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| NHS maternity wards in England to be rated by safety record | |
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| The government is to release new ratings for maternity wards across England to allow prospective parents to compare and contrast services in NHS hospitals, as part of a drive to reduce instances of stillbirth and brain injuries during labour. | The government is to release new ratings for maternity wards across England to allow prospective parents to compare and contrast services in NHS hospitals, as part of a drive to reduce instances of stillbirth and brain injuries during labour. |
| Maternity data detailing the frequency of accidents within clinical commissioning groups and the health prospects of expectant mothers – including the percentage of smokers, for example – will be collated to form England-wide ratings. | Maternity data detailing the frequency of accidents within clinical commissioning groups and the health prospects of expectant mothers – including the percentage of smokers, for example – will be collated to form England-wide ratings. |
| In a major speech on Monday, Jeremy Hunt will also unveil proposals to allow the NHS to offer compensation automatically to parents of babies left stillborn or brain-damaged because of poor care. The health secretary wants parents of children starved of oxygen at birth no longer to endure a wait of about 11 years for compensation. | In a major speech on Monday, Jeremy Hunt will also unveil proposals to allow the NHS to offer compensation automatically to parents of babies left stillborn or brain-damaged because of poor care. The health secretary wants parents of children starved of oxygen at birth no longer to endure a wait of about 11 years for compensation. |
| At present parents often become embroiled in lengthy and costly legal action against the NHS, forcing grieving families to fight for months or even years before the health service agrees to compensation. | At present parents often become embroiled in lengthy and costly legal action against the NHS, forcing grieving families to fight for months or even years before the health service agrees to compensation. |
| Bereaved parents often have to instruct solicitors to determine the cause of their child’s death, with health bosses sometimes denying any liability until they are ordered to pay compensation by a judge. | Bereaved parents often have to instruct solicitors to determine the cause of their child’s death, with health bosses sometimes denying any liability until they are ordered to pay compensation by a judge. |
| Under the new scheme, which was first recommended by Tory peer Baroness Cumberlege earlier this year, an independent rapid resolution and redress scheme will be set up to investigate tragedies in childbirth, which would quickly decide whether compensation should be paid. | Under the new scheme, which was first recommended by Tory peer Baroness Cumberlege earlier this year, an independent rapid resolution and redress scheme will be set up to investigate tragedies in childbirth, which would quickly decide whether compensation should be paid. |
| The launch comes as figures showed that the cost of settling claims with parents whose children are damaged at birth has reached more than £0.5bn. The NHS as a whole pays out more than £1bn a year in negligence compensation, and reducing that cost is seen a key way of mitigating the financial crisis facing the service. | The launch comes as figures showed that the cost of settling claims with parents whose children are damaged at birth has reached more than £0.5bn. The NHS as a whole pays out more than £1bn a year in negligence compensation, and reducing that cost is seen a key way of mitigating the financial crisis facing the service. |
| In February this year, Cumberlege recommended the investigations into maternity cases and any subsequent payouts are made by the trusts without any court involvement. The recommendation was one of several made by Cumberlege, who has been chairing an independent review of maternity services in England. | In February this year, Cumberlege recommended the investigations into maternity cases and any subsequent payouts are made by the trusts without any court involvement. The recommendation was one of several made by Cumberlege, who has been chairing an independent review of maternity services in England. |
| The new proposals are modelled on a Swedish scheme, which has reduced serious avoidable birth injuries by about 50% in the past six to seven years. | The new proposals are modelled on a Swedish scheme, which has reduced serious avoidable birth injuries by about 50% in the past six to seven years. |
| Health secretary Jeremy Hunt said he hoped to end the culture where going to court was an automatic “first step” and instead foster a culture of transparency so the NHS can learn from its mistakes. | Health secretary Jeremy Hunt said he hoped to end the culture where going to court was an automatic “first step” and instead foster a culture of transparency so the NHS can learn from its mistakes. |
| Under the plans, claims by parents who believe medical errors have caused severe damage to their children – such as cerebral palsy or brain damage – would be assessed by investigators working independently of the NHS trust. The investigators would quiz NHS staff and parents and look at medical records. | Under the plans, claims by parents who believe medical errors have caused severe damage to their children – such as cerebral palsy or brain damage – would be assessed by investigators working independently of the NHS trust. The investigators would quiz NHS staff and parents and look at medical records. |
| Their findings would be presented to a panel of legal and medical experts who would decide whether any compensation is warranted and arrange for payments to be made to the family. | Their findings would be presented to a panel of legal and medical experts who would decide whether any compensation is warranted and arrange for payments to be made to the family. |
| The government hopes the scheme – which would assess about 500 cases a year – will help dismantle what it sees as a “litigation culture”. It would work out far cheaper for the NHS than the current route, in which cases go to court or are settled out of court, often for millions of pounds. | The government hopes the scheme – which would assess about 500 cases a year – will help dismantle what it sees as a “litigation culture”. It would work out far cheaper for the NHS than the current route, in which cases go to court or are settled out of court, often for millions of pounds. |
| Data from the NHS Litigation Authority shows the compensation bill to the NHS for errors around the time of birth is rising, reaching £509.3m in 2015/16 – up from £393.2m in 2014/15. | Data from the NHS Litigation Authority shows the compensation bill to the NHS for errors around the time of birth is rising, reaching £509.3m in 2015/16 – up from £393.2m in 2014/15. |
