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RCOG statement on the National Audit Office report on maternity services in England

News 8 November 2013

The National Audit Office (NAO) today released a report on the state of maternity services in England, looking at changes in maternity care since the implementation of the Department of Health’s Maternity Matters strategy in 2007.

The report states that while there have been improvements in maternity services since 2007, there is still room for development, particularly in terms of the variations in performance outcomes of maternity units across the country.

According to the report maternity services are under significant demands and financial pressures as the current birth rate is at a 40-year high and the cost of medical litigation continues to rise, with trusts paying £482 million for maternity clinical negligence cover in 2012–13 alone – around a fifth of spending on maternity services.

Improvements were also highlighted with increased consultant cover and more midwives on labour wards, although it states that optimal staffing levels for better and safer maternity services are still not being met.

Dr David Richmond, President, Royal College of Obstetricians and Gynaecologists, said:

“The NAO report places a great amount of transparency on the current state of maternity services across England, raising valid concerns where care quality requires improvement.

“Although the UK is generally a safe place for women to give birth, we have known for some time that pressure on maternity services is growing in some areas particularly inner city conurbations placing stress on clinicians, managers and patients alike. 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. 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 team work which is an essential component is placed at risk.

“Perinatal mortality has improved over the last 10 years but the number of stillbirths is still a major area of concern and requires particular focus.

“It is also important to ensure that the future needs of a growing population are anticipated in any future workforce planning of maternity services. Developing trends and service constraints need to be closely monitored so that health objectives for the NHS are achievable and affordable.

“Additionally, the report highlights concerns around the variation in clinical outcomes of maternity units across the country. This is a concern shared by the RCOG and has been identified in our Patterns of Maternity Care in English NHS Hospitals report, which was published in May 2013.”


For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email

View the full NAO report Maternity Services in England