Hospitals need extra £400m a year to make maternity units safer

Exclusive: MPs told they must demand extra funding from government to improve maternity safety

Many maternity wards across the NHS need to improve their safety but it could cost £400 million (Getty Images/iStockphoto)

Making maternity wards safer for mothers and babies will need £400m of extra spending every year, hospital leaders have told The Independent.

They warn that without increased funding, the NHS will not be able to fully implement recommendations made by an inquiry into poor maternity care at the Shrewsbury and Telford Hospitals Trust – where dozens of babies died or were left brain damaged in the largest maternity scandal in NHS history.

Multiple maternity care failings at hospitals across the country in the past 12 months have sparked concerns over the safety of mothers and their babies with MPs on the Commons Health Select Committee launching an investigation into the issue last year.

Hospital leaders say even just covering existing shortfalls of 3,000 midwives and recruiting 20 per cent more obstetricians, will cost at least £250m a year.

To pay for extra anaesthetists, neonatal nurses and other support staff could push the cost to more than £400m.

Chris Hopson, chief executive of NHS Providers, which represents hospital trusts, told The Independent that ministers faced a choice of either making the extra cash available or forcing the NHS to cut money elsewhere.

In a letter to MPs on the committee, Mr Hopson urged them to demand extra funding in its forthcoming report on maternity safety in an effort to force ministers to confront the issue.

Mr Hopson told The Independent: “Trust chief executives feel strongly that this is a really important agenda but they can’t implement the recommendations from the Ockenden Review in full unless there is more funding made available.

“This clearly depends on the government making the funding available or NHS England making this a priority, but that would mean deprioritising something else. We need one of these two solutions to come through.”

He added: “We are urging the select committee to recognise the importance of allocating the required funding and make it a recommendation in their forthcoming report. The onus will then be on the government to formally respond to that recommendation."

In 2019, The Independent revealed the full scale of poor care at the Shrewsbury and Telford Trust, with the first report from the inquiry led by midwife Donna Ockenden, in December last year, calling for a major overhaul of maternity care.

She found more than a dozen women had died during years of repeated poor care with mothers denied choice over their births. A culture of avoiding caesarean sections meant some women were medicated and forced to endure traumatic births that left babies with fractured skulls and broken bones. Repeated failures to properly investigate meant errors were repeated over many years.

Following the Ockenden report, NHS England has told trusts they must take urgent steps to make maternity units safer.

Among the changes included twice-daily consultant ward rounds, with complex cases given a named consultant. Staff must also train together with regional networks investigating incidents from local hospitals.

Both the Royal College of Midwives chief executive Gill Walton and Dr Eddie Morris, president of the Royal College of Obstetricians and Gynaecologists, warned MPs that significantly more staff will be needed.

Since revealing the extent of poor care at the Shrewsbury and Telford Hospital Trust, concerns have emerged at East Kent Hospitals University Trust where an investigation is ongoing into baby deaths. Similar fears have been raised at hospitals in Nottingham and Basildon with the Care Quality Commission warning as many as a third of maternity units need to improve their safety record.

In a letter to committee chair Jeremy Hunt, NHS Providers warned the evidence the committee had received meant significant costs for NHS trusts.

It said: “Our initial estimate for the funding required to achieve the increase in numbers described by Ms Walton and Dr Morris is a minimum of £250m in recurrent annual funding.

“But we also need to think about the wider team. If we include shortfalls in neonatal nurses, maternity support workers and anaesthetists, for example, the total annual extra recurrent funding required could be as high as £400m or more.”

The letter added that the money could be part of a phased plan to expand the maternity workforce over a three year period starting in 2021.

It said: “We cannot continue to rely on staff being endlessly resilient and stretched in the face of constant pressure. The report highlighted the importance of behaviours, listening to women and focusing on the things that make the biggest difference, with the emphasis on multi-professional working, learning and training together. Progressing these systemic and cultural changes is reliant on sufficient numbers of skilled staff being in place.

“Urgent attention is required to ensure full funding for the staffing levels required to provide safe, high-quality care, and enable inclusive and compassionate cultures within the NHS generally, and specifically within maternity care.”

The Ockenden Review is planning to publish its final full report looking into more than 1,860 cases of poor care and examining the wider systemic failings at Shrewsbury.

The Independent has launched a campaign with charity Baby Lifeline for the reinstatement of a national maternity safety training fund.

The government promised £9.4m for new training in some specific areas to improve heart monitoring of babies at the spending review last year.

A Department of Health and Social Care spokesperson said: “We are fully committed to patient safety, eradicating avoidable harms and making the NHS the safest place in the world to give birth.

“There are record numbers of midwives working across the NHS and we recently launched a new training programme for NHS maternity and neonatal leaders to improve workplace culture and foster more collaborative working between nurses, doctors, midwives and obstetricians.

“The Ockenden Review has provided us with stark findings and we are working closely with partners across the health service to consider next steps to tackle the difficult issues it raised.”