Maternity review floats personal budgets for expectant mums

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The National Maternity Review, chaired by former Conservative health minister Baroness Julia Cumberlege, identified seven priorities to drive improvements in maternity care.

First among these was a call for personalised care centred on the woman, her baby and family. Every expectant mother should draw up a personal care plan with her midwife covering decisions about her care and her wider health needs.

It was suggested that giving women a budget would allow them much more control over their maternity care whether through an NHS trust or accredited midwifery practice.

Other priorities named in the review were: continuity of carer; safer care and a culture of honesty when things go wrong; better mental health care for pregnant women and new mothers; improved joint working between midwives, obstetricians and other health professionals; cross-boundary working in the commissioning and provision of maternity services.

A seventh priority is a reformed payment system that fairly and adequately compensates providers. It should take into account the large number of fixed costs in obstetrics, the need for the money to follow the woman and her baby as far as possible and the challenge of providing sustainable services in remote and rural areas.

Cumberlege said: “To be among the best in the world, we need to put women, babies and their families at the centre of their care.

“It is so important that they are supported through what can be a wonderful and life-changing experience.”

Despite these future challenges, the review also identified much good practice. Even with a rising birth rate and increased complex cases, the quality and outcomes of maternity services have improved significantly over the last decade.

The stillbirth and neonatal mortality rate in England fell by over 20% between 2003 and 2013, while maternal mortality reduced from 14 deaths per 100,000 to 9 deaths per 100,000. In addition, the teenage pregnancy rate almost halved between 1998 and 2013.

NHS England chief executive Simon Stevens said: “The independent review finds that quality and safety of NHS maternity services has improved substantially over the past decade, and most new mums tell us they are looked after well.

“But it rightly argues that the NHS could and should raise its game on personalised support for parents and their babies, better team working, better use of technology and more joined up maternity and mental health services.”