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Closing the gap on maternity failures26th February 2020 Clinical Negligence
Shortcomings in training for maternity staff has been brought into sharp focus recently by campaigns to reinstate the maternity safety training fund, which I previously wrote about here:
The fund (“MTSF”) was launched in 2017 to improve access to training for those involved in maternity care and brought about improvements in skills, knowledge and awareness, according to a report carried out by the Health & Social Care Commission in late 2018.
Following on from their “Mind the Gap” report, the national charity Baby Lifeline, which campaigns for improvements in maternity care, this month published a report entitled “Closing the Gap”. The report highlights the urgent need for investments to support multi-professional training in maternity services in order to avoid a range of possible bad outcomes.
Whilst the report notes that implementation of the MTSF resulted in improvements to training, the authors of the report conclude that it did not go far enough. A number of factors, including the cost of back-filling staff, lack of proper planning and imposition of deadlines upon trusts were said to result in inefficiencies in the implementation of the fund.
The report notes that budgets for Continuing Professional Development (CPD) for Nurses and Midwives have been cut year on year since 2012, and the authors make recommendations as to the minimum time which should be spent by various clinicians on CPD each year. For example, for a midwife or obstetrician, the report recommends that a minimum of 20 hours CPD ought to be funded.
Importantly, the report highlights the human and financial costs associated with the lack of training. Based on national statistics, and assuming around 600,000 births per year, the authors state that we can expect to see in England:
(i) 2,400 stillbirths per year
(ii) 1,680 early neonatal deaths per year
(iii) 1,560 cases of HIE (Hypoxic Ischaemic Encephalopathy) per year
Whilst the report states that the lifetime costs associated with an incident of HIE or almost £800,000.00, my experience of dealing with cases involving children who have suffered brain damage at birth as a result of substandard care has shown that the financial consequences can be far more profound. Cases involving children who have been left seriously disabled because of the consequences of oxygen deprivation due to a delayed delivery can receive in excess of £20 million, which ultimately is funded by the NHS.
The report concludes that a significant proportion of the financial consequences can be avoided with different care, and that the quality of care is related to the access to training.
It is hoped that the recommendations made in the report will be heeded, and that the safety fund will be reinstated as soon as possible.