Understaffed maternity units in UK struggling to cope

By Dr. Ananya Mandal, MDJul 25 2011

In the UK one baby is born every 40 seconds and this is the highest birth rate in almost 20 years. Most maternity units are struggling to cope.

Across the UK, maternity units were forced to close to new admissions 1,055 times last year, nearly always because of understaffing or lack of beds, a series of Freedom of Information requests have found. At least 927 women were turned away. On the other hand in some London trusts one in five midwifery posts lies vacant. The Royal College of Midwives says at least 4,700 extra midwives are needed in England and Wales.

On examining an increase in maternal deaths in the capital it was noted that there were 42 deaths of women over an 18-month period from January 2009 and substandard treatment was a major factor in 17 cases. The report said, “Several deaths occurred when activity in a maternity unit was high and one-to-one care could not be delivered.” The research carried out by the BBC's Panorama for a programme to be broadcast this evening, involved contacting 171 Health Trusts and Boards.

The review also unearthed evidence that many of the 29 internal hospital investigations into the deaths - termed Serious Incident Requiring Investigations reports (SIRIs) - were not entirely frank. The panel only agreed with 12 out of the 29, with the other 17 “felt to be substandard, with poor application of the SIRI process, incorrect conclusions and failure to recognize the root cause of the incident”. Internal reports into six deaths found them “inevitable”, but the panel disagreed. “Different management and earlier diagnosis could have changed the outcomes,” found the review. It went on, “In some cases the reports overlooked significant organizational or clinical factors, including inappropriate treatment and behavior of clinicians.”

NHS London's chief nurse, Trish Morris-Thompson, told the programme, “The report indicates that less than optimum care was given and death did occur. However, we need to look in the context of those 200,000 births that occurred in that time.”

Paul Burstow, the Health Minister, told the programme, “Safety is paramount in the NHS and all mothers and their babies should expect and receive consistently excellent maternity care. There is a record number of midwives entering training this year and the number of consultants in obstetrics and gynecology has increased from two years ago. We will continue to work with the Royal College of Midwives to make sure we have an appropriately resourced and skilled maternity workforce based on the most up-to-date evidence.”