RCPCH responds to NHS England’s three year delivery plan for maternity and neonatal services

On 30 March NHS England published their three year plan for maternity and neonatal services.
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The plan seeks to set out “how the NHS will make maternity and neonatal care safer, more personalised, and more equitable for women, babies, and families.”

NHS England has engaged a wide range of stakeholders who supported the development of this plan. This includes women and families who have used or are using maternity and neonatal services, members of the maternity and neonatal workforce, Royal Colleges, workforce leaders and commissioners of services, and representatives from charities and other organisations.

Following discussions, for the next three years, services are asked to concentrate on four themes:

  • Listening to and working with women and families with compassion
  • Growing, retaining, and supporting our workforce
  • Developing and sustaining a culture of safety, learning, and support
  • Standards and structures that underpin safer, more personalised, and more equitable care

In response to the publication, Dr Camilla Kingdon, RCPCH President said:

We strongly welcome the engagement approach taken by NHS England to bring women and families who have used or are using maternity and neonatal services into the discussions, alongside the workforce, commissioners and wider. 
Over the last few years, safety issues in maternity and neonatal services have made headlines leading to the important Kirkup and Ockenden reviews and lessons across the system. We as a College, and all our paediatricians are dedicated to making services safer for patients. 

There is much to be welcomed in this delivery plan and its commitment to improving safety and addressing inequalities and workforce pressures. It’s good to see the focus on improving information sharing, data collection and the interoperability of systems and we would encourage this to be extended across child health services and wider key partners. We also welcome the commitment to ensuring junior, speciality and associate specialist neonatal medical staff have appropriate clinical support and supervision in line with BAPM guidance.

However, it’s so important to note that these services are stretched and staff are trying hard to meet ever rising demand and complexity of cases. Trusts and ICBs have many competing priorities for their focus and resources. It is essential that they are supported appropriately with funding and expertise to ensure this delivery plan can be achieved.

We also ask that NHS England ensures adequate funding is provided to address the shortage of neonatal capacity through the introduction of more neonatal intensive care cots as recommended in the Neonatal Critical Care Review and improve triage within expert maternity and neonatal centres so that the right level of care is available to babies as close to the family home as possible.  If we truly want to see the aspirations of this plan realised, then significant investment in capital infrastructure will be needed, alongside substantial and ambitious workforce planning.

What we need now is real investment from government, to enable regular workforce planning at a local, regional and national level to ensure a sustainable, appropriately funded, multidisciplinary workforce that safely meets the needs of women and their babies. 

In reality, while the delivery plan is a start, the task now turns to local implementation and coordination, but they cannot do this alone. It is disappointing that the review has not adopted our recommendation for a national neonatal safety champion, who could oversee progress and adoption of all these recommendations. We will continue to make this call.