Our maternity services are improving, but we have more to do
Two years on from the start of the independent review of maternity services at Nottingham University Hospitals, Chief Executive Anthony May describes how maternity services are improving.
It is two years since Donna Ockenden began the independent review of maternity services at our hospitals.
At the start of the review, I committed that we would engage fully and openly with Donna and her team. That is what we’ve done and will continue to do.
We meet regularly with Donna and publish her feedback and our response, including the learning and changes made, on our website. The work that Donna and her team do is to be commended. The review has engaged with thousands of women, families and staff whose voices are directly contributing to making our maternity services better.
Over the past two years, our Maternity Improvement Programme, which was established in 2020, has continued to make progress, thanks to the continued dedication of our staff and the feedback that we’ve received.
Our communities can be assured that maternity services are better than they were two years ago and they continue to improve.
- Our services are safer, with fewer incidents of harm compared to two years ago.
- We have recruited more midwives and consultants and our retention rates have improved. This means there are more substantive staff delivering care and supporting women in our hospitals and in the community.
- Women and families tell us that they are having a better experience, with local and national surveys consistently showing improved feedback. The latest inspection in June from the independent regulator of healthcare in England - the Care Quality Commission (CQC) - also highlighted the positive feedback and experience from mothers.
- The service provision is better. We now have a full home births service, supporting women to give birth at home 24 hours a day, seven days a week. We have invested in new digital health records allowing women to access their maternity notes on a tablet phone or PC at any time, and later this month we will open a new fetal medicine unit providing women and families with personalised care in a purpose-built facility.
- Our services are more inclusive. Extensive work has taken place in response to feedback from our communities and Donna through the Inclusive Maternity Task Group, which is dedicated to reducing inequalities and improving outcomes. Specialist clinics, including support for diabetes and female genital mutilation, are being moved from our hospitals into the community to improve attendance and access. We have introduced a new translation app, we are providing community outreach with underrepresented communities, offering bilingual classes to Urdu speaking women, producing video and leaflet translations and our staff are undergoing cultural awareness training.
- Our regulators say we are improving. In 2023, the CQC increased the overall rating for maternity services from inadequate to requires improvement for the first time since 2020. The safety ratings at the QMC and Nottingham City Hospital also improved and the CQC removed a warning notice, issued in 2022, saying they were satisfied that improvements had been made.
We are not complacent though and there remains much more for us to do. While Donna’s feedback has undoubtedly contributed to a better maternity service, it also shines a spotlight on the areas we need to improve further for women, families and our staff. This is especially important for those women and families who we have failed.
Over the past two years, I have engaged with many families and heard about their experiences of harm, loss and tragedy. I am grateful for their engagement with us and I know how important the ongoing review and our focus on improvement is for them.
I will be pleased to welcome some of the families back to our Annual Public Meeting this year, where we will provide further details on the commitment we made last year to a new honest and transparent relationship. The meeting on Wednesday 18 September is open to everyone, so if you would like to join, please register here.
I also speak regularly with colleagues about how we can better support them. Through our Maternity Improvement Programme, we will continue to focus on our staffing levels and the experience and skill mix of our teams, as well the support we provide to colleagues. We are working very hard to establish a positive culture where staff feel safe to raise concerns and feel able to drive positive change.
Our focus remains on delivering better services now and in the future, and we will continue to work with Donna and her team to help us do that.
Anthony May
Chief Executive