UK maternity care inadequate, NHS Alliance says

Pregnant women are being failed by the United Kingdom's National Health Service, an organization representing senior healthcare managers has said.

The NHS Alliance said up to 20 of the UK's smaller maternity units should be closed because of structural failings and a shortage of workers. The country has a total of 155 obstetrician-led neonatal and maternity units.

The Department of Health and Social Care, which is the UK government department that oversees the NHS, said the issues raised by the NHS Alliance are being looked at by a taskforce that will make suggestions to ensure maternity care gets "the reforms needed to ensure services meet the needs of women and families now and in the future".

Matthew Hopkins, the NHS Alliance's director for acute care, told the BBC his organization fears the taskforce, which is expected to report its findings by the end of the year, will not come up with the recommendations that are needed.

"Difficult decisions lie ahead, consolidating maternity services to support safer, more sustainable care," he said. "It is time now to take a step back and consider how we should best organize maternity services across England, and where those services should be located."

Describing NHS maternity and neonatal care as "not fit for purpose", the NHS Alliance believes the best way forward could involve consolidating services and closing smaller units in remote, rural communities and those delivering fewer than 2,000 babies a year.

Hopkins told The Guardian newspaper: "We are calling for a thorough appraisal of maternity services and where they need to be located because the current configuration is not fit for purpose."

One of the NHS Alliance's major concerns is the growing number of babies being delivered by C-section, which it says could signal a lack of confidence in handling more complex deliveries in some units. The organization is also concerned about raised maternal mortality rates for Black and Asian women.

Hopkins said any decision to close smaller units would inevitably trigger a backlash, but that ministers will need to be brave if they are to ensure the safety of women.

"If politicians … are keen to see safe maternity services in their area, it is going to need courage to grasp the nettle that needs to be grasped in order to improve maternity services," he said.

The Royal College of Obstetricians and Gynaecologists, a professional association representing people who work in maternity care in the UK, said it would prefer to see maternity care improved without the loss of any units.

Alison Wright, the organization's president, said she wants the government to commit to "expanding the maternity workforce to ensure safe staffing levels, along with investment in training and retention of dedicated staff".