Many new mothers are being let down by the care they receive after having a baby, a survey suggests.
In a survey of 1,260 first-time mothers by the National Childbirth Trust, under half said they got the advice and support needed after giving birth.
The parenting charity said the survey showed a “shocking” level of postnatal care and warned the NHS had to improve.
The Royal College of Midwives said more money should be invested in maternity services.
Read more at BBC Health.
I wasn’t going to bother this week as I’m on holiday. But it’s a Sunday afternoon in Cornwall, it’s raining (again), and my granddaughters are noisily and messily occupied making Rice Krispie cakes with Auntie Kate, so I thought, why not?
Driving down here last week I was as reassured as you will have been to hear on the radio that Gordon is going to shave billions off the NHS budget by cutting back on the excessive sick leave taken by health service staff. It’s so simple, it’s a wonder no-one thought of it before (not least this government, who have, after all, had nearly 13 years during which you might have thought the penny would have dropped). Except, of course, they aren’t going to do any such thing, any more than following through on the promise that every pregnant woman would have one-to-one care from their own midwife. They didn’t deliver on that one, predictably, because they didn’t have enough midwives to sustain the current service, let alone extend it. This latest example of willing the end but not the means, the most recent in a seemingly endless list of empty promises (or targets, as Nulabour spin would have it), really does beggar belief. I begin to wonder just how gullible the electorate would have to be to swallow it. Again.
I’m thinking of bringing the same strategy to bear on my personal life. I’ll be retiring soon (I think I may have mentioned it before), and I had been a bit worried about the consequent precipitous drop in my income, but I realise now that it won’t be a problem. By the time I’ve halved our expenditure on electricity and gas, and reduced the food bills by 75%, I’ll actually be better off than I am now. And of course, the beauty of this approach is that I don’t have to actually achieve the savings. What’s more, I don’t even need to have the remotest idea of how I might go about doing so. All I have to do is say it will happen. Simple.
I wish getting the back off my mobile phone was as straightforward. My children and wife can all do it with ease - they just flip it off with the merest hint of pressure from their thumb, then click it back into place. I push with both thumbs until the sweat runs down my face and I weep tears of frustration, but the bloody thing won’t budge. As my daughter helpfully remarked: “I don’t know how you manage with all that complicated scanning equipment at work.” Quite. As for why I need to get the back off the wretched thing…I just don’t want to go there.
Still, no need to worry about that now. It’s still raining, but it’s six o clock, so I can get to work with the corkscrew. Don’t work too hard y’all.
Conservative leader David Cameron has said the NHS will be his “number one priority”, as the main parties step up their pre-election campaigning.
Unveiling the first part of a draft manifesto, he focused on three health issues - NHS reform, health inequalities and maternity services - and accused the government of top-down management.
On reform, he committed to giving the NHS “back to the people”. Cameron said: “It’s the patients who’ll have the power in our NHS. You’ll be able to check your health records online in the same way you do your bank account.
“You’ll have a real choice about where you get treated. You’ll have information about how good different doctors are, how good different hospitals are, information about things that really matter, like survival rates, the rate of hospital infections, your chances of going home to live independently if you have a stroke.”
He attacked the government over ongoing health inequalities saying they’re as bad today as they were in “Victorian times”. Cameron outlined the introduction of a health premium, which would “target resources on the poorest areas so we can banish health inequalities to history. With our plans, the poorer the area, the worse the health outcomes tend to be, so the more money they can get.”
He said how this additional money would be spent would be determined locally by local councils and directors of public health.
Cameron also unveiled a new approach to maternity services. He accused the government of creating “bigger and bigger baby factories” that were remote to patients.
The Conservatives will introduce maternity networks in which “local hospitals, GPs, charities, community groups and maternity consultants will all be linked up so that they can share information, expertise and services.”
He said: “Parents in many parts of Europe have a system that is more personal and more local - with more choice. And they also have lower rates of infant mortality. Why can’t our parents have the same?”
The Conservatives claimed to be the only party committed to protecting NHS spending.
Labour, meanwhile, released a document which they said showed a £34bn gap in Tory spending plans - a claim which Cameron later described as “junk”.
