News / NAO questions maternity affordability

The National Audit Office has called on the Department of Health to look at the affordability of its maternity services strategy.

In a report, Maternity services in England, the NAO said affordability was not considered before the strategy was implemented in 2007. The strategy, Maternity matters, sought to offer women choice in where and how they have their baby; provide continuity of care; and ensure an integrated service through networks and agreed care pathways.

Maternity care cost the NHS around £2.6bn in 2012/13 (£3,700 per birth). While women’s experience of the care during labour and birth was mostly positive, there were significant differences in the satisfaction rates recorded by different ethnicities.

There was wide variation between trusts in respect of quality and safety, cost and efficiency.

The NAO said the Department should re-examine affordability. The assessment should include identifying what staffing levels would be sufficient to meet commitments on continuity of care. Its report said trusts with small maternity units (fewer than 10 beds) could face difficult decisions on whether they can afford to keep the units open.

It added that litigation was rising and trusts paid £482m for maternity clinical negligence cover in 2012/13 – about a fifth of spending on maternity services and a third of the entire clinical negligence bill.

NAO auditor general Amyas Morse said that there had been some improvements in maternity. However, he added: ‘The variation in performance across the country and our findings on how services are being managed demonstrate that there is substantial scope for further improvement.

‘The Department’s implementation of its strategy has not matched its ambition.’