NHS maternity units often cover up harmful errors in childbirth, report finds | NHS

Hospitals that harm women and babies during childbirth often resort to “covering up” their errors, falsifying medical records and refusing to respond to grieving parents, a damning report has found.

“Negligent” care has devastating emotional and psychological consequences for families, conflicts between maternity staff have a “disastrous” impact on mothers, and women from ethnic minorities and the poorest experience worse outcomes due to racism and discrimination, Lady Amos said.

The recent rise in the number of older mothers and obese women having babies has also contributed to making maternity care more complicated, the former Labor minister added in a government-commissioned report amid growing concern about NHS birthing services in England.

“The system is not working for women, babies and families, nor for staff,” Amos concluded after spending months speaking to hundreds of families and maternity staff.

“We have seen maternity and neonatal services attempt to respond in difficult circumstances and face competing pressures, but too often fail to provide the safe care that women, families and babies expect and deserve, sometimes with devastating consequences. »

NHS trusts continue to provide poor care because they are doing too little to improve its quality and safety, failing to learn lessons from previous maternity scandals, she added.

“The fact that areas identified in previous reviews and investigations as requiring action appear not to have been addressed or have only been partially addressed is a source of ongoing distress for families and great frustration for staff. This cycle must stop,” she said.

Understaffing can affect every step of a woman’s maternity care. This means expectant mothers must wait a long time to be evaluated by a doctor, schedule a C-section, or begin their induced labor.

This also causes them to be unable to give birth at home due to a lack of available midwives, or to attend antenatal appointments that are too brief to properly discuss their pregnancy.

Understaffing and constant pressure on maternity wards means mothers are sent home after giving birth without being properly assessed and therefore cannot be reached when they phone for advice.

“It’s no surprise that women and families report a lack of basic care and support,” Amos said.

Its 35-page report castigates NHS trusts for several failures. Amos accused trusts of compounding the trauma of families who have experienced mistakes or inadequate care by resorting to secrecy rather than telling them the truth about what happened.

“Many families told us of a feeling there had been a ‘cover-up’ and defensiveness from NHS trusts, the resistance they faced from trusts when requesting their notes and instances of medical notes being altered or redacted,” the report said.

One woman told Amos how, three years after her daughter’s birth, the trust in question “gave my lawyers magic notes that reappeared out of nowhere after three years. We know they are inaccurate because my mother was taking notes. [the NHS] you shouldn’t have this cloak and dagger on your grades.

Amos is undertaking an independent investigation into maternity and neonatal services in England. During testimony sessions, she heard how trusts are:

• Prohibit families from being involved in investigating errors they encountered.

• Conduct investigations into errors that families view as shoddy and do not accurately reflect what happened.

• Encourage distressed families to take legal action to uncover the truth after being “denied openness and honesty as a result of harm and bereavement”.

• Failing to treat families who have lost a baby with compassion.

Paul Whiteing, chief executive of patient safety charity Action Against Medical Accidents (AvMA), said: “The evidence uncovered by Baroness Amos shows the shocking lengths some staff go to, such as hiding or falsifying medical records, in order to cover their tracks.

“This shows the scale of the challenge in improving maternity and newborn services and care. »

He added: “Unfortunately, we hear similar stories of secrecy and manipulation of medical records too often. This, along with other defensive behaviors we see in some hospitals, causes additional distress and trauma for a family already struggling with grief, pain or upset.”

Hospitals’ refusal to be transparent, as well as withholding or falsifying medical records, is “troubling,” Amos said, because it “compounds the harm already suffered by trauma or grief” and prevents them from learning about security breaches that should not happen again.

Wes Streeting, the health secretary, commissioned an Amos inquiry last August after a series of scandals relating to maternity care at NHS hospitals, including those in East Kent, Leeds, Morecambe Bay, Nottingham and Shropshire, and the soaring costs of settling negligence claims by the NHS.

The Nottingham inquiry covers 2,500 cases of alleged poor care and is the largest maternity inquiry in the history of the NHS. The report is expected to be delivered in June. An investigation into maternity care in Leeds is also underway.

Staff Amos spoke to told him how public scrutiny and criticism of NHS maternity services is now so intense that some midwives have said they “hide their name badges or uniforms in public or lie about their work when meeting people outside of work”.

MP Layla Moran, who chairs the Commons health and social care committee, said: “It is heartbreaking to once again hear the stories of families tragically abandoned by the system, but also of healthcare professionals who have faced vitriol for doing their job in difficult circumstances. »

Moran, a Liberal Democrat, urged ministers to make urgent and immediate improvements without waiting for Amos’ final report and recommendations, expected in the coming months.

Helen Morgan, the Liberal Democrats’ health spokeswoman, said: “From collapsing maternity caps to rising injuries and deaths, we have accepted the unacceptable for British women. How much more suffering will the government allow? How many more reports do they need before they act?”

“Wes Streeting should apologize for the abject failure to end this scandal after 18 months of Labor drift, which left the situation little better than under the Tories.”

Streeting said: “Baroness Amos’ report highlights the systematic, sustained and recurring failures of maternity and newborn care across the country, which have left too many mothers, babies and families victims of preventable NHS tragedies.

“I want to thank the families who bravely shared their heartbreaking stories and express my deepest admiration for the strength they have shown in trying to ensure others do not have to endure their trauma. »

He will soon launch and chair a new task force that will develop an action plan to rethink maternity care, based on the recommendations of Amos’ final report.