Urgent reforms needed to midwife training in heart rate monitoring

25th May 2017 Clinical Negligence

A couple of weeks ago I warned on this blog that the issue of poor monitoring of babies' heart rates uncovered at an NHS trust in Shrewsbury and Telford was not restricted to that region but was a national problem.

I know this due to the significant number of cases the specialist medical negligence team at JMW has handled involving severe injury to babies due to failures in this area. In the cases JMW has dealt with the heart rate monitor has often been misinterpreted by midwives or doctors, giving false reassurance that the baby is well. In reality there were clear signs that the baby's oxygen supply was compromised and they needed to be delivered urgently to avoid the awful consequences that can follow.

Huge concern

It's a huge concern to us that the same mistakes continue to be made in this area when the lives of whole families are being ruined because of avoidable errors in the use of this equipment. Over the last few days we have learned why this may be the case. According to an article in the Telegraph a senior coroner has warned that it is commonplace for midwives to qualify without training in the use of foetal heart rate monitors.

The coroner has now asked the Nursing and Midwifery Council (NMC)to take urgent steps to address this serious issue including reforming the training of midwives to ensure they have these core, basic skills before they take up a position on a labour ward. The action comes after an inquest into the death of a baby after a midwife failed to recognise serious abnormalities on the heart rate monitor and increased the dose of a drug that was administered to his mother and was contributing to his distress when it should have been stopped.

Heart rate monitoring is one of the most important tools the health service has for checking the well-being of the baby in the womb and it is extremely worrying that this lack of training has come to light.

Training must be improved

Other injuries that can be caused by heart rate monitoring issues include severe brain damage, completely devastating the child's life and leaving them in need of 24-hour care. We have several such cases at JMW and part of our job, in addition to securing compensation so the family can cope with the child's injuries, is to ensure lessons are learned. It may be that the trust reviews the competence of the staff members involved and puts in place additional training to ensure they do not repeat the same mistakes.

However with the high volume of midwives in practice and leaving and entering the profession, if their statutory training is not improved urgently then there is little trusts can do to ensure the risks are completely minimised. The NMC must realise this and understand the important role it has to play. It has stated to the Telegraph that it is undertaking a wholesale review of midwife training standards. This must be done urgently and improvements brought without delay or the NMC will have serious questions to answer about why it is allowing midwives to qualify when their standard of training is unsafe.



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Eddie Jones is a Partner and Head of Department located in Manchesterin our Clinical Negligence department

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