£2m will be provided to the Royal College of Obstetricians and Gynaecologists (RCOG), with the Royal College of Midwives (RCM) and The Healthcare Improvement Studies Institute at the University of Cambridge to research how to spot early warnings of foetal distress as part of the first phase of the Avoiding Brain injuries in Childbirth (ABC) collaboration.
The ABC review will develop a nationally agreed approach for staff to monitor a mother's labour by:
- Testing different approaches and questioning midwives and obstetricians on how they currently identify that a baby is in distress and how they then deliver babies even more safely.
- Interviewing women about their personal experience of different approaches.
- Agreeing a clear process to monitor babies and record readings during labour with a flowchart guide when to escalate a situation to the multi-disciplinary maternity team.
- Developing a nationally agreed approach to delivering babies by caesarean section when there are complications with the baby’s position.
The remainder of the money will be spent developing a work-force planning tool for maternity staff that will:
- Provide maternity staff with a new methodology that calculates the numbers, skill sets and grades of medical staff required within individual maternity units based on local needs.
- Help Trusts tackle inequalities by considering factors such as birth rates, age of population, socio-economic status of the area and geographical factors.
- Calculate the number of obstetricians at all grades required locally and nationally to provide a safe, personalised maternity service.
- Identify ways of better utilising the current workforce.
- Create better understanding of the factors that promote safety and positive culture within maternity teams and how to roll these out nationally.
The funding announcement coincides with conclusions from the parliamentary Health and Social Care Committee, chaired by Jeremy Hunt, to investigate failings at University Hospitals of Morecambe Bay NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust and East Kent Hospitals University NHS Foundation Trust, where so many babies died.
The report said a 'culture of blame' prevented staff admitting mistakes and lessons being learned and found that although maternity safety had improved, the deaths at these hospitals were a reminder much more needed to be done.
Although the funding is, of course, positive news, it feels to most medical negligence solicitors specialising in maternity negligence as having been a long time coming.
For years, the RCM and RCOG have warned that understaffing on maternity wards has reached critical levels. It seems to have taken news of the terrible tragedies at Morecombe Bay, Shrewsbury and Telford and now Nottingham hospitals for ministers to understand the absolute priority of having the right maternity staff in place at the right time with the right skills.
As we wait for publication of two further investigations into baby deaths a Shrewsbury and Telford and East Kent, Jeremy Hunt urged the NHS to 'redouble their efforts', while simultaneously reporting that 1,900 more midwives and 500 more consultants were needed to deliver a safe service and that the budget for maternity services should be increased by an extra £200-350m per year.
Governments can commission as many reports as they like, but until the fundamentals of providing a safe maternity service across the UK are understood and respected, avoidable tragedies will continue to devastate families who suffer the death or injury of a baby.
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