Major reforms in the way maternity care is provided to women in England are being forced by NHS bosses, maternity unit staff under pressure and safety concerns, according to the team investigating the biggest maternity scandal in NHS history. has been rejected.
In a damning criticism of NHS England’s approach to its new ‘continuous caregiver’ model, the Shrewsbury and Telford investigation team said the model was introduced without adequate midwives meaning the safety of women and children was at risk.
Under Continuity of Care (COC), expectant mothers are provided with a designated community midwife during their pregnancy and who is involved in the birth.
But critics say the rollout has created a two-tier system in which women in the hospital are facing long delays because wards lack adequate staff.
In April, a senior doctor at Worcester Royal Hospital was censored after sounding the alarm over changes he said were alarmingly understated to the wards.
The Royal College of Midwives Told Granthshala “There just aren’t enough midwives to embed this safely.”
The Shrewsbury investigation team argued that a dogma of the CoC model has taken hold within senior levels in NHS England, with bosses reluctant to listen to concerns about the problems that are being created on the frontline.
In the six-page dossier submitted to the MPs on the Health Committee GranthshalaThe team investigating 1,862 cases of poor maternity care at Shrewsbury NHS Trust said they had received concerns from across the country.
He cautioned: “The Maternity Review Team believes that COCs are being used as a panacea to improve maternal care provision, maternity care outcomes and women’s birth experiences.
“A change of this magnitude should come with staffing resources to facilitate this and an ear to listen when there are safety concerns. Our concerns are centered on an ambition that has been launched with the hope of being implemented with limited thinking given the impact on the service-providing workforce.
The team, led by specialist midwives Donna Ockenden, said they had heard examples of senior midwives in the trusts trying to raise their concerns to regional leading midwives, but were shot and treated as an obstacle to the “national motherhood vision”. Labeled in.
She said the heads of maternity services had told her that she had been “heavily criticized” by her trust boards for trying to implement the changes, because of adding costs: “The heads of maternity services were later criticized by their regional There was criticism by the CoC leadership for not meeting the ambition and percentage targets.
“To meet the goals, the CoC for many trusts has evolved into a tick box exercise with examples of inequalities in the care of women. When it has been raised as a safety concern by those responsible for key maternity services, they have been described as a barrier to change.”
He said: “Every single day we are aware of labor wards that have inadequate staff. This is now often accepted as the standard and lends itself to an increasing number of patient safety incidents. A plane won’t fly without the right crew, but maternity services do it every day.”
She said it was her “unanimous view that we need to refocus on the national ambition of a maternity system, which aims to reduce both maternal and neonatal morbidity year after year, which means safe motherhood throughout the continuum.” providing care.”
The Shrewsbury investigation team includes midwives, obstetricians and neonatologists from 20 different NHS trusts in England.
Their concerns have been echoed by the Royal College of Midwives, which said it has received several reports from maternity units of changes being made without adequate staff, with little consultation and with managers “top-down targets”. unable to challenge.
Gil Walton. The Chief Executive of RCM said: “While RCM wholeheartedly supports the concept of caregiver midwifery continuity, we cannot currently support the implementation as there are not enough midwives to embed it securely.
“RCM members across the UK have been consistently telling us that attempting to deliver that type of care was putting dangerous stress and pressure on the security of services. We have consistently shared this insight with NHS England and England’s Chief Midwifery Officer, Jackie Dunkley-Bent is also written in writing.
She said that when there was already a shortage of 2,000 midwives, the change could not be done “on a shoestring”.
“We want caregivers to continue – we know the evidence suggests it is better for women and babies – but imposing it without a proper foundation is setting it up to fail.”
NHS England wants 75 percent of women from ethnic minorities and disadvantaged communities to be covered by the COC model by 2024, with the majority of all women under the model this year. The rollout began in 2019 with a target of 20 percent women.
It has given an additional £96m to maternity services this year, including £47m to recruit an additional 1,000 midwives. Health Education England has pledged to train an additional 3,650 student midwives by 2023.
Granthshala The NHS asked England for a response to claims that its senior leaders were downplaying security concerns, but did not specifically respond to that question.
In a statement a spokeswoman said: “The evidence is clear – having the same caregiver before, during and after pregnancy reduces the chances of losing a child and increases women’s sense of confidence in their care, and the mother’s For these better health outcomes and children, the NHS is determined to ensure more women benefit.
“The NHS has made £96m available to trusts following findings in the Oakenden Review – most of which will go towards capacity expansion – while our planning guidance comes with a clear understanding of how to improve maternity care for mothers and their children Appropriate staffing levels are required before the trust provides, including implementing continuity of care.”
Credit: www.independent.co.uk /