The NHS England Maternity Review has now been published, and while there is much to welcome, it is also a great opportunity missed. Group B Strep is the most common cause of severe infections in newborn babies and of meningitis in babies under 3 months of age. But, yet again, this issue of group B Strep has been overlooked and ignored.
The review sets out a five year forward view for improving outcomes of maternity services in England. The vision is laudable: for maternity services across England to become safer, more personalised, kinder, professional and more family friendly. For every woman to have access to information to enable her to make decisions about her care. Where Mum and baby can access support that is centred around their individual needs and circumstances. And for all staff to be supported to deliver care which is women-centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries. But, without specifics, what likelihood is there that any of the longstanding challenges in tackling group B strep will be addressed under the new arrangements?
Group B Strep Support was invited to participate in the review. A number of parents also contributed at drop-in events and through online consultations, repeatedly raising their concerns about:
- the lack of information provided about group B Strep within existing maternity services;
- the failure of most NHS trusts to follow the UK standard for testing for group B Strep carriage published by Public Health England;
- the confusion among health professionals about what action to take when GBS is detected, and;
- the failure of many health professionals to recognise key risk factors for GBS infection in babies.
How, therefore, in what is proposed in this review – essentially a community-based model of maternity services – can any of these serious incoherencies and shortcomings be addressed? More likely, surely, will be increasing variation and inconsistency in practice, and greater danger, as more health professionals operate remote from their colleagues.
We know that during the consultation, a number of parents were assured that two specific issues would be addressed by the review:
- improved provision of high quality and timely information about group B Strep for pregnant women and;
- access within the NHS to a reliable test for GBS carriage for such women.
They weren’t. Though you can see from the National Maternity Review Online Survey Analysis – Survey on Loss and Complications here that these issues were raised time and time again.
- 16% of comments on the question “Care during pregnancy (Complications) – Quality of care” related to GBS testing and the wish for this to be available to all
- 7% of comments on the question “What could have been done differently during pregnancy (Antenatal Care) – Quality of care” related to more GBS testing
- 1% of comments on the question “Specialists communication with existing antenatal team (Complications)” related to information/testing for GBS
In summary, we cannot see how the recommendations in the report will help to address the UK’s unacceptably high and increasing rate of group B Strep infections in babies – infections that are usually preventable.
If this is the best on offer then clearly we need to look elsewhere – to the Royal College of Obstetricians & Gynaecologists and NICE – and to like-minded charities to create improvements in preventing group B Strep infection in babies.
