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NHS Delivery Choices And Staff Shortage Pressure On Maternity Services

Pregnant woman
15th November 2013

The number of births in 2012 in the UK was 792,674 compared to 669,000 in 2002, an increase of just over 18 per cent  in the last decade, according to the Office of National Statistics in August 2011 - the same year in which it was also reported that one in every 33 deliveries was either still born or had died.

Since 2001, the total number of women in the key child-bearing ages of between 15 to 44 living in the UK increased by 2 per cent. The increased pressure on NHS maternity services has also accompanied a rise in insurance cover costs to reach one fifth of the total maternity expenditure, according to figures just released by the National Audit Office.

“Pressure on maternity services is growing” 

The challenges facing the NHS today are increasingly recognised by a number of medical professionals and institutions. According  to Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists, the Audit Office report raised ‘valid concerns’.

"Although the UK is generally a safe place for women to give birth, we have known for some time that pressure on maternity services is growing in some areas, particularly inner city conurbations, placing stress on clinicians, managers and patients alike."

The NHS is constantly adapting and evolving to provide some of the most advanced and safest healthcare procedures and treatments in the world as well as providing for the very special needs of each and every one of its patients.

"Wide unexplained variations"

However, the maternity services report points to "wide unexplained variations" between Hospital  Trusts in “rates of complications” such as readmissions, injuries and infections. The ‘delivery choices’ that are now available for mothers with a variety of needs or conditions  also brings its own complexity to issues of insurance cover and birthing procedures.

The Royal College of Midwives state that nearly 85 per cent of mothers - up from 75 per cent  six years ago – have said they received a positive experience of maternity care, which was either “excellent” or “very good” . However, with “many thousands of midwives short of the number needed to deliver safe, high quality care... and  births at a 40-year high” they are, nevertheless, “determined to improve quality of services further.”

So looking for where improvements can be made could begin with attempting to understand the pressures of meeting those very differing expectations, especially at a time when there is a shortage of midwives and consultants on labour wards.

The Audit Office reports that more than a quarter of maternity units were closed to admissions for at least half a day because “demand outstripped capacity” between April and September in 2012, and goes on to suggest that a further 2,300 midwives are now required, although distribution would vary substantially across various regions of the country.

Department of Health Minister, Dan Poulter has pointed out that there are now 1,500 additional midwives in the NHS than three years ago, 5,000 more in training and increased numbers of obstetric doctors available for “high risk” births on labour wards “more of the time.”

“Scope for improvement”

The Health Minister reiterates that the “the NHS is one of the safest places in the world to have a baby ... but should always learn from any mistakes to improve patient care in the future.” It’s a view supported by the public spending watchdog, also with the proviso that “there was still a lot of scope for improvement.

Concern for the quality of NHS experience received by individual mothers and their babies is always paramount.  We should seek to positively understand the underlying issues even while, at the same time, we urge for the improvements that the Audit Office outlie.