Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217335, what the causes of these incidents were; and if he will make a statement.
Answered by Dan Poulter
Table 1 and Table 2 illustrate the number of incidents reported to the National Reporting and Learning System (NRLS) where the incident report contained keywords indicating multiple pregnancies. It is important to note that the inclusion of these keywords may not always indicate the incident directly affected a multiple pregnancy; for example, reference in the incident report may be made to previous pregnancies. The harm reported may relate to the mother or to one or more foetuses/infants. The table is attached.
Information on the specific causes for the maternity incidents outlined in Question 217335 is not held centrally as these are only available after local investigation. The NRLS collects incident reports from maternity services through upload from local reporting systems. The majority of learning and action on the causes of patient safety incidents is undertaken within trusts. NHS England reviews all reports of death and severe harm made to the NRLS and where specific remediable causes are identified NHS England issues advice through the National Patient Safety Alerting System.
Increasing numbers of reported patient safety incidents are considered to be a sign of an improving patient safety culture and increases in the number of incident reports should not be interpreted as deterioration in the safety of patients.
As organisations change considerably across time this data reflects NHS organisational structures as of 31 December 2014. This means that incidents reported before that date may have taken place in a site that was not associated with a given trust at that time.
NHS England has a wide programme of work in partnership with other organisations seeking to improve outcomes for mothers and babies, including reducing stillbirth and neonatal death and avoidable admissions to neonatal care.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217335, how many patient safety incidents involving multiple pregnancies there were in each (a) hospital trust and (b) region in each of the last 10 years.
Answered by Dan Poulter
Table 1 and Table 2 illustrate the number of incidents reported to the National Reporting and Learning System (NRLS) where the incident report contained keywords indicating multiple pregnancies. It is important to note that the inclusion of these keywords may not always indicate the incident directly affected a multiple pregnancy; for example, reference in the incident report may be made to previous pregnancies. The harm reported may relate to the mother or to one or more foetuses/infants. The table is attached.
Information on the specific causes for the maternity incidents outlined in Question 217335 is not held centrally as these are only available after local investigation. The NRLS collects incident reports from maternity services through upload from local reporting systems. The majority of learning and action on the causes of patient safety incidents is undertaken within trusts. NHS England reviews all reports of death and severe harm made to the NRLS and where specific remediable causes are identified NHS England issues advice through the National Patient Safety Alerting System.
Increasing numbers of reported patient safety incidents are considered to be a sign of an improving patient safety culture and increases in the number of incident reports should not be interpreted as deterioration in the safety of patients.
As organisations change considerably across time this data reflects NHS organisational structures as of 31 December 2014. This means that incidents reported before that date may have taken place in a site that was not associated with a given trust at that time.
NHS England has a wide programme of work in partnership with other organisations seeking to improve outcomes for mothers and babies, including reducing stillbirth and neonatal death and avoidable admissions to neonatal care.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217336, what the causes of these damages were; and if he will make a statement.
Answered by Dan Poulter
This information is attached.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217334, how many multiple pregnancies received (a) the higher tariff for the antenatal phase, (b) the delivery phase tariff with complications and co-morbidities and (c) the delivery phase tariff without complications and co-morbidities in each year since 2004.
Answered by Dan Poulter
Information on the tariff each individual multiple pregnancy attracts is not collected centrally.
NHS England is undertaking a major review of the commissioning of NHS maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.
The maternity pathway payment system was first mandated for use in 2013-14, from 2014-15, national tariffs will be set by Monitor. Monitor and NHS England have jointly established a review process and will monitor how the new system is working.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217334, what plans his Department has to review the costs of delivering care in multiple pregnancies antenatally, in delivery and postnatally; and if he will make a statement.
Answered by Dan Poulter
Information on the tariff each individual multiple pregnancy attracts is not collected centrally.
NHS England is undertaking a major review of the commissioning of NHS maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.
The maternity pathway payment system was first mandated for use in 2013-14, from 2014-15, national tariffs will be set by Monitor. Monitor and NHS England have jointly established a review process and will monitor how the new system is working.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many local winter pressure resilience plans developed for the 2014-15 winter period include reference to vaccinations.
