Cathy Warwick, Chief Executive of the Royal College of Midwives, welcomed the Maternity Safety Action Plan, calling it an “ambitious plan [that] could have a significant and positive impact on the safety of England’s maternity services. I really welcome the focus on public health, on reducing stillbirths and on improving services for pregnant women with maternal mental health problems. These are areas that desperately need attention.
She added: “The plan’s focus on issues such as improving maternity service teamwork, sharing successful strategies, openness and transparency, and on learning when things go wrong is absolutely right. These are areas where improvements can almost certainly be made without significant additional resources. A lot of work is already going on but there is more to be done and to achieve that all parts of the system must work together.
“The intention to consult on a rapid resolution and redress scheme is especially welcome as this could make a major difference to parents who experience a tragedy at birth. It is also excellent that part of this plan involves working directly with women to ensure they are aware of what can go wrong and can come forward quickly for help and advice.
“The plan quite rightly focuses on the importance of training and skilling staff up to implement quality improvement. An £8m multi- disciplinary training fund very welcome and timely. “I do, however have concerns about the ability of maternity services to fully implement the plan and achieve the ambitious targets in the current climate. The RCM’s own research which will be published next week shows that heads of midwifery are having to make significant savings. They believe these are starting to have a negative impact on the care women and babies receive.
“There is also the longstanding shortage of midwives with England remaining 3500 full time midwives short of the numbers needed. The birthrate remains historically high and births are becoming more complex. Services are often kept afloat by the hard work and dedication of maternity staff doing their best to manage, often under enormous pressure. It is essential that staffing numbers are optimal if safety is not to be compromised.
“However, just recently a report from the Council of Deans identified huge cuts in ongoing education and training budgets for midwifery, nursing and other NHS professions. We also know that there are cuts to services that contribute to better public health such as smoking cessation services. As this plan identifies, smoking is a major factor in the high rate of stillbirths, but achieving improvement is a struggle when the very services that can make a difference are no longer available.
“This in itself is an excellent plan. The RCM will do everything it can to support midwives to achieve its objectives, and the short term funding that it has identified is very welcome. However we are deeply worried about the pressures being reported to us from midwives working directly with women. If we are truly to become a country with world class maternity services the Government has to ensure that the longer term resourcing of maternity services is addressed.”
Rebecca Schiller, CEO of the human rights in childbirth charity Birthrights, said: “Birthrights welcomes innovation and investment in maternity care. We are particularly pleased to see the Health Secretary's commitment to the Better Birth report's recommendation that a 'rapid redress and resolution' compensation system is introduced. We frequently see the negative impact of a culture of fear on healthcare practitioners, and the women they care for, and believe that this new model has the potential to improve transparency and practice in maternity care as well as the lives of people whose babies are damaged during birth.
“Investment in maternity care is desperately needed but we are concerned that a narrow focus on 'safety', at the expense of a maternity system that enables midwives and doctors to provide respectful, personalised care, will not deliver the high-quality, safe service we need for all women in England. We urge those taking this initiative forwards to ensure that the vision of the National Maternity Review, which recognises that safe care is only possible in a system that wraps around the individual women, remains a key driver for positive change."