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26.10.12

Training and consultant-led care could improve maternity care

More training is needed for maternity staff to reduce accidental injury to mothers and babies, a new report recommends.

The report, based on an analysis of maternity claims reported to the NHS Litigation Authority (NHS LA) between 2000 and 2010, showed that overall, safety levels are very high. 5.5 million babies were born during this time in England, and NHS LA received 5,087 maternity claims – less than one claim per 1,000 births.

The claims mainly concerned cases where junior doctors and inexperienced midwives were often involved in the management of labour without adequate assistance from senior clinicians. An effective multi-disciplinary team is essential for good maternity care, the NHS LA stated.

Three types of case accounted for 70% of the total mistakes made: errors in CTG interpretation, management of labour, and cases where the baby suffered cerebral palsy.

NHS LA chief executive Catherine Dixon said: “It’s vital that we learn and share lessons from [maternity claims] so that professionals can improve their clinical practice in the future and prevent harm.”

RCOG vice president David Richmond, who contributed to the report, said: “This report has defined why problems occur and provides us with valuable information so that maternity services can put in place robust monitoring and risk identification systems to prevent them from recurring.”

He said there was a “strong case” to move to a consultant-delivered service, to ensure trainee doctors were supported by senior staff.

Cathy Warwick, chief executive of the Royal College of Midwives, said: “The biggest issue behind these claims is that most of the lessons to be learned from them are not new. It is tragic that the same problems reoccur in our maternity services year on year.”

She called for access to training to be protected, and for minimum staffing standards to be put in place.

Chief executive of the NHS Confederation Mike Farrar added: “We are fortunate in this country that maternity care is relatively safe but to keep it that way the NHS has got to keep learning and improving.

“We must in particular learn from the occasions where things have gone very badly wrong. You cannot turn back the clock on a tragedy but you can do everything possible to prevent recurrence by focusing relentlessly on minimising risks.”

The report is at: http://tinyurl.com/NHSLA2012

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