Tens of thousands of mothers and babies in England were harmed by potential lapses in maternity care in the past two years, the BBC has learned.
More than 276,000 incidents were logged by worried hospital staff between April 2015 and March 2017 – the equivalent of one mistake for every five births.
Most were minor or near misses, but almost a quarter of the incidents led to the mother or baby being harmed – and in 288 cases there was a death.
Ministers said safety must be improved.
Health Secretary Jeremy Hunt told the BBC the figures were "shocking" and improving the way mothers and babies were cared for was a "top priority".
"Mistakes in maternity care can lead to heart-breaking tragedies for mothers and babies."
But he said it was encouraging hospitals were being honest as that would help prevent repeat problems.
However, childbirth charity NCT said the figures suggested maternity care was "in crisis".
The incidents have been flagged up under a voluntary reporting scheme run by the regulator NHS Improvement that staff are encouraged to take part in if they have concerns about care.
The potential lapses logged include everything from short delays getting medication or records not being completed properly to babies being deprived of oxygen and life-threatening complications not being diagnosed.
'We lost our daughter – we can't move forward'
Wendy Agius was already past her due date in June 2014 when she became concerned that her baby was not moving.
Over the next two days Wendy, 33, and her husband Ryan, 37, made repeated calls to the local maternity unit – a midwifery-led unit in Eastbourne – as well as making three visits.
Each time they were told everything was fine – even after Wendy collapsed at one point.
When they returned a fourth time, no heart beat could be found. Their daughter, Talulah, had died.
"It was devastating," said Wendy. "They just kept sending us home. We were treated like an inconvenience."
It later emerged on one visit their baby's heart rate had been incorrectly recorded and their symptoms should have led to them being invited in more quickly and seen by a consultant at an earlier point.
But established guidelines were not followed.
Since then, the couple have not been able to get pregnant again.
Ryan said: "It was the worst thing imaginable. We can't move forward. It is always there every day."
East Sussex Healthcare NHS Trust, which runs the maternity service, said it had apologised for the failings.
An internal review concluded it was not possible to ascertain whether the mistakes had led to Talulah being stillborn.
How have mothers and babies been harmed?
Of the 63,380 cases of harm, nearly 55,000 involved injuries or conditions that required no more than basic first aid, such as treating a mother who had slipped in the shower.
But there were 8,134 cases of more significant harm, including 479 which caused severe harm, such as permanent disability, and 288 deaths.
Records seen by the BBC show a range of problems, including:
- delays dealing with women who had suffered haemorrhages and other complications
- babies left brain damaged after being deprived of oxygen during birth
- babies not screened for infections, leaving them at risk of meningitis, blood poisoning and pneumonia
- heart rates incorrectly measured or recorded
- delays in emergency Caesareans, causing distress to the baby
- midwives requesting help from consultants too late or not at all
- women being told to stay at home or sent away from maternity units despite reporting potentially serious problems
Overall, a third of the incidents related to mistakes with treatments or procedures, while one in five was a result of problems with the admission, transfer or discharge of mothers and babies.
Some hospitals have seen a cluster of serious incidents
The figures also highlight how some hospitals have seen more cases than others, although NHS Improvement points out that being a high reporter of incidents may just be because a hospital is more transparent about its care.
Nonetheless, in a number of the cases there are serious concerns about services.
Nine mothers died at the Royal Oldham and North Manchester General hospitals, both of which are run by the Pennine Acute Hospitals NHS Trust.
The trust said it now had new leadership, staff had been provided with extra training, and since the changes had been made there had been no more maternal deaths.
Meanwhile, five mothers and four babies died under the care of Portsmouth Hospitals NHS Trust between 2015 and 2017.
The trust said it could not provide details of what had happened because of patient confidentiality.
An inquest into the death of another baby – in 2014 – highlighted major problems at the trust.
The baby, Rafe Angelo, died from oxygen starvation.
His mother had been transferred from a local birthing centre to Queen Alexandra Hospital, which is run by the trust, after complications developed.
But there were a series of delays in her getting treatment, including an ambulance crew's detour for a toilet break and no doctors or midwives to meet the ambulance on arrival.
University Hospitals of Leicester NHS Trust also saw 11 cases of severe harm during the period.
And hospital bosses had to apologise to a couple after their baby died in 2015.
There had been delays in the mother undergoing an emergency Caesarean, while the heart rate had not been properly recorded.
The trust admitted the baby could have survived if mistakes had not been made.
Central Manchester University Hospitals NHS Trust reported the most incidents, more than 5,000.
The trust runs St Mary's Hospital in the city, which reported nine deaths, two were mothers and seven babies.
The trust said lessons had been learned from the incidents.
'We will make maternity safer' – ministers
The government has set a target for halving the overall rate of stillbirths, deaths and baby brain injuries by 2025.
To help ensure lessons are learned, the Healthcare Safety Investigations Branch, set up earlier this year, will start looking at all cases of unexplained serious harm and death from next year.
The reports made to NHS Improvement – highlighted by the BBC – will feed into that system.
The idea of both systems is to ensure the NHS creates a learning culture so similar mistakes can be prevented.
But unions have said staffing is also an issue.
The Royal College of Midwives believes the NHS in England is 3,500 midwives short of what it needs.
Staffing has also been highlighted by the Care Quality Commission, which inspects hospitals.
In its review of services earlier this year, it warned staffing and the ability to provide one-to-one care during labour was a concern.
Half of maternity units are currently judged to be not safe enough.
Maternity is also the biggest cause of clinical negligence payouts, accounting for half of the cost of all claims.
Last year, £1.9bn of claims were made – a rise of 91% since 2004-05.
Abigail Wood, head of campaigns at childbirth charity NCT, said: "Maternity care is in crisis, staffing levels are dangerously low and midwives are being stretched to the limit."
