Quality Of Care In England

The Care Quality Commission ratings

Every woman should be able access quality maternity care for herself and her baby. However, for some years the Care Quality Commission (CQC), which is the independent regulator of health care in England, has been raising concerns that quality in maternity care is poor and not improving at the rate expected.

The most recent data from 2023 show even further deterioration with nearly a half of all maternity services providing care that was rated as inadequate or needing improvement: markedly poorer than many other health care areas such as critical care, medical care and surgery. 

Two thirds are ‘inadequate’

Probably the most concerning component of the CQC review is that of safety (see map) which suggested that around 65 per cent of maternity services are now regarded as inadequate or require improvement, compared to 54 per cent the previous year. Of these, 15 per cent were rated inadequate (see map for details of specific service provider ratings and hover over points for details of other quality indicators).

Their report suggests that while many women receive excellent care, the huge pressures placed on services results in deteriorating and poor quality services by some providers. This creates wide disparities and puts the wellbeing of women and their babies at risk. Sadly, a number of reviews such as Morecombe Bay (2), Shrewsbury (3) and Cwmy Taff have highlighted the impact of inadequate quality on both women’s experience of care and outcomes.

According to the CQC, particular areas of concerns – which underpin the decline in quality - are poor governance and leadership, difficult working relationships and poor communication between staff and service users (link to our user experience page).

However, one of the most consistent and severe problems was that of staffing shortfalls, which significantly affected both safety and overall quality of care.

Urgent change

Addressing inequalities in quality of care requires multifaceted and comprehensive approaches. Yet we still need to take the first step; to acknowledge that some groups of women receive poorer care than others.

From there we need to move swiftly on to gathering the data – much of it currently unusable, unavailable, unhelpful or simply missing – which is needed to inform the policy changes we urgently need. Only then can we move forward, generating the demand and the political will to provide the safe and respectful maternity and newborn care that is every woman’s and every newborn’s right.

Reference links

1. Quality of care - Care Quality Commission (cqc.org.uk)
2.  Morecambe Bay Investigation: Report - GOV.UK (www.gov.uk)
3. (Findings, conclusions and essential actions from the indepedendent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust - final Ockenden report (publishing.service.gov.uk)
4. (Review of maternity services at the former Cwm Taf University Health Board: report | GOV.WALES) and East Kent