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23/03/2016
The study has been published by the Royal College of Obstetricians and Gynaecologists (RCOG), and carried out in collaboration with the London School of Hygiene & Tropical Medicine.
It provides a national perspective on patterns of care women receive during labour and delivery, in order to allow NHS trusts to look at their practice in context and make sure their services meet the needs of mothers and their family.
Overall, 55% of all first-time mothers had some form of intervention during labour and delivery, but the report revealed that there was 'considerable' variation across maternity units in relation to the types of intervention given and the outcomes these women experienced.
For example, there was a 1.5 to two-fold difference between NHS trusts with the lowest and highest rates of emergency caesarean sections (8% and 15%). Among first-mothers who had vaginal delivery, a similar amount of variation was seen in the rates of instrumental delivery (19% and 29%) and episiotomy (29% and 44%).
The report said that some variation in care is expected and could reflect a service that is tailored to the specific needs and preferences of individual patients or populations. The results have been adjusted to control for risk factors that are beyond the control of individual trusts – such as a woman's previous birth history, age and level of social deprivation. However, the report also warned that some of the differences could also be as a result of differences in the quality of the data submitted by trusts, as well as differences in patient characteristics that were not possible to control for, such as smoking and obesity. In addition, the variation could also suggest that not all women are getting the best possible care across the country, or that NHS resources are not being used in the most efficient way. In fact, more than 10% of hospital trusts failed all data quality checks, the report said, and has called for further NHS trust engagement to ensure IT systems are fit for purpose.
Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said: "We are concerned about the amount of variation identified in this report. Although the exact causes are difficult to establish, it is paramount that maternity units have information about their services, as well as the ability to compare themselves to the national average and to their peers.
"The RCOG is dedicated to creating a culture of openness and transparency within maternity and gynaecological care. With this information, maternity services, alongside commissioners, will be able to move towards identifying priority areas for reducing variation and further improving the safety and quality of care provided to women and their babies."
Dr David Cromwell, co-author of the report and Reader in Health Services Research at the London School of Hygiene & Tropical Medicine, added: "Despite a continued need for improvements in data quality across the NHS, the information provided to trusts within this report will help them to monitor local practice and deliver consistently good care throughout the country.
"Since we started sharing these findings in 2013, we have already seen excellent examples of trusts using the data to identify clinical issues and make improvements. Providing data to empower individual trusts to take action is exactly why we undertook this project."
The information can be accessed in an interactive format on a new website here.
(JP)
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Maternity Care 'Varies Across England' – Report
A new report has highlighted that women face variation in maternity care across England.The study has been published by the Royal College of Obstetricians and Gynaecologists (RCOG), and carried out in collaboration with the London School of Hygiene & Tropical Medicine.
It provides a national perspective on patterns of care women receive during labour and delivery, in order to allow NHS trusts to look at their practice in context and make sure their services meet the needs of mothers and their family.
Overall, 55% of all first-time mothers had some form of intervention during labour and delivery, but the report revealed that there was 'considerable' variation across maternity units in relation to the types of intervention given and the outcomes these women experienced.
For example, there was a 1.5 to two-fold difference between NHS trusts with the lowest and highest rates of emergency caesarean sections (8% and 15%). Among first-mothers who had vaginal delivery, a similar amount of variation was seen in the rates of instrumental delivery (19% and 29%) and episiotomy (29% and 44%).
The report said that some variation in care is expected and could reflect a service that is tailored to the specific needs and preferences of individual patients or populations. The results have been adjusted to control for risk factors that are beyond the control of individual trusts – such as a woman's previous birth history, age and level of social deprivation. However, the report also warned that some of the differences could also be as a result of differences in the quality of the data submitted by trusts, as well as differences in patient characteristics that were not possible to control for, such as smoking and obesity. In addition, the variation could also suggest that not all women are getting the best possible care across the country, or that NHS resources are not being used in the most efficient way. In fact, more than 10% of hospital trusts failed all data quality checks, the report said, and has called for further NHS trust engagement to ensure IT systems are fit for purpose.
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Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said: "We are concerned about the amount of variation identified in this report. Although the exact causes are difficult to establish, it is paramount that maternity units have information about their services, as well as the ability to compare themselves to the national average and to their peers.
"The RCOG is dedicated to creating a culture of openness and transparency within maternity and gynaecological care. With this information, maternity services, alongside commissioners, will be able to move towards identifying priority areas for reducing variation and further improving the safety and quality of care provided to women and their babies."
Dr David Cromwell, co-author of the report and Reader in Health Services Research at the London School of Hygiene & Tropical Medicine, added: "Despite a continued need for improvements in data quality across the NHS, the information provided to trusts within this report will help them to monitor local practice and deliver consistently good care throughout the country.
"Since we started sharing these findings in 2013, we have already seen excellent examples of trusts using the data to identify clinical issues and make improvements. Providing data to empower individual trusts to take action is exactly why we undertook this project."
The information can be accessed in an interactive format on a new website here.
(JP)
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20/03/2020
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