A recent report by the Care Quality Commission (CQC) has exposed ongoing concerns about the quality of maternity services in NHS hospitals, raising alarms about safety standards that could potentially lead to poor care and preventable harm. The findings come after a comprehensive inspection of 131 maternity units across England, which revealed that nearly half of these services were rated as ‘requires improvement’ or ‘inadequate.’ For healthcare providers and organisations responsible for ensuring compliance with safety regulations, this report is a clear wake-up call.

This blog delves into the CQC’s key findings and explores how healthcare organisations can respond to these issues, highlighting the importance of compliance in maintaining high standards in maternity services. As the CQC continues to call for urgent action, understanding the role of healthcare compliance in preventing harm and ensuring the safety of mothers and babies is more critical than ever.

Key Findings from the CQC Report

Between August 2022 and December 2023, the CQC carried out inspections across 131 maternity units as part of a national review of maternity services. The programme was initiated to provide an updated overview of maternity care quality, especially in hospitals that had not been inspected since March 2021. Although some examples of good care were found, the overall picture revealed widespread issues with safety and quality. Some of the most critical findings include:

1. Inadequate Safety Standards: Only 35% of maternity units were rated ‘good’ for safety. The remaining units either ‘require improvement’ (47%) or were deemed ‘inadequate’ (18%). Significant discrepancies were observed in how different trusts managed safety, with some failing to learn from incidents and lacking robust risk assessment processes at triage.
2. Underreporting of Serious Incidents: Some hospitals were found to either fail to report serious incidents or inconsistently grade them, leading to missed opportunities to learn from errors. This trend, if left unaddressed, could result in preventable harm becoming accepted as normal practice.
3. Delayed Risk Assessment at Triage: Staffing shortages and poor triage environments were identified as contributors to delays in risk assessments for pregnant women, with some patients waiting so long that they chose to leave without being assessed.
4. Inadequate Facilities: Some maternity units lacked sufficient space, proper facilities, or necessary life-saving equipment. The CQC has called for urgent capital investment in maternity estates, stressing the importance of creating environments that ensure both safety and dignity for women.
5. Disparities in Outcomes: The CQC highlighted a concerning gap in the way trusts addressed health inequalities, particularly among Black and ethnic minority women. There were also examples of discrimination faced by staff and service users due to ethnic background, language barriers, and insufficient communication with families.

These findings underscore the need for urgent action to prevent safety issues from becoming entrenched within the maternity system. Without immediate steps to address these concerns, poor care and preventable harm could become normalised—something the CQC, along with healthcare compliance experts, is determined to avoid.

The Role of Healthcare Compliance in Addressing Maternity Safety Concerns

The findings from the CQC inspection programme make it clear that healthcare organisations must take a proactive stance on compliance to safeguard maternity services. Ensuring adherence to safety regulations and standards is paramount in maintaining quality care and protecting both patients and staff. Here’s how healthcare providers can enhance compliance in maternity services:

1. Incident Reporting and Learning from Errors

A key finding from the CQC report was the failure of some trusts to properly report and assess serious incidents. To address this, healthcare providers must implement robust systems for incident reporting and investigation. Compliance teams should ensure that all incidents, no matter how small, are recorded accurately and analysed to uncover patterns of risk.

Learning from incidents is not just a best practice—it’s a regulatory requirement. Healthcare organisations must foster a culture where staff feel comfortable reporting errors without fear of reprisal. This will help organisations identify risks, make necessary adjustments, and prevent future harm.

2. Triage and Risk Assessment Protocols

Ensuring timely and effective risk assessment at triage is essential for the safety of both mothers and babies. The CQC’s findings revealed significant delays in triage assessments due to staffing shortages and inefficient processes. Healthcare providers should review their triage protocols, ensuring that risk assessments are carried out promptly and in a safe environment.

Compliance with risk assessment guidelines should be monitored regularly, with audits conducted to ensure adherence to safety protocols. This not only helps organisations stay compliant but also improves patient outcomes by identifying potential risks earlier in the care pathway.

3. Staffing Levels and Training

Chronic staffing shortages were highlighted as a significant contributor to many of the safety issues identified by the CQC. Ensuring that maternity services are adequately staffed is a key component of regulatory compliance. Healthcare organisations must take steps to ensure that their staffing levels meet the standards set by regulatory bodies like the CQC and the National Institute for Health and Care Excellence (NICE).

In addition to ensuring adequate staffing levels, compliance teams should work closely with human resources departments to provide ongoing training and professional development for maternity staff. Properly trained staff are better equipped to handle incidents, manage patient care, and ensure compliance with safety regulations.

4. Investment in Facilities and Equipment

The CQC report also raised concerns about the condition of some maternity units, noting that they were not fit for purpose and lacked essential life-saving equipment. Healthcare providers should review the physical condition of their maternity units and invest in necessary upgrades to ensure compliance with safety standards.

Capital investment in facilities and equipment is crucial for delivering high-quality care. Compliance teams should work with hospital management to advocate for funding that is ring-fenced for improving maternity services, ensuring that the money is spent where it is most needed.

5. Addressing Health Inequalities

Disparities in maternal outcomes for Black and ethnic minority women were another area of concern identified by the CQC. Healthcare providers must ensure that they are actively addressing health inequalities and providing equitable care for all patients. This includes ensuring that staff receive training on cultural competency and language barriers, as well as improving communication with families to ensure they are informed and involved in care decisions.

Compliance teams should monitor demographic data to identify any disparities in care and outcomes, and work with leadership to develop strategies to address these inequalities. This is critical not only for ensuring compliance with equality standards but also for improving the overall quality of care in maternity services.

The Way Forward: Ensuring Compliance for Safer Maternity Services

The CQC’s latest findings on maternity services are a stark reminder that healthcare providers cannot afford to become complacent when it comes to safety and quality of care. Preventable harm must never be normalised, and the role of healthcare compliance in ensuring that standards are met and maintained is more important than ever.

Urgent action is needed at all levels of the healthcare system to address the issues raised by the CQC. From improving incident reporting and risk assessment protocols to investing in staff and facilities, healthcare providers must take a proactive approach to compliance to safeguard the health and well-being of mothers and babies.

At its core, compliance in healthcare is about ensuring that care is safe, effective, and equitable. By focusing on these principles, healthcare providers can make meaningful improvements to maternity services and prevent harm from becoming an accepted part of the system.

For organisations looking to stay ahead of regulatory requirements, now is the time to act. Investing in compliance today will lead to safer, higher-quality care tomorrow, ensuring that maternity services across the UK provide the best possible outcomes for mothers, babies, and families.