Maternity Services

(asked on 29th January 2015) - View Source

Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what steps they are taking to improve maternity and neonatal care in NHS hospitals.


Answered by
Earl Howe Portrait
Earl Howe
Deputy Leader of the House of Lords
This question was answered on 12th February 2015

Women should receive excellent maternity services that focus on the best outcomes for women and their babies and on women’s experience of care. For premature and sick newborn babies and their families, neonatal services should deliver the best evidence-based care to improve both life expectancy and quality of life for newborn babies.

Maternity services feature prominently in the key objectives set out in the Mandate between the Government and NHS England, which states that women should be offered the greatest choice of providers and a named midwife who is responsible for ensuring she has personalised one-to-one care throughout pregnancy, childbirth and during the postnatal period, including additional support for those who have a health concern.

To support these objectives the Government has taken steps to improve the size and capacity of the maternity workforce and to improve the quality of the environments in which women give birth and are cared for. There is now a record number of midwives working in the National Health Service, nearly 2,000 more since 2010, and a record 6,400 midwifery students currently in training.

The number of midwifery-led units has increased from 87 units in 2007 to 152 units in 2013, giving more women increased choice of place of birth. 79% of women of childbearing age in England now live within a 30 minute drive of both a midwifery-led unit and an obstetric unit - up from 59% in 2007.

In 2013 and 2014, the Government invested £35 million in capital which provided new equipment and facilities such as birthing pools, reclining chairs and beds that allow fathers to stay overnight, ensuite bathrooms, midwife-led units, complex needs suites for women with mental health or substance misuse problems and bereavement rooms to support families after a stillbirth or an early neonatal death.

The Friends and Family Test in December showed that 96% of women would recommend their maternity service for antenatal care, 97% for their labour and birth care and 98% for their postnatal community care.

We have raised awareness of the importance of good maternal mental health during pregnancy and the first year after birth. The Mandate between the Government and NHS England also includes a specific objective to reduce the incidence and impact of postnatal depression through earlier diagnosis, and better intervention and support.

In England, the number of inpatient mother and baby units specialising in psychiatric care during the perinatal period increased from 10 units in 2010 to 17 units in 2014.

Health Education England (HEE) will ensure that training in perinatal mental health is available so that specialist staff will be available to every birthing unit by 2017. HEE will work with the National College of Midwifery and the Royal College of Midwives to ensure that there is a core module focussing on perinatal mental health in the undergraduate training of all midwives.

We have trained 400 perinatal mental health visitor champions who are supporting health visitors with the identification and management of anxiety, mild to moderate depression and other perinatal mental disorders and knowing when to refer on.

The Department has also commissioned the National Perinatal Epidemiology Unit at Oxford University to develop a perinatal mental health indicator, which will help us to better identify and address gaps in our services. NHS England is developing a plan to support women with postnatal mental health problems by March 2015 which will share best practice and learning with the NHS.

The Government has also made reducing stillbirth an improvement area for the NHS in the NHS Outcomes Framework. The stillbirth rate is falling – from 3,558 stillbirths in 2012 to 3,284 in 2013. The Department of Health is working with key partners on programmes aimed at reducing stillbirth and neonatal mortality by raising awareness of the known risk factors, identifying the currently known and unknown factors and causes associated with perinatal and infant mortality and facilitating the learning and sharing of good practice across the NHS.

As a specialised service, responsibility for commissioning neonatal critical care rests with NHS England. In 2014, NHS England published service specifications for neonatal critical care services and Neonatal Critical Care Retrieval, which take account of the principles set out in the Toolkit for High Quality Neonatal Services (2009).

It is for local hospital trusts and specialised commissioners to decide how best to use the guidance and the NICE quality standard for specialist neonatal care to improve babies’ chances of survival and minimise mortality associated with being born either premature or unwell. Trusts should provide a family-centred approach to care and improve the quality of care by working in partnership with other providers and commissioners through Operational Delivery Networks as part of the broader Maternity and Children’s Strategic Network.

Reticulating Splines