£3.1bn spent over NHS pregnancy errors

An NHS Litigation Authority report shows that between 2000 and 2010, the organisation dealt with 5,078 claims which have resulted in payouts totalling £3.1 billion.

Junior doctors and inexperienced midwives are “often” involved in maternity care cases which result in legal action, according to the NHS LA, which manages legal claims made against the NHS in England.

A third of the money that was paid out, or is yet to be paid, is attributable to cases which resulted in the baby having cerebral palsy. There were 542 claims for cerebral palsy, with a combined pay out of £1.3 billion, data shows.

Misinterpretation or the poor management of the results of cardiotocograph (CTG) readings - which monitor a baby’s heart rate and a mother’s contractions while the baby is in the uterus - resulted in payments totalling £466m.

The highest number of claims were for mismanaged labour, with 715 claimants receiving a total of £424m.

Botched C sections accounted for the second highest number of claims - with 647 families receiving a total of £216m.

NHS LA chief executive Catherine Dixon said: “Having a baby while under the care of NHS doctors and midwives remains very safe. Out of 5.5 million births in England during the decade covered by the report, about one in a thousand result in a legal claim against the NHS.

“However, because maternity claims are so serious as they involve harm to mothers and their babies, it’s vital that we learn and share lessons from them so that professionals can improve their clinical practice in the future and prevent harm. That is what our report aims to do.”

Royal College of Obstetricians and Gynaecologists vice president David Richmond added: “This report has defined why problems occur and provides us with valuable information so that maternity services can put in place robust monitoring and risk identification systems to prevent them from recurring.

“Our most recent reports make a strong case for the NHS to move to a consultant-delivered service so that trainee doctors receive adequate support and women have access to qualified specialists throughout the day and night.

“Alongside the recommendations from the NHS LA, we now have good information on how we can learn from past mistakes so that new ones can be prevented.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “The biggest issue behind these claims is that most of the lessons to be learned from them are not new. It is tragic that the same problems reoccur in our maternity services year on year.

“The big question we all have to ask ourselves is why is it so difficult for well meaning professionals to put learning into practice?

“In maternity services we have excellent policies and guidelines which inform practice. We also have a strong body of evidence which should guide us into developing the services which are most likely to meet the needs of women and ensure positive outcomes. Far more needs to be done to ensure that maternity service provision reflects this evidence.”

Mike Farrar, chief executive of the NHS Confederation, added: “We are fortunate in this country that maternity care is relatively safe but to keep it that way the NHS has got to keep learning and improving.

“We must in particular learn from the occasions where things have gone very badly wrong. You cannot turn back the clock on a tragedy but you can do everything possible to prevent recurrence by focusing relentlessly on minimising risks.”

The Department of Health said that compensation payments are large for errors in maternity care because the children involved may have care needs that have to be funded for the rest of their lives.

Health minister Dan Poulter said: “The NHS remains one of the safest places in the world to have a baby, but no matter how well our midwives and doctors look after women giving birth, bad things still sometimes happen to a very small number of mothers and babies.

“On rare occasions care falls below acceptable standards and unsafe care should never be tolerated.

“As a doctor who has worked in maternity care, I am acutely aware of the pain and stress that can be caused to parents and babies in these situations. If these incidents hadn’t happened in the first place, the NHS would have had £3bn more to spend on patient care over the past ten years.

“The NHS should always learn from any mistakes to improve patient care in the future - which is exactly why reports like these are so important.”