NHS spending money for maternity on clinical negligence cover
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The National Audit Office (NAO) have published a report this morning on maternity services in England.
The headline, according to the media, is that the NHS spends one fifth of all money for maternity services on clinical negligence cover, approximately £700 per live birth.
It reports that the number of claims against NHS maternity services has increased by 80% in the last five years to 2012-13 and the cost to the NHS for litigation cover for maternity claims is £482 million in 2012. The NAO has also focused on the variations in maternity services. There are wide unexplained variation in the performance of trusts in terms of complications rates and medical intervention rates even adjusting for maternal characteristics and clinical risk factors. In some hospitals up to 1.6% of women were readmitted as an emergency, whilst it was only 0.5% in others.
Infections rates in newborns also varied - some hospitals recorded 0.6% of babies suffered an infection, while it was as high as 4.2% in others.
The NAO suggests that whilst the number of midwives have increased since 2007, in order to keep pace with the rising birth rate and to reach a proposed national benchmark of 29.5 births per midwife, an additional 2.300 midwives are required.Again, in terms of consultants, whilst there has been an increase in their presence on obstetric units, 53% of units still do not achieve the levels of presence recommended by the Royal College of Obstetricians and Gynaecologists and the NHS Litigation Authority.
Whilst it is important to understand the costs involved in these claims, it should be recognised that the awards for successful clinical negligence claims in this area are significantly high and can reach £8 or £9 million because it is necessary to provide for a life time of care for the injured child from birth. However, clearly the real issue is to prevent the errors in the first place and to ensure that there are sufficient midwives and consultants available to provide the standard of care that should be expected by mothers and babies.
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