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Understanding Cumberlege: The right to quality maternity care

Newborn baby
27th July 2016

There are around 700,000 births in the UK every year, and for most families it is a momentous and joyous occasion.

Whilst maternity care standards have improved dramatically over the decades, there are still risks associated with childbirth and complications can occur. However, this risk can be compounded when those responsible for supporting mother and baby are negligent.

High-profile cases in the media, such as the Morecombe Bay NHS Trust scandal, bring these shortcomings into sharp focus.

In response, Baroness Julia Cumberlege was asked by NHS England to lead a major independent review of maternity services and to suggest areas where the quality of patient care for both mother and child could be improved.

This post briefly examines the key points from the resulting ‘Cumberlege report’ and looks at the support available for those who have suffered from negligence during maternity care. 

Key points from the report

The Morecombe Bay NHS Trust has seen eight midwives investigated over failings which contributed to the deaths of 12 mothers and babies between 2004 and 2013. One midwife was struck off after admitting to 68 mistakes which contributed to the deaths of two babies and the poor care of twelve patients.

The situation in Morecombe is referenced in the opening summary to the 2016 Cumberlege Report entitled: ‘Better Births: Improving outcomes of maternity services in England’. Whilst these failings are shocking, the report was commissioned because negligence, oversight and accidents are unfortunately still regular occurrences in maternity wards across the UK.

Based on surveys of new mothers and their families, healthcare professionals, commissioners and provider organisations, the report makes detailed recommendations for improvements and analyses the cost implications of sub-standard care. Baroness Cumberlege concludes: ‘maternity services in England must become safer, more personalised, kinder, professional and more family-friendly’.

The report recognises the improvements seen over the past decade which includes a 20% reduction in stillbirth and neonatal mortality rates. It also states that maternal mortality in the UK has also reduced from 14 deaths per 100,000 maternities in 2003/05 to nine deaths per 100,000 maternities in 2011/13.

However, £560 million is spent each year by the NHS in compensating patients who suffered because of medical negligence during maternity care. Cumberlege makes the important point that around half of all maternity-related deaths would have had a different outcome had better care been provided.

The report also emphasises that some medical professionals operate under a culture of fear and are therefore unwilling to admit fault in cases of negligence. Clearly more needs to be done to ensure the professional duty of candour is followed and that patients experience openness and honesty when things go wrong.

One of the report’s recommendations around negligence is the implementation of a model of ‘no-fault compensation’.

The aim is to avoid prolonging patient pain, reduce legal costs to the NHS, and limit delays in families’ ability to find redress.

However, much more work needs to be done to explore how this may be implemented so that patients’ access to justice is not restricted and their needs are adequately met.

Safety is a joint responsibility

Despite the observations and recommendations around Maternity service quality, the Cumberlege report makes it clear that responsibility for patient care does not solely rest on the shoulders of the NHS.

According to the report: ‘Women have made it abundantly clear to us that they want to be in control of their care, in partnership with their healthcare professionals. With this control comes a responsibility which mothers must accept and professionals must support’.

The implications of this are significant. Your Legal Friend’s Healthcare and you: an informed choice? report found that 64% of patients do not fully understand their right to make an informed choice when receiving medical treatment, whilst almost a quarter (22%) admit they are not aware of the right at all.

Informed Choice ensures patients receive all relevant information regarding their diagnosis and treatment options before they agree to proceed.
The results of our research suggest that much more needs to be done to educate patients about this central ethical principal if the NHS is to deliver the ‘control’ agenda, without increasing the risk of negligence.

Available support

Despite the discussion around implementing ‘no-fault compensation’, the current system is still effective and it’s vital that patients know there is a route to redress if things go wrong.

Your Legal Friend’s medical negligence team are highly experienced. We understand the deeply sensitive nature of the problems that can occur around the time of childbirth. We are here to help mothers and their families identify cases of negligence and provide the support required to pursue a case.

If you or a loved one have been subject to failings in maternity care standards, we can help.

Call us on 0808 301 8622