• NHS England finds 74.2 per cent of CCGs not meeting maternity standards
  • Sevenfold variation in the likelihood of neonatal death
  • Almost 20 per cent variation found across England in how women perceived patient choice and maternity experience

Almost 75 per cent of clinical commissioning groups are failing to provide the expected standards of maternity care in England, new NHS England ratings show.

CCGs in England have been given an overall rating based on four improvement indicators published by NHS England: patient choice; experience; maternal smoking; and neonatal mortality rates.

Eleven CCGs were reported as having “greatest need for improvement” with another 144 needing some improvement. Only one, West Kent CCG, was labelled as “top performing” with another 53 rated as “performing well”.

The ratings showed:

  • Significant variation in neonatal mortality and stillbirth rate per 1,000 births, with 13.2 infant deaths per 1,000 in North Kirklees and just 1.8 in Bracknell and Ascot. The national average was 7.1 per 1,000 births.
  • 65.4 per cent of women across all CCGs felt they had a choice of maternity services, with even the best performing CCG in this category perceived as offering choice to just three-quarters of women.
  • A variation of almost 20 per cent in how women rated their experience of maternity services, ranging from 69.8 per cent for women in Tower Hamlets, to 87 per cent for those within the Bath and North East Somerset CCG area.
  • Eleven regions where more than 20 per cent of women were smoking up to their due date, with Blackpool, Swale and North East Lincolnshire the worst CCG areas

The new maternity ratings are one of six “clinical priority areas” that CCGs will be rated on as part of a CCG improvement and assessment framework by NHS England. Speaking at the Conservative Party conference earlier this month, health secretary Jeremy Hunt referred to the new system as “Ofsted ratings.”

A spokesman for NHS England said today: “The data will help CCGs self-assess more effectively and target areas which need improvement, and NHS England will be offering a comprehensive support package to enable that improvement to happen.”

However the CCG improvement and safety framework for 2016-17 said it was “designed to supply indicators for adoption in STPs as markers of success”.

With maternity seen as an area of contention in the country-wide sustainability and transformation plans it is unclear how these ratings will impact on future service reconfiguration.

Worst performing CCGs

CCGMaternal smoking rate at delivery (2015-16 Q3)Neonatal mortality and stillbirth rate per 1000 births (2014 ONS Extract)Women’s experience of maternity service score out of 100 (CQC Maternity Survey 2015)Choice’s in maternity services - score out of 100 (CQC Maternity Survey 2015)Overall  rating
South Warwickshire CCG 7.9% 9.8 72.1 56.1 Greatest need for improvement
Slough CCG 8.1% 8.1 72.5 58.7 Greatest need for improvement
South Gloucestershire CCG 10.7% 7.6 75.0 61.0 Greatest need for improvement
Milton Keynes CCG 10.8% 7.2 72.9 57.6 Greatest need for improvement
East Riding of Yorkshire CCG 14.7% 5.6 72.5 57.7 Greatest need for improvement
Wolverhampton CCG 15.8% 10.3 75.1 59.6 Greatest need for improvement
Bradford Districts CCG 18.2% 10.6 79.2 66.9 Greatest need for improvement
Nottingham City CCG 18.8% 12.4 78.6 67.7 Greatest need for improvement
Durham Dales, Easington and Sedgefield CCG 21.2% 5.9 80.3 60.7 Greatest need for improvement
South Tees CCG 22.3% 6.4 76.6 56.6 Greatest need for improvement
Hull CCG 22.5% 10.7 81.1 66.5 Greatest need for improvement

Best performing CCG

CCGMaternal smoking rate at delivery (2015-16 Q3)Neonatal mortality and stillbirth rate per 1000 births (2014 ONS Extract)Women’s experience of maternity service score out of 100 (CQC Maternity Survey 2015)Choice’s in maternity services - score out of 100 (CQC Maternity Survey 2015)Overall  rating
West Kent CCG 10.1% 4.1 83.6 69.1 Top performing

New CCG ratings: 75 per cent failing on maternity care