The NHS Maternity Survey shows mixed progress in mothers’ experience of care
Over 17,000 women who gave birth in January and February 2019 responded to the Maternity Survey, making this the biggest source of data on mothers’ experiences of NHS maternity care in England. It offers insight into their experiences along the maternity pathway and this year the results are mixed in many areas that matter most to mothers.
One important aspect of care is continuity, where women are seen by the same midwife throughout their maternity journey. Research shows this is linked to a variety of positive outcomes including improved safety and reduction in miscarriages. This year’s survey revealed that 63% of women did not see the same midwife for all of their antenatal check-ups, 84% did not see the same midwives during labour and birth as they saw during their antenatal care and 72% did not see the same midwife for all of their postnatal visits at home.
Key measures such as women’s access to care have seen declines with 94% saying they had a phone number for their midwives, which is a high percentage, but down from 97% for the first time since 2013. The results also showed that less than two thirds (62%) of women were always able to get a member of staff to help them when they needed attention in hospital after the birth.
One of the priority areas laid out in the Better Births report from 2016, was “to ensure safe care based on a relationship of mutual trust and respect”. Women’s experience of interacting and communicating with staff in maternity services continues to be positive, particularly during labour and birth. In 2019, 88% of women (up 2% from last year) felt they were given appropriate advice at the start of labour and 84% said they felt their concerns were taken seriously when raised during labour and birth. There was also positive feedback about antenatal check-ups where the majority of women (83%, compared to 76% in 2013) said that midwives “always” listened to them.
The Maternity Survey results 2019 did show more areas of improvement overall than in 2018. Encouraging results included, 82% of respondents felt they were ‘always’ involved in decisions about their antenatal care and nearly all respondents (98%) answered positively when asked if they were treated with respect and dignity during labour and birth. 66% were ‘always’ given the information or explanations they needed when in hospital after the birth and the majority of respondents (90% up from 88% in 2018) answered ‘yes, always’ when asked if they were spoken to in a way they could understand during labour and birth.
Better care includes women having access to their midwife as they require, after having had their baby. This year’s survey showed that 25% of women in 2019 (compared to 23% in 2018) would have liked to have seen a midwife at home or in a clinic ‘more often’ after the birth. In parallel with this, there has been a significant decrease in the proportion of women saying they saw the midwife ‘as much as they wanted’, from 73% in 2018 to 70% in 2019. The Picker Principles of Person Centred Care recognise that fast access to reliable health advice is vital to ensuring the women have a good overall experience.
The survey presents a mixed picture regarding progress in maternal care. Mothers report good and improving relationships with healthcare staff and quality of information is getting better. This is in line with the Picker Principles of Person Centred Care which emphasise the importance of good communication and positive relationships.
Despite this it is concerning that continuity of care has declined. Poor results may be related to the gaps in the workforce: the Royal College of Midwives has recently reported that the NHS in England is short of almost 2,500 midwives. To ensure person centred care the midwifery workforce needs to be increased and supported in line with government commitments to train 3000 extra midwives.
Chris Graham, CEO of Picker
The full CQC survey report on the can be found here.
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