Hospital Dr News

Time to cut maternity services negligence bill

One fifth of all spending on maternity services in England is now set aside to cover negligence claims, a report reveals.

In the last year trusts paid out some £482 million to protect themselves against a growing quantity of litigation, the National Audit Office said.

Maternity services account for a third of the total NHS clinical negligence bill. The number of maternity claims rose by 80% in the five years up to that point.

Tthe MDU said urgent legal reform is needed to the system for compensating patients in clinical negligence claims.

Dr Christine Tomkins, MDU chief executive said:

“This is a staggering amount of money for the NHS to pay out in damages for maternity claims in one year. And of course this is only a fraction of the NHS’s total clinical negligence bill which was a jaw-dropping £1.25bn over 2012-13. As the NAO points out, each of these claims represents an adverse outcome for the women and babies concerned, but also for the taxpayer.

“When you consider that this is money that would otherwise be spent on patient care, you can see why we have been calling for urgent legal reform.  No one would deny that patients who have been negligently harmed should be fairly compensated but ultimately every citizen is paying for this inexorable rise in NHS claims costs.

Its report says most maternity services are “good” – but are blighted by midwife shortages and regular closures of units to patients.

Tomkins added: “We agree with the NAO that more must be done to improve risk management and safety of care. But the practice of medicine is complex and can never be totally risk free.  We must do everything we can to avoid negligent injury to patients but this must go hand in hand with legal reform to prevent the massive increases in damages we are seeing.”

The report says there are “significant and unexplained” differences in performance of services around the country.

And while death-rates of babies have fallen, there is scope for improvement, the auditors say.

Audit office head Amyas Morse said: “Since the Department of Health’s 2007 strategy, there have been improvements in maternity services, but the variation in performance across the country, and our findings on how services are being managed, demonstrate there is substantial scope for further improvement.”

The Royal College of Obstetricians and Gynaecologists called for more consultants and midwives to help deal with pressures in some areas.

President Dr David Richmond said: “More consultants are needed to deal with not only the rapidly increasing birth rate but the rise in complex pregnancies, with older mothers, maternal obesity and multiple pregnancies at the fore.

“We still need significantly more consultants if we are to provide the care we recommend, currently none of the largest units in England achieve the target of 24 hour presence 7 days a week. In addition we need a substantial increase in midwifery numbers to again match recommendations.

“Continuity of care suffers at such a crucial time in maternity care and the teamwork, which is an essential component, is placed at risk.”

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