The King's Fund is to conduct an inquiry into the safety of maternity services in England.
The year-long investigation will look at the safety record of maternity services, where progress has been made as well as areas of concern. There have been a number of recent high-profile reports on quality and safety in maternity services and the inquiry will seek to establish the extent to which their recommendations have been implemented and to find out why in some cases they have not been followed through.*
It also will examine death rates and complications around pregnancy and birth and consider why these are higher for some of the most vulnerable groups and what can be done to tackle this.
Baroness Onora O'Neill, a senior figure in medical ethics and President of the British Academy, has been appointed to chair the inquiry and will be working with a panel of experts.** The scope of the investigation will be established early next year following a first-stage review of current research. The inquiry will issue a call for evidence at that time with a final report expected in autumn 2007.
The inquiry team will analyse evidence from a wide range of organisations and individuals, and aim to:
- summarise the available data and evidence about the safety of maternity services
- identify the reasons for poor outcomes, especially for the most vulnerable women
- examine the factors which influence safety, and determine whether health care staff and organisations are following existing best practice guidelines and if not, why not
- devise effective strategies to tackle the problems identified, and produce a robust set of recommendations for improving safety and quality.
Inquiry chair Baroness O'Neill said: 'This investigation is a vital opportunity to take an objective look at our maternity services, find out where things are going right, and work out why things may be going wrong.
'Medical research has delivered many advances in health care for mothers and babies in recent years, so it is worrying that maternal health appears to be worse in some of the most disadvantaged communities compared with the better off. This review should give us the knowledge-base we need to tackle these problems effectively, and ensure all maternity services in this country meet high standards of care.'
The King's Fund chief executive Niall Dickson added:
'There are thousands of dedicated and skilled professionals and support staff who do a fantastic job every day in these services, sometimes working under considerable pressure. But there is also a widespread view that we can do better and we need to understand the challenges the service is facing.
'There is growing concern about safety and enough evidence to suggest all is not well. We recognise this is an area of high emotion and some controversy. Our aim in establishing this inquiry is to understand better the nature of the problem and to begin to find solutions. We hope the inquiry will make a real difference to the care and support mothers and babies receive.
'The inquiry team will want to hear from front line professionals, experts, women and their families to gather a full picture of the state of maternity care.
'We are delighted that Baroness O'Neill is chairing the inquiry. Together with other members of the inquiry team she will bring an incisive, intellectually rigorous and independent perspective to this crucial area of health care.'
Notes to editors:
1. No further information is available at this stage. Further announcements will be made early in 2007 when the first stage of the inquiry is complete and the call for evidence is issued. For further background information, please contact the Fund’s Press and Public Affairs Office on 020 7307 2585, 020 7307 2632 or 020 7307 2581.
2. *The following provides examples of recent high-profile reports on quality and safety in maternity services:
- House of Commons Health Committee. Provision of Maternity Services. Fourth Report of Session 2002-03. June 2003.
- House of Commons Health Committee. Inequalities in Access to Maternity Services. Eighth Report of Session 2002-03. July 2003. http://www.publications.parliament.uk/pa/cm200203/cmselect/cmhealth/696/696.pdf
- Understanding the patient safety issues for some vulnerable groups of women known to be at higher risk of maternal death or morbidity. NPSA. February 2005. http://www.npsa.nhs.uk/site/media/documents/1743_FinalReport.pdf
- Investigation into 10 maternal deaths at, or following delivery at, Northwick Park Hospital, North West London Hospitals NHS Trust, between April 2002 and April 2005. Healthcare Commission, August 2006. http://www.healthcarecommission.org.uk/_db/_documents/Northwick_tagged.pdf
- Why Mothers Die 2000-2002 - Report on confidential enquiries into maternal deaths in the United Kingdom. CEMACH, 2006.
3. **Baroness O’Neill will be assisted by a panel of experts, including Jocelyn Cornwell, formerly of the Healthcare Commission and Audit Commission; and Charles Vincent, Director of the Clinical Safety Research Unit at Imperial College London. The Fund is in the process of recruiting a clinician to complete the panel. In addition, the inquiry team will be supported by up to four professional advisors, including at least one midwife and one obstetrician. The final make-up of the panel will be confirmed and announced at the time of the call for evidence, in early 2007.
4. The King’s Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.