CQC survey shows only limited improvement in maternity care experiences

The Care Quality Commission has published its findings from its national survey of more than 17,600 women who gave birth in February last year show that many had a good experience, particularly in relation to interactions with staff, access to midwives and emotional support during pregnancy.

However, for some women the care they received fell short of expectations with issues highlighted around continuity of care, choice in antenatal and postnatal services and access to help, information and support after giving birth.

Published on Tuesday 29 January, the findings highlight women’s views on all aspects of their maternity care from the first time they saw a clinician or midwife, during labour and birth, through to the care provided at home in the weeks following the arrival of their baby.

Nationally, there appears to be a limited improvement in women’s experience between 2017 (the last time the survey was carried out) and 2018 and in some areas women’s experience has declined. However, several areas continue to show positive results over time when compared to results from the 2013 and 2015 surveys.

Responses to the 2018 survey include the following notable trends:

• Most women (82%) said that during their antenatal check-ups the midwives they saw ‘always’ listened to them (unchanged from 2017, but up from 79% in 2013 and 2015) and more women in 2018 (68%) said they were asked how they felt emotionally during their antenatal care (up from 64% in 2017 and 57% in 2015).
• 88% of women surveyed said that they were ‘always’ treated with respect and dignity during labour and birth (the same as in 2017, but slightly up from 86% who said this in 2015 and 85% in 2013).
• More women in the 2018 survey (71%) said their partner or someone else close to them could stay with them as much as they wanted during their stay in hospital (69% in 2017 and 63% in 2015).
• In 2018, more than nine in ten women (97%) said that during their pregnancy they had a telephone number for a midwife or midwifery team that they could contact. Of those who tried to contact a midwife during their pregnancy, just under three-quarters (73%) ‘always’ got the help that they needed. These results have remained stable over time.
• Over two-thirds of women (68%) in 2018 said they were not given a choice about where their antenatal check-ups would take place, however, this proportion has declined gradually over time (from 71% in 2013 and 69% in 2015 and 2017).
• Over three-quarters of women (77%) reported that they were never left alone during the birth of their baby at a time when it worried them. This is unchanged from 2017 but has improved from 74% in 2013 and 2015.
• Over a quarter of women (28%) said they did not see the same midwife for their antenatal checks but would have liked to, and only 15% said that the midwives who cared for them during labour and birth had been involved in their antenatal care; the same as in 2017.
• In 2018, fewer women felt that they were ‘definitely’ given enough information about their own physical recovery (57% in 2017 falling to 53% in 2018) or about any emotional changes they might experience (59% in 2017 and 56% in 2018) after the birth.
• Almost a quarter (24%) of women surveyed said the midwife or midwives that visited them at home did not appear to be aware of their medical history; compared to 23% in 2017 and 22% in 2015.
• The proportion of women who said they would have liked to have seen a midwife ‘more often’ after they went home has also slightly increased – 23% said this in 2018 compared with 21% in 2017.

“I am pleased that the findings of this year’s survey show that many women are experiencing high quality care and treatment during pregnancy and birth. This is a testament to efforts and dedication of staff working hard to provide care for pregnant women and new mothers across the country.
 

The survey reveals a number of positive results, with support during antenatal check-ups and partner involvement showing encouraging upward trends. However, the results also indicate that in other areas women’s experiences continue to fall short.
 

It is particularly disappointing to see that scores for questions about postnatal care remain poor – information provision, emotional support and communication after birth are all highlighted as areas where experiences could be improved. Similarly, ensuring greater continuity of care for women through the whole maternal journey is an area where trusts need to focus their attention.
 

It is vital NHS trusts listen to and work with those who use maternity services to fully understand what is working well and what might need to improve. I hope that trusts will make full use of their individual survey results to identify where changes can be made to ensure consistent and high-quality care for the benefit of all women and their families. This is of huge importance if we are to realise the ambition of the NHS long term plan for the best maternity care in the world.”

Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals and lead for Maternity

The full results for England, as well as individual results for each trust are available on the CQC’s website at www.cqc.org.uk/maternitysurvey

This is the sixth survey of its kind that CQC has carried out to help trusts better understand the experiences of women using maternity services and involved 129 NHS trusts. The results are used by CQC as part of its wider monitoring of hospital services.