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The latest report on patient safety in England reveals a concerning rise in maternal deaths, especially among those of an ethnic background, as well as a North-South divide.
Two years on from its first survey of patient safety, the 2024 report finds that for the first time in a decade, rates of maternal and neonatal deaths have risen and continue to rise.
Maternal deaths per 100,000 maternities increased from 9.71 in 2022 to 13.41 in 2024.
The report was produced by the Institute of Global Health Innovation at Imperial College London, and commissioned by the charity Patient Safety.
“Our latest report on patient safety in England reveals alarming declines. The deterioration in maternity care, in particular, requires immediate action. Our analysis highlights a troubling increase in neonatal and maternal deaths, with Black women disproportionately affected,” said Ara Darzi, co-director of the Institute of Global Health Innovation.
The data also show that maternal death rates for women from Black ethnic backgrounds are almost three times higher than for White women. Perhaps unsurprisingly, the national survey, conducted in partnership with YouGov, found that people from Black ethnic backgrounds were significantly more concerned about safety in maternity services than people from any other demographic group.
North-South divide
While compared to OECD countries, the UK as a whole performs about average on rates of deaths from treatable causes, such as sepsis and blood clots, the report also found that the impact of unsafe care was not spread evenly across England. Adverse effects of medical treatment, which led to death or disability, was twice as high in the North East of England than in Greater London.
The North of England also had the highest proportion of hospital trusts with a greater than expected number of deaths – a figure that has increased from 8% to 14% since the last report.
The human, societal and economic cost of clinical harm, the report says, is considerable, and growing.
Based on work by the Organisation for Economic Co-operation and Development (OECD), the costs of unsafe care in England can be conservatively estimated at £14.7 billion a year. This figure excludes the indirect impact of harm, such as on people’s quality of life and ability to work, and the rising costs of clinical negligence claims.
Two recommendations
The report makes two recommendations support the long-term improvement of patient safety in England.
First, it suggests that local NHS organisations must be supported to adopt evidence-based interventions to tackle the most common safety problems causing significant harm to patients. “Our analysis of trust patient safety plans identified six common problems that many organisations are tackling, such as pressure ulcers and patient falls. Adopting proven interventions to common problems like these would finally see the NHS truly acting like a National Health Service,” it says.
The first port of call for NHS organisations should be a repository of such interventions, along with the support they need to implement them, rather than developing their own solutions from scratch.
Second, it recommends that national organisations agree on a focused set of patient safety improvement priorities for the system to rally around.
“Our analysis found a crowded landscape of patient safety bodies, an opaque process for national priority setting, and evidence that the system cannot keep pace with the volume of recommendations it receives,” the report says.
It suggests that patients and healthcare workers become partners in the development of these priorities, and where national organisations rationalise their own activities to ensure the NHS is supported to deliver improvements against them.
