NHS leaders say maternity care organisation is 'not fit for purpose'

NHS leaders in England have declared the organization of maternity care to be unfit for purpose, citing safety concerns and the potential closure of smaller units. The NHS Alliance, representing health managers, warns that difficult decisions need to be made and a consolidation of maternity services is required to ensure safer care. A government taskforce on neonatal and maternity care must address issues such as a shortage of specialist staff and a surge in C-sections.

The Department of Health and Social Care asserts that every woman deserves safe maternity care, and the taskforce will implement the necessary reforms. However, NHS Alliance leaders point out particular pressures on smaller units in rural and coastal areas, where units delivering 1,500 to 2,000 babies per year might need to close.

The rise in C-sections, inadequate operating theatres, and decaying buildings pose safety risks, as well as difficulties in maintaining safe staffing numbers for 24-hour care, including midwives and consultants.

The NHS Alliance's director, Matthew Hopkins, emphasized that difficult decisions lie ahead, with the need to consolidate maternity services for safer, more sustainable care. Any local plans must involve NHS leaders, clinical staff, patients, and communities, and politicians must have the courage to advocate for patient safety. The director stressed the importance of considering how maternity services should be best organized and located across England.

Recent data shows that one in four births in England now involves an emergency caesarean, according to BBC analysis. Factors contributing to maternity care failings include racism and poor staff relationships, as reported in a recent study. In August, a Devon trust suspended standard birthing services at a hospital in Barnstaple due to staffing issues, leaving pregnant mothers to travel 53 miles to Exeter for delivery.

The trust stated that suspension was the only safe option, and a readiness assessment is planned for October, with patient safety as the top priority.

Campaigners argue that the delay is disappointing, with one couple expressing anxiety and anger over the longer journey required for their second son's birth. Catherine Mchomvu, chief executive of the Devon Antenatal Family Centre, campaigns for the future of the Barnstaple facility, warning that reductions nationally will undermine the quality of care.

She highlights the lack of continuity of care due to closures, as women and babies will not see the same healthcare team throughout their antenatal and postnatal experiences.

In June, Baroness Valerie Amos's review found that women and babies are not being listened to, heard, or believed, with racism and discrimination embedded throughout the system.