The State of Maternity Services in England

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The Picker Institute has today published a new report; The state of Maternity Services in England which focuses on the meaning of maternity care and evaluates the main characteristics of maternity services in England. In addition, the report, written by Giuseppe Paparella, Policy Officer, outlines the broader implications of changing quality in maternity care settings. Finally, suggestions are included, for further actions and policy measures that are needed to improve the quality of care in English maternity services.

Key highlights for maternity services

Child birth is without doubt one hospital experience that every user hopes will be unforgettable, and one where providing a person centred, family friendly experience is key. Perhaps of all healthcare services areas, maternity care is one that, comparatively speaking, people are more likely to actively choose because it not only offers the right care, but the right experience.

However, evidence from the NHS Maternity Survey, shows a need for improvement in several aspects of maternity services:

  • During the period December 2013 to May 2015 almost half of safety assessments in inspections by Care Quality Commission were either “inadequate” (7%) or “requiring improvement” (41%)
  • As reported by the most recent NHS Maternity Survey these trends persist to some extent: according to recent findings, only 57% of women said their midwife definitely asked them how they were feeling emotionally during antenatal visits.
  • Similarly, just 54% of women giving birth for the first time felt they were definitely given enough information about emotional changes which may be experienced after the birth.

Effective service user involvement, a pillar of person centred care, is not always being achieved – particularly in terms of postnatal care – and there remains significant room for improvement in some key components of maternal patient experience.

As outlined in the report:

Improving people’s experiences of care requires providers to hear and respond to user feedback, and to ensure that staff feel supported to provide the best quality care.

Results from the national and the NHS staff survey should be powerful tools to help services in this task, but they should be complemented by other evidence – including the feedback volunteered by families through compliments and complaints, as well as through targeted efforts to understand and explore people’s experiences.

To pursue improvements in maternity services, as recommended in the 2016 National Maternity Review, maternity care should become safer, more personalised, and more family friendly.

This means that women and families ought to have access to information to enable them to make decisions about care, and that they can access support that is centred on their individual needs and circumstances.

It also means that healthcare staff need to be supported to deliver person centred care.

To enable this, they should have the opportunity to work in high performing teams and organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries.

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