The National Maternity Review: Better Births

We look at the implications of The National Maternity Review’s report “Better Births: improving outcomes of maternity services in England”.
The National Maternity Review’s report “Better Births: improving outcomes of maternity services in England” was published on 23rd February 2016 and strives to ensure that every woman is offered clinically safe and effective, choice based births, suited to their needs and wishes.

NHS England commissioned a review, led by Baroness Julia Cumberlege, in an effort to improve the maternity services across England over the course of the next 5 years.

The review identified significant discrepancies across the country in how maternity services are delivered with almost 40% of services being rendered inadequate or in need of improvement by the CQC.

With the safety of births being called into question and hospital investigations occurring across the nation following hundreds of needless deaths of mothers and babies, due to failures in the care provided, it is apparent that action needs to be taken to prevent or, at the very least, reduce the chance of such travesties occurring in the future.

The most significant proposals to improve the service appear to be:

1. Personalised care approach

With the average cost of a straight forward birth standing at around £3,000.00 it has been recommended that each expectant mother be allocated a personal maternity care budget to be spent on their choice of NHS care. The mother-to-be can play a pivotal role in the personalisation of the birth and places the mother and baby at the centre of their care.

2. Continuation of care

To ensure that the expectant mother has the same midwifery team throughout pregnancy and birth as well as post-natally. Such proposal ensures continuity and consistency of services between the midwifery team and allocated obstetrician and a full care package is implemented across the board.

3. Safer Care

Implementation of rapid referral protocols between professionals and across organisations to ensure that the woman and her baby can access specialist care when they need it.

The idea is that, with professionals working together, providing access to the right care in the right place; leadership for a safety culture as well as investigations, honesty and learning when things go wrong alongside collation of comparable data on the quality and outcomes of their services and performance, services will naturally improve.

4. A Payment System

The Maternity Review proposes a ‘rapid resolution and redress’ scheme which, in effect, would bring about openness and pro-activity in identifying treatment that has caused avoidable harm and thereafter, offer compensation and care packages without the need for the families/litigation friends to take legal action.

Medical negligence solicitors welcome such pro-activity and, in principle, this would help to compensate the child quickly to ensure they get the services that they may require going forward, but in doing so there could be an issue of under settling in the absence of suitable and sufficient safeguards.

“Capped damages” would mean that matters are not looked at on a case by case basis. This could result in a minor brain injured child being compensated at a certain level but, a complex brain injury may not attract the level of damages necessary to cater for that child’s current and future needs.
Treatments, therapies, equipment and adaptations are fundamental to a brain injured child and unique to that specific child and their families. The costs of such provisions are ever increasing. The availability and accessibility of such services through the NHS is diminishing and strained with the funding varying and the criteria to be able to access the services constantly changing and varying depending on where you live.

In considering the Review, Action for Victims of Medical Accidents (AvMA) has put forward some fundamental standards that must be met if the recommendations are to work;

• It must be sufficiently independent and expert enough to be able to investigate and determine whether cases meet the criteria for compensation.
• It should award compensation based on actual needs (not a ‘capped’ sum).
• It must guarantee ongoing access to the services that the child needs whether private of NHS based
• The family has to have access to specialist advice and, where necessary, the families must retain their civil right to resort to legal action if they need to.

It is clear that the Review has a lot of potential and a redress scheme is possible. To be fit for purpose, however, such a scheme must be able to guarantee that children will get compensation and services based on needs rather than based on what best suits the state.

All in all the Review seems a significant step forward in the provision of excellent care within the maternity services which should be beneficial and encouraging to all expecting parents.

More information

If you would like more information on this review please contact our Medical Negligence Department on 01708 229444 or email mail@pinneytalfourd.co.uk


This article was written by Kim Huggins, Medical Negligence solicitor at Pinney Talfourd Solicitors. The contents of this article are for the purposes of general awareness only. They do not purport to constitute legal or professional advice. Specific legal advice should be taken on each individual matter. This article is based on the law as at March 2016.