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‘Alarming declines’ in patient safety as maternity care deteriorates – report

Experts have analysed publicly available data for the latest National State of Patient Safety report.

Storm Newton
Thursday 12 December 2024 00:01 GMT
Authors also pointed to an uneven spread of the impacts of unsafe care, which they said were ‘greater in the North than the South’ (Jeff Moore/PA)
Authors also pointed to an uneven spread of the impacts of unsafe care, which they said were ‘greater in the North than the South’ (Jeff Moore/PA) (PA Wire)

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The rates of women dying during or shortly after pregnancy, and babies dying within 28 days of being born, have increased for the first time in a decade, according to new analysis.

It comes as a report found there has been “alarming declines” in patient safety across many areas of the NHS in recent years, with maternity care in particular deteriorating.

Experts warned these issues – which also include long waits for some services and a North/South divide in the impacts of unsafe care – needed addressing urgently in order to “repair the health service”.

The NHS is now falling behind leading nations in patient safety. We urgently need to address these issues to repair the health service, and provide high-quality care for all patients and their families

Lord Darzi

Researchers at the Institute of Global Health Innovation at Imperial College London looked at publicly available data released over the last two years for the 2024 National State of Patient Safety report.

It reassessed a number of metrics analysed for the first report in 2022 and found there had been failings in 12 of the 22 measured.

The report said its analysis of the most recent MBRRACE-UK reviews – an audit programme that collects data on the deaths of mothers and babies – and data from the Office for National Statistics “provides cause for concern”.

It found rates of neonatal deaths – babies born at 20 weeks or after, but who die before they are 28-days-old – and maternal deaths – women who die while pregnant or up to six weeks after due to issues linked to pregnancy – increased for the first time in 10 years and are continuing to rise.

The deterioration in maternity care, in particular, requires immediate action. Our analysis highlights a troubling increase in neonatal and maternal deaths, with black women disproportionately affected

Lord Darzi

Lord Darzi, co-director at the Institute of Global Health Innovation, who recently led a review into the NHS, said: “Our latest report on patient safety in England reveals alarming declines.

“The deterioration in maternity care, in particular, requires immediate action.

“Our analysis highlights a troubling increase in neonatal and maternal deaths, with black women disproportionately affected.”

Between 2013 and 2020, the neonatal death rate fell by 17%, from 1.7 to 1.3 per 1,000 live births.

But it rose to 1.5 per 1,000 live births in 2022, an increase of 15.4%.

This report delivers a stark and urgent message: since 2022, patient safety in the NHS has deteriorated in far too many areas

James Titcombe, Patient Safety Watch

Maternal deaths were described as “steady” between 2011 and 2013 and 2017 and 2019, although between 2017 and 2019 and 2020 to 2022, the rate increased from 8.8 to 13.4 deaths per 100,000.

The report described the figure as “a statistically significant increase of 52.3%”.

These issues come alongside “growing concerns about access to urgent care and the spiralling costs of unsafe care”, the report said.

It added that “addressing patient safety in the NHS is not just a moral obligation but an urgent financial necessity”.

It also pointed to an uneven spread of the impacts of unsafe care, which are “greater in the North than the South”.

Our analysis paints a worrying picture of patient safety across many areas, making it very difficult to choose specific areas to prioritise

Report co-author Melanie Leis

Lord Darzi added: “The NHS is now falling behind leading nations in patient safety.

“We urgently need to address these issues to repair the health service, and provide high-quality care for all patients and their families.”

James Titcombe, chief executive of the charity Patient Safety Watch, which commissioned the report, said its findings must “contribute to urgent and meaningful discussion” about change to ensure trends are reversed when the data is revisited in 2026.

“This report delivers a stark and urgent message: since 2022, patient safety in the NHS has deteriorated in far too many areas,” Mr Titcombe said.

“Its findings and recommendations must contribute to urgent and meaningful discussion about the changes needed, so that when we revisit the data in two years, we see these troubling trends reversed and tangible progress in reducing the devastating impact of healthcare harm on patients, families, and healthcare professionals.”

Patient safety is paramount, and all women and their babies deserve safe, high-quality care. We are working to introduce a culture of transparency in our health service and will never turn a blind eye to failure

Department of Health and Social Care spokesperson

Co-author of the report Melanie Leis, director of policy and analysis at the Institute of Global Health Innovation, added: “Our analysis paints a worrying picture of patient safety across many areas, making it very difficult to choose specific areas to prioritise.

“We hope the clear signal sent by the public, healthcare and social care workers through our survey results can help inform this decision-making process.”

A Department of Health and Social Care spokesperson said: “Patient safety is paramount, and all women and their babies deserve safe, high-quality care. We are working to introduce a culture of transparency in our health service and will never turn a blind eye to failure.

“We are committed to driving up standards in healthcare through our Plan for Change, and we will tackle the shocking inequalities that exist across the country.

“We will also work closely with NHS England to train thousands more midwives to better support women throughout their pregnancy and beyond.”

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