Everyone would agree that pregnant women, new mothers, and their babies should receive the highest standard of care. Unfortunately, that is often not the case. When maternity staff are not properly trained, mothers and their children suffer.
What is the Maternity Safety Training Fund?
In order to make sure that women and their newborn children receive appropriate care, Health Education England established the Maternity Safety Training Fund. This fund was designed to support the government’s goal of reducing the number of neonatal and maternal deaths, as well as stillbirths, by half by the year 2025. The Maternity Safety Training Fund was designed to deliver over ₤8.1 million to NHS Trusts for training in order to improve the standard of care for mothers and babies.
These funds were delivered to 136 trusts and 44 different courses were provided to staff in different areas involved with the care of pregnant women, mothers, and babies. These courses covered medical skills as well as teamwork and leadership training.
An evaluation of the outcomes of these training programs showed that they were effective in improving the skills and confidence of maternity staff. However, it is vital that this training is ongoing and funding for it is reestablished, because there is still a lot of progress that needs to be made.
Call to Reinstate the Maternity Safety Training Fund
After the reports showing the poor outcomes for many women and children, there has been a call to reinstate the Maternity Safety Training Fund in order to provide ongoing training for maternity staff. The 2016 effort was shown to be effective, and yet the fund was shuttered after only a year and training subsequently decreased.
A petition was set up by Baby Lifeline, a charity dedicated to the support of pregnant women and babies in the UK, in early 2020. They are calling for the reinstatement of this fund, stating that the prevention of death and disability is always a sufficient reason for funding maternity care training, but that there will also be a financial benefit to the NHS in the reduction of maternity medical negligence compensation claims.
This proposal is supported by the Royal College of Midwives as well as the Royal College of Obstetrics and Gynecology. The authors of the reports from the Trusts in which poor outcomes were reported are also signatories to the letter to the Prime Minister in support of reinstating the training fund.
The former health secretary, Jeremy Hunt, also supports reinstating the fund and continuing to provide appropriate training. He said that the money the fund already provided for one year made a big difference, but only about 8% of Trusts are supplying all the care needed to prevent many of these deaths and more training is necessary.
Why Maternity Training is Important
The two key reasons for highlighting the need for effective maternity training programs are:
- Poor UK rankings in maternity care
Outcomes for mothers and babies in the United Kingdom compare unfavorably to those in much of Europe and other developed countries.
- High rates of mother and baby deaths
The rate of infant mortality in the UK is around 4 deaths per 1,000 live births. Based on current birth rates, this translates into over 1500 deaths a year. This does not include stillbirths or children with permanent brain injury due to oxygen deprivation. The maternal mortality rate is around 7 deaths per 100,000 live births. While these numbers have been declining over the past decades, the rate of decline is decreasing.
Childbirth Negligence: The Statistics
In the past several years there have been instances of infant or mother deaths that would have been avoidable if staff had received the appropriate training and followed the best healthcare practices. Infant outcomes at East Kent University Hospitals Trust between 2014 and 2018 included 138 babies with brain damage caused by lack of oxygen, 143 stillbirths, and 68 infant deaths. A report from Shrewsbury and Telford Hospitals Trust also showed poor outcomes, with deaths and disability caused by a lack of proper care.
According to a statement released by NHS Resolution February 13 2020:
“Maternity claims represent around 10 per cent of the total number of clinical negligence claims received by NHS Resolution each year, but relate to 60% of the annual £9 billion cost of harm in relation to the Clinical Negligence Scheme for Trusts. Incidents occurring in maternity have a significant life-long impact on affected patients and their families and are traumatic for the NHS staff involved”.
A study by NHS Resolution analysed 5,087 maternity claims on the NHS Litigation Authority’s (NHSLA) claims database as at 1st April 2010 with an incident date between 1st April 2000 and 31st March 2010. The total value of these claims was £3,117,649,888. Overall, obstetrics and gynaecology claims account for 20% of the number of all clinical negligence claims notified to the NHSLA and 49% of the total value.
Total number (%) of reported CNST claims by specialty 01/04/95 to 31/03/11
Total value (%) of reported CNST claims by specialty 01/04/95 to 31/03/11
The three most frequent categories of claim were those relating to management of labour, Cesarean section and cerebral palsy and these three categories account for approximately 70% of the total figure of £3.1 billion, paid out on or expected to be paid, for all maternity claims.
Top 10 categories of claims by number between 1st April 2000 and 31st March 2010 as at 31st March 2010
Top 10 categories of claims by total value between 1st April 2000 and 31st March 2010 as at 31st March 2010
How Training Can Improve Outcomes
These poor outcomes can be avoided through proper training and education for staff at all levels. In a 2006 study, appropriate training was shown to reduce neonatal brain injuries caused by hypoxia by up to 50%, and injuries due to shoulder dystocia by up to 70%. Teams also exhibited better teamwork and improved knowledge.
This led to the establishment of one training program, PROMPT (PRactical Obstetric Multi-Professional Training). This program has been adopted by most maternity units in the UK, although implementation does vary.
Problems in Creating and Providing Effective Maternity Training Programs
While there are training programs that help maternity staff avoid many of the possible complications of childbirth that lead to mother or infant death, these programs are not uniformly well-implemented at Trusts across the UK. Sometimes programs are not consistently attended, the frequency and duration of mandatory training varies, and the degree of hands-on interactive learning can vary as well.
In order for training to have the most effectiveness, it requires buy-in at all levels, from administration and management throughout all staff. Another barrier to establishing effective training programs for maternity staff is funding, both for training programs themselves, as well as ensuring that staffing levels are sufficient to cover patient care needs as well as allowing all staff to obtain regular training during working hours, including travel for external training opportunities.
Why choose Devonshires Claims to support your childbirth injury compensation claim?
If you feel that the care you or your child received prior to, during or after birth was negligent, you may decide to bring a claim in order to secure justice and compensation for yours and your child’s injuries. Speak to one of our medical negligence solicitors who specialise in birth injuries.
Devonshires Claims support victims of medical negligence by providing:
- A free no-obligation case evaluation
- A no win no fee agreement
- A network of medical experts and specialist medical negligence barristers
- Over 20 years’ experience in securing justice and compensation