A clear set of actions is needed to improve NHS maternity services | Letters

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"Inquiry into NHS Maternity Services Aims to Address Systemic Failures and Disparities"

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The inquiry initiated by Wes Streeting regarding the NHS maternity services aims to address the significant shortcomings in care quality and systemic challenges faced by trusts across England. Stakeholders emphasize the need for a comprehensive examination of the deeply rooted issues impacting staff morale and the culture within maternity services. Notably, the inquiry acknowledges the alarming disparities in maternal mortality rates, particularly affecting black and Asian mothers and those from disadvantaged backgrounds. Amidst a complex regulatory environment, trust leaders express a desire for a unified approach to improve care, which has been complicated by numerous recommendations that have not translated into effective action. Saffron Cordery, Deputy Chief Executive of NHS Providers, highlights the necessity for clear, actionable steps to enhance service delivery across all NHS maternity units.

Despite the urgency of the inquiry, some experts voice skepticism about its potential effectiveness. Ann Pearson, who has overseen maternity and perinatal services, criticizes the inquiry as politically driven and lacking in substantive value for affected families. She argues that previous strategic initiatives have already been implemented without yielding significant improvements. The divide between obstetricians and midwives further complicates efforts to prioritize women's needs, suggesting a need for collaborative teamwork and better communication. Zoe Green raises concerns about underlying misogynistic attitudes influencing maternity care practices, while Simon Gibbs suggests examining the successful units to glean insights rather than solely focusing on failures. As funding for maternity services is set to drastically decrease, there is a pressing need for a reevaluation of strategies to ensure the safety and well-being of mothers and their babies moving forward.

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This inquiry (Wes Streeting announces investigation into ‘failing’ NHS maternity services, 23 June) needs to get to the heart of why NHS maternity services in England are falling far short of where they need to be.

It must leave no stone unturned; there are significant, systemic challenges that affect trusts’ ability to consistently deliver high-quality care, deep-rooted issues with morale and culture within maternity services and, as you highlight (Editorial, 23 June), the “shockingly higher risk of mortality faced by black and Asian mothers” and those from more deprived backgrounds.

There have been innumerable recommendations and a regulatory landscape that has become complex, distracting and difficult for trusts to navigate. Trust leaders will welcome proposals to introduce one clear set of actions to improve care across everyNHSmaternity service.Saffron CorderyDeputy chief executive, NHS Providers

After a number of years overseeing maternity and perinatal services at regional level, this proposal frustrates me. The inquiry is purely politically motivated and will not add any value to the women, babies and families affected previously or who may be in the future.

Multiple strategic transformation programmes have been commissioned and funded. There is nothing new to discover; obstetricians focus on healthy babies, midwives focus on happy mothers. The medical v social models of care make this an impossible divide, not helped by either group frequently failing to listen and respond effectively to women’s concerns.

Perhaps when there are sufficient staff to work together as a team, and we place the woman at the centre of care and an effective digital infrastructure is in place to support effective communication, instead of focusing on the either/or approach of “high risk” v “low risk”, we might get somewhere.Ann PearsonGatley, Cheshire

We do not need another review of failing maternity services. The national service development funding (SDF) for maternity serviceswill be cutfrom £95m in 2024-25 to just £2m in 2025-26.

The patriarchyrulesand as a consequence misogyny sets the tone for maternity care.Why else would there be gynaecology beds for women experiencing miscarriage, ectopic pregnancy or termination on a postnatal ward?Zoe GreenLondon

Although failures in maternity care are of great concern, rather than simply chasing after the evidence of what failures look like and castigating those accused of “passing the buck”, perhapsWes Streetingshould also look at the 10 best performing units to find out what they do and how they achieve success. That might prove informative and more inspirational than (once again) punishing those that fail.Simon GibbsEmeritus professor of inclusive educational psychology and philosophy, Newcastle University

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Source: The Guardian