Tackling the Maternity Crisis

Chair: Cllr Nick da Costa (Chair, FCC); Aide: Jess Brown-Fuller MP; Hall Aide: Cllr Sandra Gidley

Submitted by: 14 members 
Mover: Helen Morgan MP (Spokesperson for Health and Social Care) 
Summation: To be announced

Conference notes that:

1. Maternal deaths in the UK are higher than at any point in the last decade.
2. 65 per cent of maternity units are not safe to give birth in, according to the Care Quality Commission, and the Commission has stated that they are "concerned about the potential normalising of serious harm in maternity".
3. Shortages of experienced staff, including specialist doctors and senior midwives, especially at night, has been repeatedly identified as a source of failure in maternity, including in landmark maternity investigations such as the Ockenden report into failings at Shrewsbury and Telford Hospital Trust.
4. Maternity represents the largest share of clinical negligence payments, at £1.3 billion a year.
5. Reviews into maternity have come up with more than 700 recommendations in the past decade, but improvements have been limited.
6. There have been repeated investigations into maternity services in recent years, often uncovering similar failings, including most recently the Nottingham, Leeds and Sussex investigations and the national Amos Review.

Conference believes that:

1. Britain should be the safest country in the world in which to have a baby.
2. Every maternity unit should meet ‘good’ or ‘outstanding’ standards of safety.
3. No woman should face injury or trauma due to unsafe healthcare.
4. There should be sufficient staff to ensure mothers benefit from the greatest possible safety and choice during pregnancy and labour.

Conference calls for:

1. Every maternity unit to be brought up to good levels of safety through:
   1. Consultant obstetricians to be present on every labour ward 24 hours a day, 7 days a week.
   2. One-to-one midwifery care for every woman in labour.
2. A capital investment programme that:
   1. Brings every maternity and neonatal unit up to good condition; this should include renovation of the 42 per cent of units in need of major repair and immediately starting repairs in the 7 per cent of units that run a risk of imminent breakdown.
   2. Delivers new dedicated bereavement suites.
   3. Invests in high-quality equipment that reduces the rate of injury, including identifying and developing new tools such as air cuff alternatives to forceps.

Conference additionally calls for:

1. A national Maternity Commissioner to oversee improved standards of care.
2. Mandatory, regularly updated, salaried training each year that:
   1. Includes foetal monitoring and emergency procedures for all maternity staff.
   2. Includes 52 hours’ salaried training time for midwives, as recommended by the Royal College of Midwives.
   3. Clearly communicates a shared understanding of safety, with focused training for those in leadership roles in building a culture of openness and speaking up.
3. A Director of Midwifery to be appointed in every maternity service, alongside an extra 300 consultant midwives across the country to help drive clinical excellence.
4. A restoration of Service Development Funding (£95 million), which the Labour Government cut, to support enhanced care for complex pregnancies, multiple births or bereavement care and support.
5. Guaranteed bereavement specialists and perinatal mental health specialists in every maternity service.
6. A dedicated neonatal workforce plan which ensures that neonatal teams are properly staffed in every hospital, including the right mix of specialists.
7. Better support during pregnancy including:
   1. Guaranteed access to preconception services and timely antenatal booking.
   2. Clear referral pathways to support personalised care by multidisciplinary teams from the earliest opportunity to support mothers’ safety and preferences.
8. Review national standards and funding to ensure every mother has access to high-quality antenatal classes, regardless of postcode.
9. Disparities in maternity care, which particularly impacts black and Asian women, disabled women and women from deprived backgrounds, to be tackled, including through:
   1. Mandatory training on inequalities, including identifying specific risks, such as recognising jaundice or cyanosis in babies with darker skin tones.
   2. A cross-government target and strategy for eliminating maternal health disparities, backed by new investment in public health.
10. A systematic review of complaints processes in maternity and neonatal care to deliver new national standards, including on communication with patients, transparency and ease of registering a complaint.
11. Transparent national monitoring, with clear national benchmarks for success, for the hundreds of recommendations of the major reviews into maternity services in the UK.
12. All miscarriages to be recorded so that the issue is no longer hidden, national targets can be set, and the impact of interventions can be measured.
13. Support and referral including to NHS mental health support services to be made available after every miscarriage, not just after three.

Applicability: England

Mover: 7 minutes; summation of motion and movers and summation of any amendments: 4 minutes; all other speakers: 3 minutes. For eligibility and procedure for speaking in this debate, see page 10 of the agenda. You can submit a speaker's card online here or in person.

In addition to speeches from the platform, voting members will be able to make concise (maximum one-minute) interventions from the floor during the debate on the motion. See pages 10-11 of the agenda for further information.

The deadline for amendments to this motion is 13.00 Monday 7 September; see pages 11-12 of the agenda for more information.

Those selected for debate will be printed in Conference Extra and Saturday’s Conference Daily. The deadline for requests for separate votes is 09.00 Thursday 17 September; see page 9 of the agenda for more information.