Responding to the manifesto, Anna Dixon, acting chief executive of the King’s Fund, said: “Whichever party forms a government after the next election, they will inherit an NHS facing the toughest financial challenge in its history. Whether or not current spending is protected, demand will continue to rise and the NHS needs to figure out how to do more for less without compromising safety or quality.”
Read an at-a-glance guide to the manifesto.
Read the full speech.
A recent report revealed that the general sentiment amongst hospital managers and healthcare professionals is that improvements are still needed in our maternity services.
Many of us are already working at full tilt in the NHS, so what more, especially in the current economic climate, could feasibly be done?
Some matters are beyond our control - the year-on-year rise in the birth rate and subsequent increase in the number of complicated pregnancies within the general population (resulting mainly from lifestyle changes) and Working Time Directive compliance for instance. What these developments all point to is the urgent need for adequate staffing in our maternity units. We need more midwives to provide one-to-one midwifery care to women throughout their pregnancy and more consultant presence in the labour ward to ensure round-the-clock care.
More importantly, we need to work together as a team so that women receive the best care available to them.
This leads us to the issue of leadership. Good, solid working relationships within the obstetric workforce, between ourselves and our midwifery, anaesthetist and neonatal colleagues, helps improve the quality of services and this in turn enhances women’s experiences. This can be done through active collaboration, good communication and the sharing of knowledge so that we can all learn from one another and develop best practice models of care. Leadership attributes may not be present in everyone but it is something which could be cultivated in individuals.
There is talk that the NHS is beginning to clamp down on the amount of time doctors spend on non-clinical duties outside their trusts. There are good reasons why this is happening. Staff shortages and increasing workloads mean that doctors are needed in their hospitals. However, new regulation on medical revalidation means that doctors need to demonstrate they are up-to-speed in their knowledge and skills. But how do you develop that if you are in your trust all day interacting with the same people?
A lot of good work occurs outside of trusts, for example in Department of Health and NHS working parties, royal college committees and expert groups. Whether engaging in research, formulating policy, auditing practice or producing clinical guidelines, contribution often results in improved standards in healthcare provision.
It would be short-sighted if NHS managers restricted the amount of external work doctors do (and I am not referring to private practice), since the experiences gained from being involved in these activities are transferable into doctors’ professional lives. If the long-term aim is to help develop clinician’s leadership abilities, then doctors should be supported by their trusts to undertake these activities.
Maternity services are improving but there are still significant barriers to progress, a King’s Fund report claims.
Teams reported that the barriers preventing progress include a lack of staff, poor communication between staff from different disciplines or different units, particularly during transfer, and a lack of leadership.
The report is based on the outcome of a series of regional events held with midwives, obstetricians and risk managers. It’s the first stage of the Safer Births Initiative - a service improvement programme.
Solutions identified by the teams included new ways of deploying staff, such as case loading or flexible rostering across labour ward and community teams, developing support roles to take on new responsibilities and enabling midwives and obstetricians to attend the same multidisciplinary handover.
Dr Anna Dixon, director of policy at The King’s Fund, said: “This report shows that maternity professionals are introducing new ways of working that should improve the safety of care provided to mothers and babies. We are seeing progress and an appetite locally for change - there are many examples of local innovation where solutions focus on making the best use of existing resources to deliver safe care.
“Yet frontline staff who took part in our events also identified obstacles they face in providing the safest possible care. They told us that they want to be able to exchange ideas and good practice with other trusts and that they need practical advice on how to improve safety, tailored to their local circumstances, not simply more guidance.”
The RCOG welcomed the report but also called on the government to ring fence, at trust level, the £330m it’s promised maternity services between 2008 and 2010. Clinical directors and heads of widwifery need to work with NHS managers to ensure that these funds are secured and appropriately allocated, it said.
The RCOG acknowledged that finding trained staff was a problem and that, while rota and service redesign could help, there was still a need to recruit more midwives to provide one-to-one midwifery care to women throughout their pregnancy and for more consultant presence on the labour ward.
Professor Sir Sabaratnam Arulkumaran, RCOG president, expressed support the drive for more effective use of existing resources. “You can pour money into the system however what is fundamental is not what you buy but how you go about planning your services when funds are tight,” he said.
Read more on the RCOG’s solutions to the challenges.
