APPENDIX 32
Memorandum by the Chief Executive, Commission
for Health Improvement (MS 39)
WRITTEN EVIDENCE
FROM THE
COMMISSION FOR
HEALTH IMPROVEMENT
FOR THE
INQUIRY INTO
PROVISION OF
MATERNITY SERVICES
I am pleased to provide evidence on the provision
of maternity services on behalf of the Commission for Health Improvement.
CHI frequently finds examples of good practice
in maternity services that are not found in the rest of the organisation.
Overall maternity services are often providing a better standard
of care to patients than other parts of the NHS.
NOTABLE PRACTICE
— Maternity services are notably committed
to involving service users and acting as a result of their input.
— Maternity services often have a systematic
approach to clinical governance.
— Maternity services provide some examples
of non-medical, though not always multi-professional audit.
— There are several practices for which
maternity services are singled out and that other NHS departments
can learn from. These include annual midwife registration checking,
systematic workforce planning and clinical supervision.
AREAS FOR
IMPROVEMENT
— We have observed shortages of midwives
and obstetricians. These shortages are a serious problem for maternity
services and represent sources of clinical risk. Shortages of
obstetricians can lead to cancelled clinics and inadequate labour
ward cover.
— CHI has asked a small number of
trusts to gain an understanding of findings from routine statistics
such as high caesarian section rates or an excess of obstetric
operations early in the week.
— At some trusts, we have reported
that midwives are bearing an unacceptable workload and that there
is a shortage of radiologists. CHI has asked some trusts to review
current provision to ensure adequate staffing.
— Several maternity services have
had poor access to clinical information that hampered service
delivery.
We plan to publish a report on the maternity
service at Ashford and St Peter's Hospitals NHS Trust in March.
CHI's investigation follows the death of a baby in the maternity
unit in May 2002 which is currently the subject of an ongoing
police investigation. The report will contain national recommendations
for the NHS. We will send a copy of the final report to the committee
when it is published.
The information above is based on a relatively
small number of reports. If members of the committee would like
further details on any of these findings please do let me know.
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