Maternity wards in England to be rated by safety record

The government is to release new ratings for maternity wards across England to allow prospective parents to compare and contrast services in NHS hospitals, as part of a drive to reduce instances of stillbirth and brain injuries during labour.

Maternity data detailing the frequency of accidents within clinical commissioning groups and the health prospects of expectant mothers – including the percentage of smokers, for example – will be collated to form England-wide ratings.

In a major speech on Monday, Jeremy Hunt will also unveil proposals to allow the NHS to offer compensation automatically to parents of babies left stillborn or brain-damaged because of poor care. The health secretary wants parents of children starved of oxygen at birth no longer to endure a wait of about 11 years for compensation.

Stillbirth rates are still among the highest in western Europe, according to Jeremy Hunt. Photograph: Carl Court/Getty Images

At present parents often become embroiled in lengthy and costly legal action against the NHS, forcing grieving families to fight for months or even years before the health service agrees to compensation.

Bereaved parents often have to instruct solicitors to determine the cause of their child’s death, with health bosses sometimes denying any liability until they are ordered to pay compensation by a judge.

Under the new scheme, which was first recommended by Tory peer Baroness Cumberlege earlier this year, an independent rapid resolution and redress scheme will be set up to investigate tragedies in childbirth, which would quickly decide whether compensation should be paid.

The launch comes as figures showed that the cost of settling claims with parents whose children are damaged at birth has reached more than £0.5bn. The NHS as a whole pays out more than £1bn a year in negligence compensation, and reducing that cost is seen a key way of mitigating the financial crisis facing the service.

In February this year, Cumberlege recommended the investigations into maternity cases and any subsequent payouts are made by the trusts without any court involvement. The recommendation was one of several made by Cumberlege, who has been chairing an independent review of maternity services in England.

The new proposals are modelled on a Swedish scheme, which has reduced serious avoidable birth injuries by about 50% in the past six to seven years.

Health secretary Jeremy Hunt said he hoped to end the culture where going to court was an automatic “first step” and instead foster a culture of transparency so the NHS can learn from its mistakes.

Under the plans, claims by parents who believe medical errors have caused severe damage to their children – such as cerebral palsy or brain damage – would be assessed by investigators working independently of the NHS trust. The investigators would quiz NHS staff and parents and look at medical records.

Compensation for errors around the time of birth has reached more than £500m a year. Photograph: Sturti/Getty Images

Their findings would be presented to a panel of legal and medical experts who would decide whether any compensation is warranted and arrange for payments to be made to the family.

The government hopes the scheme – which would assess about 500 cases a year – will help dismantle what it sees as a “litigation culture”. It would work out far cheaper for the NHS than the current route, in which cases go to court or are settled out of court, often for millions of pounds.

Data from the NHS Litigation Authority shows the compensation bill to the NHS for errors around the time of birth is rising, reaching £509.3m in 2015/16 – up from £393.2m in 2014/15.

A spokeswoman for the Department of Health said the plan, which will be the subject of a consultation, would not “lock” parents into the scheme and would let them bring their own legal case against the trust if they were unhappy with the outcome.

The new maternity ward ratings follow Hunt’s recent creation of similar schemes to help patients and families compare the quality of cancer and dementia care. However, once they start being published, they will set out details for services within each of the NHS’s 209 GP-led clinical commissioning groups rather than the 156 acute hospital trusts with maternity services. Hunt said that openness about the quality of care will help empower patients and reduce wide variation in care quality.

In a speech at the Royal College of Obstetricians and Gynaecologists, Hunt will also set out £8m for training, with at least £40,000 available to each NHS trust in England.

A £250,000 maternity safety innovation fund will pilot new ideas for improving care, while maternity ratings for every part of England – using data that already exists – will be published together to encourage greater transparency.

Other measures being unveiled include a new Healthcare Safety Investigation Branch, modelled on the Air Accidents Investigation Branch. A new tool will also standardise the investigation of every stillbirth and early baby death so lessons can be learned.

Hunt said: “Our NHS maternity staff do a fantastic job under huge pressure. But even though we have made much progress, our stillbirth rates are still among the highest in western Europe and many on the frontline say there is still too much of a blame culture when things go wrong – often caused by fear of litigation or worry about damage to reputation and careers.

“These comprehensive measures will give practical support to help trusts improve their approach to safety – and help to foster an open and transparent culture so that the courts become a last resort not an automatic first step.”

In May this year a new report revealed figures that 15 babies are dying every day in the UK from stillbirth, during labour or within four weeks of being born.

The report was published by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries in the UK), which is a collaboration of academics and medical experts.

It found that there were big variations in death rates across the country, from 4.1 to 7.1 per 1,000 births. Women from the poorest backgrounds and black and Asian mothers run a higher risk that their baby will die in the womb or soon after birth.

In nearly half of all stillbirths (46%), the causes of death are unknown, said the report. The biggest causes of death in the early weeks of life are complications following birth (32%) and congenital anomalies such as heart defects (28%), and very premature birth (13%).

The MBRRACE team flagged up the need for research into premature births and also called for every maternity unit to review and record the causes of death in the same way to try to discover why there are such stark variations around the country.

James Taylor, head of policy and public affairs at disability charity Scope, said of the new plans: “Finding out that your child has been affected by a birth injury can be a very traumatic time for parents.

“So it is very positive that the government will be listening to disabled people and their parents on how the NHS can better support families when serious issues do occur during birth.”

