Pregnancy
Health secretary orders urgent maternity care review
Health secretary Wes Streeting has launched a national investigation into England’s worst-performing maternity units after a series of scandals involving baby deaths and maternal harm.
The review will focus on up to 10 of the most underperforming maternity and neonatal services, including those in Leeds, Sussex, Gloucester, and Mid and South Essex. It will begin this summer, with findings due by December 2025.
Speaking at the Royal College of Obstetricians and Gynaecologists World Congress on Monday, the health secretary said the level of risk facing women and babies is “considerably higher” than it should be, warning of a deep-rooted crisis in care.
The announcement follows major failings uncovered in Shrewsbury and Telford, East Kent, Morecambe and Nottingham.
Last year, the maternity regulator found that two-thirds of services were rated as “requires improvement” or “inadequate” for safety.
Streeting told the congress: “Over the last year, I’ve been wrestling with how we tackle problems in maternity and neonatal units, and I’ve come to the realisation that while there is action we can take now, we have to acknowledge that this has become systemic.
“It’s not just a few bad units. Up and down the country, maternity units are failing, hospitals are failing, trusts are failing, regulators are failing.
“There’s too much obfuscation, too much passing the buck and giving lip service.”
He said he had met with bereaved families who had lost babies or experienced serious harm during childbirth.
He said: “What they have experienced is devastating—deeply painful stories of trauma, loss, and a lack of basic compassion—caused by failures in NHS maternity care that should never have happened.
“Their bravery in speaking out has made it clear. We must act and we must act now.
“I know nobody wants better for women and babies than the thousands of NHS midwives, obstetricians, maternity and neonatal staff, and that the vast majority of births are safe and without incident, but it’s clear something is going wrong.
“That’s why I’ve ordered a rapid national investigation to make sure these families get the truth and the accountability they deserve, and ensure no parent or baby is ever let down again.”
The investigation will be carried out in two stages.
The first will look urgently at the worst-performing units to give families answers as quickly as possible, while the second will assess the maternity system more broadly and produce a national improvement plan.
Streeting said the review would be co-produced with victims of maternity failings, giving families a voice in how the inquiry is run.
This includes examining individual cases in Leeds and Sussex, including nine specific cases identified by families in Sussex.
“I’m currently discussing with Leeds families the best way to grip the challenges brought to light in that trust by their campaigning, reports in the media and the latest CQC report.
In March 2022, an investigation into Shrewsbury and Telford NHS Trust found that neglect and poor care provision caused 200 babies and nine mothers to die needlessly.
A push to reduce caesarean sections and increase natural birth rates was partly blamed.
Earlier this year, Nottingham University Hospitals NHS Trust was fined £1.6m in court for a “long list of failings” in maternity care.
The trust is now at the centre of the largest-ever inquiry into NHS maternity services and was charged with five counts of failing to provide adequate care, putting mothers and babies at risk of serious harm, and a sixth charge related to harm caused to a baby named Quinn.
It is the first trust to be prosecuted more than once by the maternity regulator, the Care Quality Commission.
The Birth Trauma Association estimates that around 20,000 women each year develop post-natal post-traumatic stress disorder, with up to 200,000 experiencing trauma symptoms after childbirth.
Pregnant women are among the first groups offered the NHS flu vaccine this winter, which has been updated to better match the subclade K strain.
Schoolchildren are also being prioritised and, like pregnant women, can receive the vaccine from September because they can catch and spread flu easily.
Protecting them also helps others, including younger siblings and grandparents.
Other eligible groups, including people aged 65 and over, will be able to receive a free NHS flu vaccine from October and should receive an invitation by phone or post.
Dr Amanda Doyle from NHS England said: “Last year’s flu season came early and was made worse by a new variant, which had a major impact for patients and put enormous pressure on urgent and emergency care services across the country.
“With the NHS experiencing its busiest summer on record, staff have started preparing for this winter earlier than ever – and with services already under significant pressure, it is vital that everyone offered the vaccine comes forward.”
Last winter’s flu season began more than a month earlier than usual as a new mutated strain circulated.
The strain was sometimes referred to as “Super flu”, although this is not a medical term and does not mean the virus is harder to treat. The name reflected that people had yet to build up immunity against it.
Flu vaccines are updated each year to better match the influenza viruses expected to circulate. These viruses continually mutate, so experts must predict how they are likely to change.
This winter’s vaccine includes changes intended to provide a better match for subclade K.
It remains unclear when flu will begin circulating widely this winter or how severe the season will be. Experts often look at flu activity in southern hemisphere countries such as Australia and New Zealand for indications of how the UK season could develop.
Their flu season peaks in July or August. Australia has recorded fewer cases than last year, while New Zealand has experienced high numbers.
Everyone is at risk of catching flu, regardless of age or how fit and healthy they are.
Doyle said: “Flu can really knock you for six, and for some children and pregnant women it can mean becoming seriously ill or ending up in hospital.”
