The Care Quality Commission (CQC) State of Care report 2022/23 shows a maternity system in crisis. We have known even prior to the COVID-19 pandemic the pressure that maternity services are under, which has only worsened over time.
The CQC has revealed both qualitative and quantitative data that chimes with our own investigation into the state of the maternity system via our Systemic Racism Not Broken Bodies report released in 2022.
Almost half of all maternity services inspected in 2023 by the CQC have so far been rated as either in need of improvement or inadequate, a percentage that has increased year-on-year. This is a shocking statistic.
In 2023, staffing shortages, toxic workplaces, leadership, safety and systemic racism remain key themes. All of these issues have one clear outcome: they result in the voices and decisions of women and birthing people being ignored.
The starting point, even in times of crisis, must always be the rights of women and birthing people to make their own decisions about their own maternity care. This is a fundamental right enshrined in the Human Rights Act 1998. They must be given the information they need to make decisions, and to have those decisions upheld and protected.
We can clearly see in this report the impact of the cost-of-living crisis on already stretched services. Trusts need to invest in staff retention, staff wellbeing and in ensuring that the workforce truly reflects the population it serves, right up to a senior level. There needs to be more awareness and acknowledgement of the reality of racism and discrimination in maternity services.
Above all, they need to ensure an individualised approach when it comes to maternity care, enabling women and birthing people to make informed decisions about their care.
We are also concerned about what we hear from the midwives interviewed for this report about lack of translation services being used to help those with limited English. This echoes what we continue to hear through our training to healthcare professionals and is having a fundamental impact on communication and informed consent.
Robust and meaningful action must now be taken to address systemic issues as well as ensuring that those delivering care feel supported and equipped to provide care underpinned by human rights law. It is critical that all those managing, delivering and regulating hospitals and Trusts understand that rights-based, person-centred care is crucial to delivering safe maternity care.
Read the full report here.