National review of maternity care in challenging circumstances
There should be a national review of the provision of maternity care and paediatrics in challenging circumstances, including areas that are rural, difficult to recruit to, or isolated. This should identify the requirements to sustain safe services under these conditions. In conjunction, a national protocol should be drawn up that defines the types of unit required in different settings and the levels of care that it is appropriate to offer in them. Action: NHS England, the Care Quality Commission, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of Paediatrics and Child Health, the National Institute for Health and Care Excellence.
How was this assessed?
Response
Accepted
Response
Accepted7.
We accept this recommendation. A review of maternity care, which will also
consider neonatal care and paediatrics in the context of maternity care, is underway.
8.
In its report to Cumbria Clinical Commissioning Group, the Royal College of
Obstetricians and Gynaecologists highlighted the association between frequent
exposure to complex cases and more favourable outcomes for patients across all
aspects of clinical care. The report suggests that some units, particularly rural and
isolated units, need to develop innovative models of care that enable clinicians to
maintain their skills and competencies and staffing structures to ensure safe levels of
expert clinical coverage.
9.
NHS England announced a review of maternity services on 3 March 2015.
Baroness Cumberlege is the independent Chair leading the review and is being
supported by a core team of experts, including Catherine Calderwood, the Chief
Medical Officer for Scotland, who worked on the Morecambe Bay Investigation and
James Titcombe OBE, one of the family members affected by the failings at
Morecambe Bay.
The Review will develop proposals for the future shape of
modern, high quality and sustainable maternity services across England. The terms
of reference set out three complementary objectives:
• review the UK and international evidence and make recommendations on
safe and efficient models of maternity services, including midwife-led units
• ensure that the NHS supports and enables women to make safe and
appropriate choices of maternity care for them and their babies
• support NHS staff including midwives to provide responsive care.
10. The review will pay particular attention to the challenges of achieving the
objectives in more geographically isolated areas.
It will also consider the links
between the different models of maternity care and neonatal units, ensuring access
to appropriate levels of more intensive care following birth, if they are needed. It is
expected to conclude and publish proposals by the end of the year.