Today saw the publication of the Independent Investigation of the National Health Service (NHS) in England by Lord Darzi. We were pleased to see such an honest review, which will hopefully give the new government a roadmap to achieve real change based on the past and current picture of the NHS in England.
The report notes that the NHS is in serious trouble, and the first step in rebuilding it and rebuilding the public’s trust in it, is to be completely honest. In it, he talks about his findings around maternity and newborn care, in which he says that “today, too many women, babies and families are being let down”.
We were pleased to be able to contribute our own research to help inform this review of maternity and newborn care.
Inequalities
Lord Darzi points out that there has been some progress in trying to reduce the number of babies dying in England. However, the number of mothers dying has increased in the most recent published data, and this is not just due to the deaths caused by Covid-19.
Lord Darzi writes: “most worrying are the huge inequalities that exist in maternity care”. National datasets are showing us that black women are almost three times more likely as white women to die in pregnancy, childbirth, and the year following birth. Similarly, in areas of high deprivation, babies are twice as likely to die in their first few weeks of life than in the least deprived.
Tackling inequalities is a big part of the work that we do, in our education and in our campaigning.
Lack of progress, increased complexity
Lord Darzi notes that there has been a lack of progress in maternity care, and there was a common theme of recommendations not being adopted following reviews and investigations. He also notes that women need more complex care than before, and that the landscape of births has changed with more caesarean sections and inductions than 2001.
Focus on staff skills, leadership and culture
He stated that staff shortages alone could not be to blame for the lack of improvement, with there being a better ratio of births per midwife annually in comparison to other similar countries (France, Germany, and Spain). Instead, skills, staffing mix, clinical models, leadership, and culture need to be put under the microscope.
Findings from Baby Lifeline’s research – Mind the Gap – was submitted as evidence, and clearly shows detrimental gaps in training offered to maternity health professionals in continuing themes and topics relating to avoidable harm and death.
Lord Darzi gave special mention to our Honorary President, Bill Kirkup’s, review into the quality of care at East Kent, which mentions training and a culture that prevents learning from past mistakes.
Lord Darzi does point out, though, that the health of the maternity and neonatal workforce is a potential factor in staff being available to give care, with sickness rates being very high. This shows a need to focus on caring for professionals in these roles by reducing burnout, investing in spaces for them to rest and take a break, and giving them the tools they need to feel confident in the care they’re giving.
Hope for the future, and supporting NHS professionals
He finished by concluding that the issues were not insurmountable, and that they can “all be solved with sufficient time, attention, and focus”.
In his address today, Prime Minister Kier Starmer spoke about reform for the NHS, but emphasized the “talents and passions” in the NHS workforce. The Secretary of State for Health and Social Care, Wes Streeting, also talked about giving health professionals “the tools they need” to give the best care.
Baby Lifeline’s work, since its inception, has been exactly that – centred on supporting health professionals with education and equipment to improve safety.
Judy Ledger, CEO & Founder of Baby Lifeline, says:
“We feel optimistic about the honesty of Lord Darzi’s review, and the importance the government is giving it. We hope that maternity and neonatal care is given a platform within this review and is not an afterthought as it has been in the past.
Years of underfunding has meant that women, babies, and NHS professionals working in maternity and neonatal care have had to bear the brunt of failures in the system. We look forward to working with the government to get this right for our future generations.”