Maternity wards in England to be rated by safety record

Lead to for celebration as NHS is rated the ideal healthcare system | @guardianletters

The findings of the study come as no shock to those who have campaigned to preserve the NHS publicly funded, says Dr Jacky Davis. Photograph: Alamy

As a complete-time employee of the NHS for a lot more than forty many years I was delighted to go through that the Washington-based mostly Commonwealth Fund, seeking at healthcare across the created world, puts the NHS in pole position total, in spite of astonishingly lower fees matched only by New Zealand (Expert panel costs NHS world’s greatest healthcare system, 18 June). This is a colossal achievement and probably represents the very best and most reasonable assessment of what the NHS is today – despite a lot of pressures and, of course, imperfections, still a exceptional mix of “quality, access and efficiency”. One require hardly add fairness and equity because this blazes out so obviously in comparing our program with, say, the US, where the extremely very best is outstandingly excellent (I worked there for a 12 months), but the peaks are obviously outweighed by the tragic and shameful troughs (I noticed these initial-hand too).

It is usually a pleasure to search soon after visitors from the US unexpectedly requiring emergency healthcare right here (I have knowledgeable this a lot of times in a lengthy job) and hear their comments – nearly usually a mixture of admiration and disbelief that our significantly-maligned healthcare technique can supply this kind of compassion and quality with no unwelcome and exhausting concerns of payment at the point of need to have.

My pride in reading through the report was much more-than-somewhat diminished not just by the unfair and repeated brickbats thrown at us by mainly hostile media coverage, but also, and far far more importantly, the threats posed by continual reorganisation and what numerous see as a gradual unravelling of the founding concepts of the NHS.

It truly is wonderful to see the robust report from Jeremy Hunt, who recognises that the wonderful difficult operate of NHS workers has now been effectively and impartially measured by international specialists, but we need to trumpet this great achievement far more entirely.

Large marks to the Guardian for the front-page story, but why relegate it to the foot of the webpage under the photo of a grieving Brazilian football fan?
Jeffrey Tobias
Professor of cancer medication, UCL, and advisor in clinical oncology, UCL NHS Hospitals Believe in

• Steve Richards hits the nail on the head (If folks come to feel powerless it is because they are, 18 June). Last 12 months I wrote to my regional MP and asked how choices have been produced about the amount and spot of GP practices. I was concerned because the developing of huge new estate had not been supported by a new, nearer, overall health facility. My MP advised me to get in touch with the clinical commissioning unit – even I knew that was incorrect – but I wrote and asked for my request to be passed on. I at some point spoke to an official. She was valuable but there was no way I could have recognized (or located out) that her particular workplace was accountable for GP practices. I invested the latter component of my job as an ombudsman’s investigator. If I could not locate out in which and how to trace this info, what hope, as Steve Richards says, for the patient who just desires to know why they are not able to get an appointment to see their medical doctor?
Maureen Panton
Malvern, Worcs

• The findings of the Commonwealth Fund’s most recent review come as no shock to those who have steadfastly campaigned to maintain our NHS publicly funded, publicly delivered and publicly accountable. The media now requirements to challenge the politicians’ mantra of “we can’t go on like this” and “we cannot afford the NHS”. We require fewer stories focusing on difficulties and far more celebrating the one.5 million patients noticed by the NHS every 36 hours. We need to have to inquire politicians: “If we cannot afford the NHS, now acknowledged as the most value-effective services, what are they suggesting we can afford?”
Dr Jacky Davis
Founder member, Preserve our NHS Public

• So the NHS has been rated the world’s greatest healthcare system? Its only black mark is its bad record on retaining individuals alive. Nothing at all significant then.
Christiane Goaziou
Wotton under Edge, Gloucestershire

Lead to for celebration as NHS is rated the ideal healthcare system | @guardianletters

Britain rated equal with Belarus as a location to be a mom

By last 12 months it had slipped to 23rd, but substantial-risk pregnancies, believed to be linked to increasing obesity issues, IVF, social deprivation and numerous pregnancies have pushed the nation even more down the ratings.

The increased quantity of older girls becoming pregnant and poorer access to health care in the Uk, specially among some ethnic minority groups and asylum seekers, had been also noted by the charity as troubles holding Britain back.

Nevertheless, advances in healthcare, including the handle of infectious illnesses, enhanced public wellness infrastructure and greater midwifery and neonatal intensive care has also noticed decreases in the numbers of infant deaths, according to Save the Kids.

Britain stays ahead of the US which was positioned at 31.

American ladies encounter the same threat of maternal death as those in Iran or Romania, according to the report.

It factors out that in the US, the threat that a 15-yr-old woman will die throughout her lifetime from a pregnancy-associated lead to has elevated by more than 50 per cent given that 2000, from one particular in three,700 to 1 in two,400.

Armed conflict, political instability and natural disasters played a important part in eroding the well-becoming of mothers and young children in the world’s poorest countries.

Problems-hit nations in Africa filled the bottom slots with Somalia ranked at 178, behind the Democratic Republic of the Congo at 177 and Mali and Niger which were each placed at 175.

“The tragedy is that in countries like the Democratic Republic Congo you are statistically a lot more probably to die if you are a woman or kid than if you are an armed fighter,” stated Justin Forsyth, Save the Children chief executive.

“This report warns that these women and youngsters must not be written off. Their chances of survival rely on accessibility to midwives. The report calls for a experienced health worker to be existing at every single birth”.

Britain rated equal with Belarus as a location to be a mom