Care Quality Commission
National survey shows some improvement in maternity experiences, but help not always available when needed
Findings from a survey of more than 25,500 women and people who used NHS maternity services in 2023 indicate some aspects of care have improved in the past year, but many maternity care experiences are still less positive than they were five years ago.
Published today (Friday 9 February 2024), the findings of CQC’s latest annual national maternity survey capture what women who gave birth in February 2023 felt about the care they received while pregnant, in hospital during and after labour, and once at home in the weeks following the arrival of their baby.
This year’s results show that many respondents were more positive about their interactions with staff - particularly during antenatal care. Most people surveyed (81%) said they were ‘always’ given enough time to ask questions or discuss their pregnancy at antenatal check-ups (up from 77% in 2022), and 83% said that midwives providing antenatal care ‘always’ listened to them (an increase from 80% in 2022).
Positive experiences were also reported during labour and birth. Most (85%) said they were given appropriate advice and support when they contacted a midwife or the hospital when in early labour (82% in 2022). Additionally, the vast majority said theirpartner was involved as much as they wanted during labour (94% in 2023 up from 90% in 2022), and four in five (80%) felt any concerns they raised during labour and birth were taken seriously by staff (an increase from 77% in 2022).
Mental health support had also improved in 2023. Three-quarters (75%) said their midwife ‘definitely’ asked about their mental health during antenatal check-ups (compared with 71% who said this in 2022) and 88% felt they were given enough support for their mental health throughout pregnancy (up from 85% in 2022).
However, for some women and other people who used maternity services the care they received fell short of expectations and the long term trend shows that satisfaction levels have fallen over time for many questions where a year on year comparison is available.
A quarter (25%) of people surveyed said they were left alone at some point during, or shortly after, the birth of their baby at a time when it worried them – a higher proportion than those who said this in 2018 (23%) and 2019 (22%).
In 2023 just over half of respondents (55%) were ‘always’ able to get a member of staff to help them when they needed it while in hospital after giving birth (down from 57% in 2022) and 10% said they were not able to get help at all.
Over the past five years, fewer women and other people using maternity services have reported saying they saw or spoke to a midwife as much as they wanted after giving birth - 73% in 2018 compared to 63% in 2023. And just under a third (32%) of those surveyed in 2023 said they would like to have had contact with a midwife ‘more often’.
More than a quarter (28%) of those surveyed felt they were not always treated with kindness or understanding while in hospital after giving birth – a small improvement on the 29% who said this in 2022 but still higher than in 2018 (26%) and 2019 (24%).
Survey results also show a five-year downward trend for respondents saying they were ‘always’ given the information and explanations they needed whilst in hospital after the birth. In 2023, 60% said they ‘always’ received the information and explanations they needed, compared to 65% who said this in 2018.
Subgroup analysis of the survey results at a national level show that those who had higher frequency of contact with the same midwife during their antenatal check-ups were more positive about their experiences for nearly all question areas. People with a long-term mental health condition reported lower levels of confidence and trust in staff providing antenatal care, were less likely to say they felt treated with respect and dignity and less likely to say their concerns were taken seriously. Additionally, survey respondents who had an emergency caesarean were more likely to consider making a complaint.
Commenting on the survey, Kate Terroni, CQC’s Deputy Chief Executive, said:
It is encouraging to see that satisfaction among many of those surveyed remains high, and a real positive that for some aspects of care people are reporting a better experience than in 2022. That’s a direct reflection of the efforts of frontline staff working hard to provide high quality care in the face of significant challenges.
However, it’s very clear that far too many women and people using maternity services feel their care could have been better. Positive feedback about the availability of staff and being able to get help or speak to a midwife while in hospital has declined over time. This echoes what we’re hearing directly from front line staff – many of whom have shared their own concerns about the impact of staff shortages on their ability to provide care.
It is vital that we listen to those who use and work in maternity services to understand what makes a good experience and what needs to improve. This will help ensure we can better support staff to provide the level of care that they want to be able to deliver every time and ensure a consistently good maternity experience for everyone. We will continue to report on the findings from our recent national maternity inspection programme to highlight where we find action is needed as well as where we see things working well. Alongside this I hope that all trusts will use their individual survey results to help identify what changes can be made to drive up quality in their own services.
This is the tenth survey of its kind that CQC has carried out to help trusts better understand the experiences of women and other people using maternity services and involved 121 NHS acute trusts. The results are used by CQC as part of its wider monitoring of hospital services and will feed into future maternity service inspections.
Questionnaires for the next CQC maternity survey will be sent out from April this year. The 2024 survey will ask women who give birth in February 2024 about their experience of care. CQC is encouraging people who receive the 2024 maternity survey via email or post to participate. This will help ensure the insight gathered is representative and reflects the views and experiences of all those receiving NHS maternity care in England so that targeted action can be taken to address areas where improvements are required.
About the Care Quality Commission
The Care Quality Commission (CQC) is the independent regulator of health and social care in England.
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.
We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.
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