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FactCheck: Our analysis finds one in nine maternity services ‘double downgraded’ since 2022

By Brian O’Flynn

One in nine maternity services in England has been “double downgraded” by the Care Quality Commission (CQC) as part of its national inspection programme, exclusive FactCheck analysis reveals.

Our findings come as a parliamentary report on birth trauma published today laid bare the harrowing experiences of some women giving birth across the country.

Some said they were “mocked or shouted at” or left “lying in blood stained sheets”, while staff described a “maternity system in which overwork and understaffing” are “endemic”.

Adding to that troubling picture, new FactCheck analysis shows how inspection ratings at many of England’s maternity units are plummeting, with over a third of services being downgraded.

Maternity services ‘facing significant challenges’

The health watchdog announced in 2022 that it would carry out a special programme of inspections in response to the “significant challenges” maternity services were facing across the country.

The programme inspected all active NHS hospital maternity services that hadn’t been inspected since 2021.

The CQC uses a similar system to Ofsted in schools, with services given one of four ratings at the end of an inspection – outstanding, good, needs improvement, or inadequate.

We have analysed inspection reports from 130 maternity units in the scheme, and compared each with the last time the service was rated.

Our analysis reveals:

  • 34 maternity units dropped by one rating compared to the last time they were rated.
  • 15 units were what we’re calling “double downgraded” – dropping two ratings in a single inspection. This was practically unheard of before the pandemic.
  • Together, that means a third of all inspections in the programme resulted in some kind of downgrade.
  • Just nine facilities saw improvement compared to their last rating – and the rest stayed the same or had never been rated before so we can’t compare them.

Overall, we find that nearly half (46 per cent) of all maternity units inspected in the programme were rated as “inadequate” or “requires improvement”.

NHS England told us the experiences described in the birth trauma report “are simply not good enough” and that it’s working with local leaders across England to “create and nurture a culture where women are listened to”.

The Secretary of State for Health and Social Care, Victoria Atkins, told us she is “hugely grateful” to MP Theo Clarke, who led the inquiry into birth trauma published today, “and all those brave women who came forward”.

She says she is “determined to improve the quality and consistency of care”. She added that the government is “now investing £186m a year more than in 2021 to improve maternity and neonatal care” and “announced an extra £35m at the Spring Budget to boost maternity safety, with more midwives and better training”.

Kate Terroni, the Deputy Chief Executive of the CQC said: “We know that many women receive good, safe maternity care, but sadly that’s not everyone’s experience.”

She said that some of the issues arose from “the quality of staff training; poor risk assessment; and a failure to engage with, learn from and listen to the needs of women”.

“It’s not acceptable that maternity safety is still so far from where it needs to be. As a healthcare system, we need to do better for women and for babies,” she said.

(Photo credit: Chris Porsz/Bav Media/Shutterstock)

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