| A spokeswoman for the Department of Health said the plan, which will be the subject of a consultation, would not “lock” parents into the scheme and would let them bring their own legal case against the trust if they were unhappy with the outcome. | A spokeswoman for the Department of Health said the plan, which will be the subject of a consultation, would not “lock” parents into the scheme and would let them bring their own legal case against the trust if they were unhappy with the outcome. |
| The new maternity ward ratings follow Hunt’s recent creation of similar schemes to help patients and families compare the quality of cancer and dementia care. However, once they start being published, they will set out details for services within each of the NHS’s 209 GP-led clinical commissioning groups rather than the 156 acute hospital trusts with maternity services. Hunt said that openness about the quality of care will help empower patients and reduce wide variation in care quality. | The new maternity ward ratings follow Hunt’s recent creation of similar schemes to help patients and families compare the quality of cancer and dementia care. However, once they start being published, they will set out details for services within each of the NHS’s 209 GP-led clinical commissioning groups rather than the 156 acute hospital trusts with maternity services. Hunt said that openness about the quality of care will help empower patients and reduce wide variation in care quality. |
| In a speech at the Royal College of Obstetricians and Gynaecologists, Hunt will also set out £8m for training, with at least £40,000 available to each NHS trust in England. | In a speech at the Royal College of Obstetricians and Gynaecologists, Hunt will also set out £8m for training, with at least £40,000 available to each NHS trust in England. |
| A £250,000 maternity safety innovation fund will pilot new ideas for improving care, while maternity ratings for every part of England – using data that already exists – will be published together to encourage greater transparency. | A £250,000 maternity safety innovation fund will pilot new ideas for improving care, while maternity ratings for every part of England – using data that already exists – will be published together to encourage greater transparency. |
| Other measures being unveiled include a new Healthcare Safety Investigation Branch, modelled on the Air Accidents Investigation Branch. A new tool will also standardise the investigation of every stillbirth and early baby death so lessons can be learned. | Other measures being unveiled include a new Healthcare Safety Investigation Branch, modelled on the Air Accidents Investigation Branch. A new tool will also standardise the investigation of every stillbirth and early baby death so lessons can be learned. |
| Hunt said: “Our NHS maternity staff do a fantastic job under huge pressure. But even though we have made much progress, our stillbirth rates are still among the highest in western Europe and many on the frontline say there is still too much of a blame culture when things go wrong – often caused by fear of litigation or worry about damage to reputation and careers. | Hunt said: “Our NHS maternity staff do a fantastic job under huge pressure. But even though we have made much progress, our stillbirth rates are still among the highest in western Europe and many on the frontline say there is still too much of a blame culture when things go wrong – often caused by fear of litigation or worry about damage to reputation and careers. |
| “These comprehensive measures will give practical support to help trusts improve their approach to safety – and help to foster an open and transparent culture so that the courts become a last resort not an automatic first step.” | “These comprehensive measures will give practical support to help trusts improve their approach to safety – and help to foster an open and transparent culture so that the courts become a last resort not an automatic first step.” |
| In May this year a new report revealed figures that 15 babies are dying every day in the UK from stillbirth, during labour or within four weeks of being born. | In May this year a new report revealed figures that 15 babies are dying every day in the UK from stillbirth, during labour or within four weeks of being born. |
| The report was published by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries in the UK), which is a collaboration of academics and medical experts. | The report was published by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries in the UK), which is a collaboration of academics and medical experts. |
| It found that there were big variations in death rates across the country, from 4.1 to 7.1 per 1,000 births. Women from the poorest backgrounds and black and Asian mothers run a higher risk that their baby will die in the womb or soon after birth. | It found that there were big variations in death rates across the country, from 4.1 to 7.1 per 1,000 births. Women from the poorest backgrounds and black and Asian mothers run a higher risk that their baby will die in the womb or soon after birth. |
| In nearly half of all stillbirths (46%), the causes of death are unknown, said the report. The biggest causes of death in the early weeks of life are complications following birth (32%) and congenital anomalies such as heart defects (28%), and very premature birth (13%). | In nearly half of all stillbirths (46%), the causes of death are unknown, said the report. The biggest causes of death in the early weeks of life are complications following birth (32%) and congenital anomalies such as heart defects (28%), and very premature birth (13%). |
| The MBRRACE team flagged up the need for research into premature births and also called for every maternity unit to review and record the causes of death in the same way to try to discover why there are such stark variations around the country. | The MBRRACE team flagged up the need for research into premature births and also called for every maternity unit to review and record the causes of death in the same way to try to discover why there are such stark variations around the country. |
| James Taylor, head of policy and public affairs at disability charity Scope, said of the new plans: “Finding out that your child has been affected by a birth injury can be a very traumatic time for parents. | James Taylor, head of policy and public affairs at disability charity Scope, said of the new plans: “Finding out that your child has been affected by a birth injury can be a very traumatic time for parents. |
| “So it is very positive that the government will be listening to disabled people and their parents on how the NHS can better support families when serious issues do occur during birth.” | “So it is very positive that the government will be listening to disabled people and their parents on how the NHS can better support families when serious issues do occur during birth.” |