Fourth Report - The safety of maternity services in England

The government states it is considering the recommendation but confirms its existing commitment to funding the RCOG to develop a workforce planning tool to calculate obstetrician requirements. The response details the tool's purpose but does not explicitly address the recommendation for it to include anaesthetist workforce requirements.

The government is considering this conclusion, noting recent investment for 1,200 additional midwives and 100 consultant obstetricians and the commissioning of a new workforce planning tool. They will take recommendations on funding for staffing into consideration and assess workforce levels, but do not commit to further funding at this stage.

The government is considering the recommendation for an immediate budget increase for maternity services, noting recent investment and an ongoing assessment of workforce levels, but does not commit to the specific funding amount or immediate action.

The government accepts this recommendation, highlighting existing collaboration with HEE and RCOG on workforce planning for obstetrics, gynaecology, and anaesthetics. They note the recent funding for an RCOG tool, to be available next year, which will help NHS Trusts calculate their obstetrician staffing needs.

The government accepts in part, stating that funding was announced in March 2021 for multi-disciplinary team training. NHSEI will undertake further work to align this funding with a Core Competency Framework and monitor its impact on training, also noting existing incentive schemes.

The government accepts the recommendation in part, citing the development of a Core Competency Framework and allocated funding for multi-disciplinary training and staff backfill. Further work is planned to align this funding with the framework and monitor its impact.

The government accepts the recommendation in part, confirming funding for maternity training and staff backfill, and the development of a Core Competency Framework. NHSEI will undertake further work to align funding and monitor training, leveraging existing incentive schemes, but does not explicitly commit to ringfencing budgets and public reporting as requested.

The government accepts the recommendation and is developing a Core Competency Framework and a national Registry of Recommendations to address training variations and ensure minimum core requirements for maternity services. They will also work with Royal Colleges and the CQC on standardising fetal monitoring training.

The government accepts the recommendation, describing the development of a Core Competency Framework for essential training targets, with stretch targets to be considered later. While the MTP cannot enforce targets as it is not a regulator, it will collaborate with Royal Colleges and the CQC to share information and support inspection programmes.

The government accepts the recommendation in part, detailing HSIB's ongoing efforts to improve family engagement and the timeliness of reports through enhanced collaboration, awareness building, and feedback mechanisms. It also notes future provisions in the Health and Care Bill regarding who will carry out maternity investigations.

The Government accepts the recommendation in part, outlining HSIB's ongoing work to improve the timeliness of investigations, strengthen collaboration with trusts, and enhance engagement with multidisciplinary teams, including through surveys and staff engagement videos.

The government accepts the recommendation, committing that maternity services will complete a Training Needs Analysis and NHSEI will work with HEE to ensure national training packages support relevant staff, aligning with the Core Competency Framework.

The Government accepts the recommendation in part, stating HSIB will continue investigations and noting that HSIB has already made changes in the last year to improve timeliness, collaboration, and engagement with trusts and staff, including conducting surveys and creating engagement videos.

The Government accepts the recommendation in part, stating HSIB is working with academic partners to develop meaningful data for public sharing, and a new single notification portal (LFPSE) will be commissioned to streamline data collection and sharing across organisations.

The Government accepts in part, committing to commission a single notification portal (LFPSE) in 2021/22 to streamline data collection and sharing, improve MSDS data, and highlights the existing Maternity Services Dashboard to enhance data utilisation.

The government accepts the recommendation in part, committing to commission a single notification portal in 2021/22 to streamline data collection and enable sharing. It also highlights existing efforts through the CNST MIS and a Maternity Services Dashboard to improve data and identify gaps.

The government rejects this conclusion, stating it does not intend to implement a Rapid Redress and Resolution Scheme. This decision was made after a 2017 consultation, as benefits were achieved through other initiatives and the scheme would not address rising clinical negligence costs.

The government states it will publish a consultation on patient safety and rising clinical negligence costs, with decisions on next steps to be taken after the consultation, thereby deferring action on the issues raised in the committee's conclusion.

The government plans to consult on next steps to address clinical negligence costs, stating that decisions will be made following this consultation, rather than committing to implement the Rapid Redress and Resolution Scheme in full or providing a review timetable.

The government will publish a consultation on litigation reforms to improve patient safety and address rising costs, with decisions on next steps to be taken only after the consultation.

The Government plans to consult on next steps to address the rising costs of clinical negligence, with decisions to be made after the consultation.

The government welcomes the recommendation, noting that DHSC is working with regulators and highlighting existing work by the GMC and NMC, such as new guidance, outreach sessions, and commissioned research, which are already addressing the blame culture and supporting a just culture within healthcare.

The government accepts the recommendation in part, noting that health disparities have complex causes beyond the Department's sole remit. It outlines existing initiatives like the NHS Mandate's aim for reduction in disparities, support for PIGF based tests, the Maternity Transformation Programme, and the commitment to Equity Action Plans.

The government accepts this recommendation, committing to requiring all maternity services to complete a Training Needs Analysis with provided guidance. NHSEI will also work with HEE to ensure national training for 2021/22 supports skill updates for Continuity of Carer teams and care for women from diverse ethnic backgrounds.

The government accepts this recommendation in part, pointing to the NHS Mandate's aim for year-on-year reductions in health disparities for Black, Asian and Minority Ethnic women. They highlight various ongoing initiatives and Equity Action Plans due by February 2022, but do not commit to a specific target with a clear timeframe to end the disparity as requested.

The government accepts this recommendation in part, outlining ongoing programmes for personalised and safe care, multi-disciplinary training, and shared decision tools. NHSEI has an improvement oversight group for personalised care and aims for every woman to have a Personalised Care and Support Plan by March 2022. The RCM has also established the Re:Birth Project to develop a consensus on terminology.

The government accepts this conclusion in part, outlining ongoing programmes for personalised and safe care, multi-disciplinary training, and shared decision tools. NHSEI has an improvement oversight group for personalised care and aims for every woman to have a Personalised Care and Support Plan by March 2022, addressing the need for women to be fully informed.

The government accepts the recommendation in part, focusing on personalised care, multi-disciplinary training, and shared decision-making tools, with an ambition for every woman to have a Personalised Care and Support Plan by March 2022. It also notes a project to develop consensus on birth terminology.

The government accepts this recommendation in part, stating NHSEI has an improvement oversight group focused on personalised care and support planning, aiming for every woman to have a Personalised Care and Support Plan by March 2022. This addresses the intent for informed choice but does not explicitly commit to establishing the specific working group with the full remit outlined in the recommendation.

The government accepts this recommendation, agreeing that Caesarean Section rates should not be used for performance management and supports the use of Robson criteria. NHSEI will issue further communication advising against total Caesarean rates and encouraging the intelligent use of Robson group data for quality improvement.