Nearly 50% of Maternity Units Deemed Inadequate or Requiring Improvement: CQC

Poor quality care and preventable harm in NHS maternity services “will become normalized” if action is not taken, as warned by the health care watchdog.

Nearly half of the locations were rated as “requires improvement” (36 percent) or “inadequate” (12 percent).

Some locations have experienced a decline in standards since their previous inspections, with well-led ratings dropping by 2 levels at 12 maternity units and safety ratings dropping by 2 levels at 11 units.

The inspections, conducted between 2022 and 2024, highlighted that safety remains a major concern, with none of the 131 services receiving an “outstanding” safety rating. Nearly half (47 percent) were rated as “requires improvement,” 35 percent as “good,” and 18 percent as “inadequate” in terms of safety.

The CQC mentioned that in cases where significant concerns were identified, enforcement powers were used to ensure NHS trusts made substantial improvements to protect women and babies from harm.

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“Although most services managed patient safety incidents well, we are concerned about the potential normalizing of serious harm in maternity,” the report emphasized.

The scrutiny on maternity care has increased following various high-profile inquiries into NHS trusts, such as the Ockenden Review by leading midwife Donna Ockenden investigating over 200 baby deaths at the Shrewsbury and Telford Hospital NHS Trust and the independent investigation by Dr. Bill Kirkup on maternity and neonatal services in East Kent.

Widespread Issues

The health care watchdog initiated a national maternity inspection program and assessed all NHS hospital maternity locations that had not been inspected since before March 2021.

It was noted that while some hospitals provided good care and showed excellent practices, “many” issues identified in East Kent and Shrewsbury and Telford were prevalent across England, with a significant number of women and babies not receiving the expected high-quality care.

“Key issues continue to affect quality and safety—and unfortunately, these are not new. Poor incident management with limited learning, failure to ensure safe and timely triage assessments, inadequate facilities and equipment access, lack of oversight from trust Boards, and significant staff recruitment and retention challenges,” the report highlighted.

Poor maternity triage was among the national issues identified by the CQC as needing improvement, with instances where women faced delays in assessment upon arrival at the hospital due to staffing issues. In some cases, delays were so severe that women left before being seen by a midwife or doctor.

Nicola Wise, CQC’s director of secondary and specialist care, stated: “Sadly, our recent maternity inspection program has shown the urgent need for action, indicating that the failings identified in recent high-profile investigations are not isolated incidents limited to a few trusts.

“While examples of good care and dedicated staff were observed, we remain concerned about the ongoing impact of key issues on quality and safety.”

‘Cause for National Shame’

Health and Social Care Secretary Wes Streeting described the CQC’s findings as a “cause for national shame.”

Streeting, speaking at an Institute for Public Policy Research (IPPR) event in London, expressed, “Women deserve better—childbirth should not be a source of fear or trauma for them.”

“It is completely unacceptable that nearly half of the maternity units reviewed by the CQC are delivering substandard care,” he added.

The minister emphasized the importance of applying the lessons learned from investigations like Donna Ockenden’s beyond specific trusts and across the country.

Recent findings included shortcomings in cancer care compared to other countries, increased waiting times for hospital procedures in 15 years, and A&E waiting times contributing to thousands of additional deaths annually.

PA Media contributed to this report.