• Inspectors told not to promote “normality agenda” over caesarean
  • CQC has “reviewed” language that criticised providers for not promoting “normal” births
  • “Absolutely not our view” that trusts should reduce caesarean use says regulator

The Care Quality Commission has admitted that it was mistaken in promoting the “normality agenda” in maternity services.

Inspectors have criticised trusts in the past for not prioritising “normal” births over caesarean sections.

But now the CQC has said that it has “reviewed this language” and it now realises “in some cases” it got it wrong.

Promoting normal births at the expense of interventions like caesarean section “at any cost” was one of the factors that led to multiple baby deaths at Furness General Hospital, according to the 2015 report of Morecambe Bay Inquiry.

In August, CQC inspectors improved Walsall Healthcare Trust’s rating for maternity services from inadequate to requires improvement.

But the regulator also highlighted a lack of urgency in promoting normal births, saying: “We were not assured encouraging patients to have active births and developing the normality agenda was regarded as a priority.”

Today in a statement to the HSJ, Heidi Smoult, the CQC’s deputy chief inspector of hospitals, said: “It is absolutely not our view that trusts should be encouraged to reduce caesarean rates. It is about making sure the care provided is safe, personalised and appropriate.”

The CQC has now issued guidance to make sure the wording in its reports reflects this position and does not appear to “encourage one approach over another”.

The Royal College of Obstetricians and Gynaecologists also came in for criticism earlier this year for promoting normal births.

It conducted a review of Walsall trust’s maternity unit in October 2017 and told the trust to “review intervention rates and suggest ways to reduce inappropriate interventions in line with the normality agenda”.