NHS Leaders Warn Maternity Care Organization 'Not Fit for Purpose,' Risking Safety

NHS leaders in England have declared the current organization of maternity care "not fit for purpose," warning that patient safety is at risk and that some smaller maternity units may need to close.

According to the NHS Alliance, an organization representing health managers, difficult decisions are imminent regarding the consolidation of maternity services to support safer care. The alliance highlighted key issues that a government taskforce must address, including a shortage of specialist staff and an increase in Cesarean sections.

The Department of Health and Social Care stated that every woman deserves safe maternity care and that the taskforce is intended to "deliver the reforms needed to ensure services meet the needs of women and families now and in the future."

However, the NHS Alliance pointed to particular pressures on smaller units in rural and coastal areas, suggesting that those delivering between 1,500 and 2,000 babies annually might be candidates for closure. The rise in C-sections presents a challenge, compounded by inadequate operating theaters and beds in outdated facilities, which pose a safety risk.

Leaders also noted that some smaller units struggle to maintain safe staffing levels for 24-hour care, including the availability of midwives and consultant obstetricians.

The organization urged the government's taskforce to confront these strategic issues, which also encompass significantly worse outcomes in deprived communities and higher maternal mortality rates for Black and Asian women.

Matthew Hopkins, director of the NHS Alliance's acute and ambulance network, emphasized the need for consolidation to achieve safer, more sustainable care. He stated that any local plans must involve NHS leaders, clinical staff, patients, and communities, and that politicians must demonstrate the courage to prioritize patient safety.

"It is time now to take a step back and consider how we should best organise maternity services across England, and where those services should be located," Hopkins said.

Recent events underscore these concerns. In August, a trust in Devon temporarily suspended standard birthing services at a hospital in Barnstaple, requiring pregnant mothers to travel 53 miles to Exeter to give birth. The Royal Devon University Healthcare NHS Foundation Trust cited staffing issues as the reason for this measure, stating it was the "only safe course of action" after exploring all other options, including locum cover and inter-organizational support.

The North Devon maternity facility remains suspended, with the trust planning a "readiness assessment" in October, prioritizing patient safety. Campaigners have expressed disappointment with the delay, with one couple sharing their anxiety over the increased travel distance for the birth of their second son.

Catherine Mchomvu, chief executive of the Devon Antenatal Family Centre, warned that national reductions in services would undermine care quality. "If we had closures of smaller units you are going to find that women are not going to receive any level of continuity of care - that's purely because they are not going to see the same healthcare team more than once throughout the whole antenatal and post-natal experience," she said.

In June, Baroness Valerie Amos's review found that women and babies were not being "listened to, heard or believed," and that racism and discrimination were "embedded throughout the system."