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Officers’ update, March 2016

Dr David Richmond, RCOG President, writes...

You will be aware that the NHS England-commissioned National Maternity Review was published at the end of February. As an independent expert member of the review team, I can attest that the terms of reference were extremely tight and that not everything we wanted to see included was within the scope, with one example being early pregnancy complications. Additionally, some of the essential issues linked to provision of obstetric services, such as workforce planning, rota gaps and specialised commissioning of complex maternal and fetal needs, didn’t receive the level of attention we would have liked.

I was, however, pleased that the review looked at a potential rapid redress model for situations where there has been harm, that it advocated networks of care and promoted training – particularly multi-professional skills and drills. It also focused on the need to standardise perinatal reviews and develop a dashboard of clinical indicators for benchmarking. The spotlight on continuity of care, not just by a midwifery team but also with doctor and medical input, was also welcomed.

You won’t have failed to notice that one particular recommendation – the proposal for NHS Personal Maternity Care Budgets to give women more control over their care – received the most media prominence. It’s worth being aware that, although this received a lot of professional reticence, from both obstetric and midwifery colleagues, this was an area that NHS England and the Chair wished to consider piloting.

Key to realising all the recommendations in the report will be an NHS England implementation panel, and we will strive to have appropriate RCOG representation on this group. It is also our intention that many of the medical aspects not covered in the review are areas that our Safer Women’s Healthcare working party is picking up in their series of reports, due to be published in the summer.