Reaction to survey on women’s experiences: Watchdog pleased most women
happy with care but says there are areas of the service that can be
Commission announces major review of maternity services
The Healthcare Commission today (Tuesday) urged NHS trusts to ensure they
provide accessible and high quality maternity care to all women, their
babies and families.
The Commission is reacting to today’s release of the report “Recorded
Delivery”, the National Perinatal Epidemiology Unit (NPEU) survey on
women’s experiences in maternity care, co-funded by the Healthcare
Commission, Department of Health and the Information Centre for Health and
The survey paints a generally positive picture of the way mothers are
experiencing maternity care in NHS trusts. It shows most women are happy
with the care they receive, but also provides examples of areas where
trusts can improve and examine their services in more detail.
Increasing numbers of women (38%) now report being offered a choice of home
birth compared with 18% twelve years ago and there is an increase in the
proportion of women visiting a health professional early in their
pregnancies. There also appears to be increasing flexibility of the types
of antenatal care women are being provided with, in line with NICE
guidance. However postnatal care for women has shown a less marked
improvement in some areas such as cleanliness and privacy since 1995.
The survey found that women have a very positive view of the professionals
caring for them. Almost all women felt they were treated with respect and
kindness during their initial antenatal booking appointment. During labour,
perceptions of doctors and midwives were also generally positive, although
there are still variations in the way care is provided for, and experienced
by, different groups of women, in particular minority ethnic women.
The Commission also welcomes the huge improvement in the way women report
receiving information from doctors, 93% of women in this survey said
doctors spoke to them in a way they understood compared with 66% in 1995.
This reflects the move towards more women-centred care and the principles
of the National Service Framework.
The Commission points to key areas for improvement arising from the survey,
many of which it has already highlighted in previous investigations into
· while more women understand the information that doctors are giving
them, there is still room for improvement in the communication and
information given to women and their families, including antenatal
education and information about screening. This was particularly
highlighted in cases of women who have the greatest difficulty in accessing
· there is disparity in the way care is provided to, or experienced by,
women particularly in minority ethnic groups. The Commission’s
investigations into the maternal deaths of ten women at North West London
Hospitals Trust indicated that nine out of the ten women were from a
minority ethnic background. We recommended trusts should concentrate on
ensuring care is tailored to the individual needs of women
· women’s experience of postnatal care has barely improved in the last
ten years, despite significant investment in facilities, with a quarter of
women surveyed said that they were unhappy with the cleanliness, lack of
privacy, temperature and noise concerns and stating that staff were
· staff communication needs to be improved – only 57% of women felt
staff communicated with each other ‘well’. Inadequate team working and
communication between staff were significant factors in the Commission’s
three investigations into maternity services which found that pressures on
staff numbers can have a serious impact on time available for communication
Reacting to the NPEU survey Healthcare Commission Chief Executive Anna
Walker said: “There is a lot to celebrate in this survey in terms of
improvements to women’s experiences of maternity services. However there
are some areas where there is room for improvement. These are areas we have
picked up on in our own investigations and made sure that the trusts
concerned have taken action”.
The Commission today announced it is undertaking a major review of
maternity care in England in response to concerns raised from its
investigations about the quality of maternity services.
Ms Walker said: “Our review of maternity care will build on both the
findings of the NPEU survey and the learning from our maternity
investigations. It will determine this year exactly what is happening in
maternity units; staffing levels and grades, outcomes for patients and
complexity of care.
“This review will check progress against maternity standards in the
National Service Framework, aspects of NICE guidance and the Commission’s
own recommendations from previous investigations.
“ Our programme will include a survey in May of every woman who gave birth
in every NHS trust during February.* It will be the largest survey of its
kind, asking up to 50,000 women about their experiences of maternity care
in the NHS. The findings will enable trusts to target improvements
The findings from the review and survey will provide benchmarks and
recommendations for trusts, commissioners of services and the public to
allow them to compare, plan and identify the factors of success in
providing safe, high quality maternity services.
A full national report on maternity services will be released in 2008.