Answered by Jane Ellison
Operational Resilience and Capacity Planning 2014/15 published in June 2014 required System Resilience Groups (SRGs) to produce plans which demonstrated comprehensive flu planning in line with guidance published by Public Health England in 2014. SRGs needed to demonstrate flexible preparations for the unpredictability of flu, how vaccination requirements would be met, extending to voluntary and independent sector organisations where appropriate.
The plan assurance process showed all systems had addressed flu planning requirements as part of their resilience and capacity plans.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what funding he has allocated to improving vaccination coverage as part of local winter pressure resilience plans developed for the 2014-15 winter period.
Answered by Jane Ellison
A total of £700 million of operational resilience funding was made available in 2014/15 to support cross-system resilience, with £640 million made directly available to System Resilience Groups (SRGs) through clinical commissioning groups. SRGs agreed locally how this money was to be spent.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what guidance his Department issues to hospitals on the role of improved vaccination in reducing seasonal pressures.
Answered by Jane Ellison
The Annual Flu Plan and Annual Flu letter provide guidance on the seasonal flu vaccination programme, and is sent to a range of healthcare professionals. This provides the necessary information to help local areas prepare for vaccinating eligible groups with the seasonal flu vaccine, and highlights the importance of the programme in helping to reduce pressure on the National Health Service.
When appropriate a letter from the Chief Medical Officer is sent to the NHS recommending the use of anti-viral medicines for appropriate groups.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 15 December 2014 to Question 217336, what (a) damages, (b) defence costs, (c) claimant costs and (d) periodic payment orders were paid in each (i) hospital trust and (ii) region in each of the last 10 years.
Answered by Dan Poulter
This information is attached.
Asked by: Bob Russell (Liberal Democrat - Colchester)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to improve the UK's patient safety OECD ranking for patient safety incidents involving multiple pregnancies; and if he will make a statement.
Answered by Dan Poulter
The Organisation for Economic Co-operation and Development rankings on patient safety are informed by the Health Care Quality Indicators which currently do not compare or rank nations specifically by patient safety incidents involving multiple pregnancies. There are five indicators which are used to rank countries for patient safety:
Women should receive excellent maternity care that focuses on the best outcomes for women and their babies and on women’s experience of care.
There must be a relentless focus on safe care, right first time. This means creating a culture within the National Health Service that is open. A culture that reports errors, analyses what went wrong, and puts those lessons into practice as quickly as possible.
A safety culture is open and fair, shares information openly and freely, delivers fair treatment for staff when an incident happens, and encourages people to speak up about mistakes.
The Department commissioned the National Institute of Care and Excellence (NICE) to produce clinical guidelines and quality standards for the management of twin and triplet pregnancies in the antenatal period. NICE have also produced a pathway to support professionals to care for women with multiple pregnancies who suffer from complications.
NHS England has developed a Maternity Safety Thermometer – which is available to all trusts and allows maternity teams to take a temperature check on harm and records the proportion of mothers who have experienced harm free care, but also records the number of harm(s) associated with maternity care. It supports improvements in patient care and patient experience, prompts immediate actions by healthcare staff and integrates measurement for improvement into daily routines.
The Maternity Safety Thermometer was tested in a pilot phase from June 2013 until October 2014 and is now fully released and available to any organisation wanting to use it.
NHS England is undertaking a major review of the commissioning of NHS maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.
Recent advances in maternity care, changes in the demographics of women having babies, and preferences of where they want to give birth will form a key focus. Firstly, the review will evaluate the United Kingdom and international evidence and make recommendations on safe and efficient models of maternity services. Secondly it will ensure that the NHS supports and enables women to make safe and appropriate choices of maternity care for them and their babies. Thirdly it will support NHS staff including midwives to provide responsive care.
The terms of reference for the review were published on the 3 March. They can be found online at:
http://www.england.nhs.uk/wpcontent/uploads/2015/03/maternity-rev-tor.pdf
This review, which is expected to report in by the end of the year, will be led by an external chair, supported by a diverse panel.