The post Maternity mistakes: Lapses lead to mistake every five births appeared first on News Wire Now.
Burkina Faso: Growing Violence Threatens Health Care
Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, t..
Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, the number of displaced has increased fivefold, from 50,000 last December, to 270,000 in August. As ever, the most vulnerable suffer most: the very young, and the very old.
When Alidou Sawadogos elderly mother fell ill, he faced a long and dangerous journey to get treatment for her.
“When she collapsed, a friend called me,” he explains. “By the time I arrived she was already unconscious. I decided to take her to the health center and luckily someone who had a motorcycle helped me. Because of the violence many people who are sick wait at home and die. Everyone is afraid of taking the road to the health center in Barsalogho.”
Across Burkina Faso, the rising insecurity has forced over a hundred health centers to close, or to limit their work. Half a million people now have little or no access to health care. Dedicated health workers, among them Dr Bertrand Dibli in Barsalogho, are struggling to meet the needs, and to stay safe themselves.
“This is one of the few health centers that isnt closed,” he says. “We dont have enough equipment. And the insecurity has caused huge anxiety among health workers. Even coming here to Barsalogho is a huge challenge because the route is so dangerous.”
The ICRC has been working to support Burkina Fasos health professionals, with medical kits, and vaccination campaigns. During his visit to the country, ICRC President Peter Maurer expressed his concern at the multiple challenges facing Burkina Fasos people.
“We are very concerned,” he said. “Very worried about the upsurge in violence, its a vicious circle that is trapping the civilian population between armed groups.”
“We also see,” Mr Maurer added, “that it is not only the violence that is affecting the country, it is also under development, and climate change. Together with the violence that is obstructing the health services, its an accumulation of factors.”
And so the ICRC – jointly with the Burkinabé Red Cross – is also delivering food to the displaced, and helping to improve access to water supplies. All of this, says nurse Jeanette Kientega, is desperately needed by a population uprooted by conflict, and denied access to basic health care.
“By the time they are able to get here, it is often too late” she says. “Sometimes we can help, but if they have already been ill a long time, it is difficult. We try to do what we can.” (more…)
World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC
WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the G..
WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.
The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.
The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.
“WHO is very grateful for the World Banks support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”
The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Banks previously announced financial package of up to US$300 million and covers over half of SRP4s needs, with the remainder requiring additional funding from other donors and partners.
“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” said Annette Dixon, Vice President, Human Development at the World Bank. “The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”
The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEFs total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.
Borno State launches first Malaria Operational Plan, reawakens fight against malaria
Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nige..
Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nigeria, the Malaria Annual Operational Plan (MAOP) was developed and launched on 08 August 2019 with technical support from the World Health Organization (WHO) and partners. Aligned to the National Malaria Strategic Plan (2014 -2020), MAOP was developed through a broad-based stakeholders workshop involving malaria stakeholders, reviewed on different thematic areas and endorsed by the Commissioner for Health and Permanent Secretary, Borno State Ministry of Health.
Speaking during the launch, the Borno state Malaria Programme Manager, Mr Mala Waziri described the MAOP as the first to be endorsed and disseminated in Borno State. “WHO has made us proud by supporting the first ever Malaria Operational Plan right from development, review, printing to dissemination.”
Dr Ibrahim Kida, the Ministerial Secretary Borno State Ministry of Health and Incident Manager of the state, described the launch as “an historic event as stakeholders across the health sector made commitments to use the document as an implementation guide for all malaria programs”. The plan was also described as an advocacy tool for planning domestic funds mobilization.
The MAOP has seven objectives among which are: provide at least 50% of targeted population with appropriate preventive measures by 2020; ensure that all persons with suspected malaria who seek care are tested with Rapid Diagnostic Test (RDT) or microscopy by 2020 and all persons with confirmed malaria seen in private or public health facilities receive prompt treatment with an effective anti-malarial drug by 2020.
The MAOP will further ensure that at least 50% of the population practice appropriate malaria prevention and management by 2020, ensuring timely availability of appropriate anti-malarial medicines and commodities required for prevention, diagnosis and treatment of malaria in Borno State by 2020.
In addition, it seeks to ensure that all health facilities report on key malaria indicators routinely by 2020 and finally strengthen governance and coordination of all stakeholders for effective program implementation towards an A rating by 2020 on a standardized scorecard. These strategic objectives have specific targets and the MAOP takes into account the humanitarian response.
“Malaria remains a leading cause of poor health in Nigeria. According to the 2018 WHO Malaria Report, 53million cases are recorded annually in Nigeria, roughly 1 in 4 persons is infected with malaria contributing 25% of the global burden,” says Dr Nglass Ini Abasi, WHO Malaria Consultant for the North East.
“Furthermore, 81,640 deaths are recorded annually (9 deaths every hour), which accounts for 19% of global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in West Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has a goal to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero and WHO is working assiduously with Government to ensure the burden is reduced accordingly.”
Results from WHO’s Early Warning, Alert and Response System (EWARS) week 30 report from 223 sites, (including 32 IDP camps) show that malaria was the leading cause of morbidity and mortality accounting for 35% of cases and 46% of reported deaths. In addition, results from the Nigeria Humanitarian Response Strategy (NHRS 2019-2021) indicate 7.1million people are in dire need of healthcare and 6.2million are targeted for immediate attention.
Despite recent improvements, insecurity remains a challenge limiting access to the functional health facilities. Easily preventable and treatable diseases such as malaria, acute respiratory infection and diarrheal diseases account for the greatest proportion of morbidity and mortality among the vulnerable population. Furthermore, Malaria is endemic in North East Nigeria and the transmission is perennial with a marked seasonal peak from July to November every year. (more…)
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