NHS trusts to share ideas and best practices surrounding maternity care
- Implementation of a rapid resolution and redress scheme, intended to offer expedited investigation and financial support to families affected by a poor-quality care
The seven early adopter cities, which include locations that were strategically chosen based on their implementation of broader changes to NHS services, will trial a variety of recommendations. A new model of staffing which is built on the foundation of small community teams to manage large caseloads, the creation of simplified access to a wide range of maternity services and personalized plans of care are all included in the trial implementation plan.
Why it Matters
The country’s ideal for cutting the traumatizing effects of poor maternity care in half by the year 2030 is an ambitious move, but based on birthing statistics, it is all but necessary. According to the Better Births report, nearly 700,000 births take place each year in England, and trends point to an increase in birth rates over the next few years. While negative outcomes closely tied to negligent care, including stillbirths, maternal deaths, and neonatal deaths, have decreased steadily over time, these issues still plague NHS trusts across the board. Unfortunately, with additional births come more complexities in care for expectant mothers and their newborn children, as well as a growing need for care plans that best suit the needs of these patients. The Safer Maternity Care action plan was established to do just that, but concern looms for a particular aspect of the plan.
Some question the far-reaching goals of the Department of Health, especially as it relates to the compensation given to families who experienced a loss or significant negative outcome due to poor-quality maternity care. Part of the issue dragging the NHS down, which played a critical role in the establishment of the Safer Maternity Care plan, is the exorbitant cost of the litigation process when negligence does take place and the lack of transparency of the claims process overall. The rapid resolution and redress scheme that comprises a major component of the new safety plan, alongside the rating publications of trusts are meant to ease these issues, but there is even more worry that the secrecy of negligence within NHS may be exponentially worse moving forward.
A representative from Patient Claim Line, a UK firm of medical solicitors, explains, “When an occurrence of death or serious injury takes place with a birthing mother or her child, the family isn’t typically met with supporting communication, adding to the negative impact of their loss.” Instead of owning up to mistakes made, individuals have to fight to get information, and maternity claims are by far the costliest because of it. Giving families the option to bypass the long process of investigation and the following litigation to receive quicker access to financial support sounds viable on the surface; in practice, it has the potential to leave families without the compensation necessary to care for a severely disabled child or mother for a lifetime.
The Safer Maternity Care plan shows great potential for improving the quality of care given to expectant mothers and their newborns, through improved services, more personalized care plans, and a community-based team of providers who understand the delicate needs of maternity care plans. However, some aspects of the plan that tout greater transparency and support to suffering families of negligent care may create a culture of sweeping issues under the rug, more so than is already the case. In order to make the new plan work, NHS trusts need to shift focus toward preventing issues in the first place, rather than increasing the speed at which they are resolved after the fact.