The flu vaccine cannot give you flu. Instead, it helps the body know how to fight the virus.
Children aged two and over receive a nasal spray version, while adults receive an injection. One dose is needed ahead of winter.
Free NHS flu vaccines are available through pharmacies, GPs and schools. People who are not eligible for a free vaccination can pay around £10 to £20.
Schoolchildren and pregnant women can receive a free NHS flu vaccine from September onwards.
From October, free vaccination will also be available to children aged two or older who have not yet started school, people aged 65 and over, those with certain long-term health conditions, care home residents and carers of older or disabled people, including those receiving a carer’s allowance.
It will also be available to people living with someone who has a weakened immune system and those experiencing homelessness or staying in a homeless hostel or night shelter.
More adults will also be offered vaccination against respiratory syncytial virus (RSV), a virus that attacks the lungs, this winter.
From September, adults with certain pre-existing health conditions, such as chronic lung disease, will be invited for the RSV vaccine when they turn 65 rather than waiting until 75.
Four leading cardiovascular health groups have agreed new guidance for healthcare professionals assessing patients with suspected heart attacks.
Historically, some less common forms of heart attack, which evidence shows affect women far more than men, have been classified as less important, with treatment and care often worse as a result.
Experts said women had been receiving less effective treatments that did not always target the specific cause of their heart attack and could even make them more unwell.
The changes were announced in Munich on the opening day of the annual congress of the European Society of Cardiology (ESC).
Professor Bryan Williams, chief scientific and medical officer of the British Heart Foundation, said: “This is a landmark moment, a radical shift in how we define and diagnose heart attacks worldwide which will transform people’s care.
“For decades, women have missed out on accurate diagnoses and treatment.
“This focus on finding less common causes of heart attacks, which predominantly affect women, should help to change that. It could be life-changing for huge numbers of women in the UK and worldwide.”
The new guidance upgrades three types of heart attack that can be up to 10 times more common in women and are often caused by childbirth, exercise and emotional stress.
The most serious cases, previously known as “type 1” and now classed as “primary” heart attacks, had previously prioritised those caused by a clot blocking blood flow to the heart.
Other forms can involve reduced blood flow for different reasons, including the tightening or tearing of coronary arteries. These can be more likely to be missed or treated less urgently.
The guidance also introduces a lower diagnostic threshold for women based on levels of troponin, a protein released into the blood when the heart is injured and damaged.
Previously, women were expected to meet the same troponin threshold as men to receive a diagnosis.
Williams said the streamlined heart attack categories would also help patients understand the cause of their heart attack and what comes next.
The three upgraded types are coronary artery spasm, coronary embolism and spontaneous coronary artery dissection (SCAD).
Coronary artery spasm involves the tightening of an artery, which can deprive the heart muscle of blood and oxygen. It can be caused by emotional stress, exercise or extreme cold.
Coronary embolism occurs when a blood clot or fatty deposit travels to a coronary artery and causes a blockage.
SCAD is caused by a tear in a coronary artery. Around 80 per cent of cases occur in women, and it often happens during or soon after pregnancy.
Professor Nicholas Mills, a cardiologist at the University of Edinburgh who led the international taskforce behind the guidance, said it was “the first time that we’ve had a truly global approach to aligning how we diagnose what is probably the most important diagnosis there is”.
He said: “It kills so many people, and we’ve never got everyone together around the world to agree how we’re going to describe it, classify it, explain it to our patients.
“Our job now is to implement this as widely as possible. It’s just as relevant for the UK as it is for any other country around the world. It is a revolution. It’s going to make care better for patients.”
Mills said there had been “unintended systematic bias against women”, including through the use of the key blood test for diagnosing heart attacks at an average level, which picks up all men but misses some women.
He said: “This is used for all types of heart attack in every emergency department in the world, and we want to make sure that it’s used correctly.”
The guidance was drawn up by the ESC, the American College of Cardiology, the American Heart Association and the World Heart Federation.
KOVE Medical has raised €1.7 million to support first-in-human studies of an implantable device designed to reduce preterm birth risk after foetal surgery.
The University of Zurich spin-off is developing a device designed to close defects left by surgical instruments following fetoscopy, a minimally invasive procedure performed inside the womb.
Fetoscopies can treat life-threatening conditions before birth but require surgical instruments to pass through the uterine wall and amniotic sac.
This can weaken the protective membrane, causing fluid leakage or rupture and often leading to preterm birth.
KOVE Medical said in a statement on LinkedIn: “This is a crucial step forward for our company, and we are incredibly grateful for the strong support and trust from our syndicate of visionary angel investors.”
KOVE Medical says its device closes the defect at the end of the procedure, stabilising the membrane and preventing complications. The aim is to make in-utero interventions safe enough to become a standard method of care.
The company plans to use the seed funding to reach first-in-human studies, a key milestone for a medical device seeking regulatory approval.
The CHF1.6m round was backed by a syndicate of angel investors.
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