Joint statement from the RCoA and the OAA on the publication of the Independent Review of Maternity Services at Nottingham University Hospitals NHS Trust

The Royal College of Anaesthetists (RCoA) and the Obstetric Anaesthetists’ Association (OAA) welcome the publication of the Independent Review of Maternity Services at Nottingham University Hospitals NHS Trust.

First and foremost, our thoughts are with the women, babies and families whose experiences have informed this report. We recognise the immense suffering described by many families and the courage it has taken to share their stories. Their determination to seek answers and drive improvements in care has made an important contribution to maternity services across the UK.

The report highlights the importance of adequate staffing levels, multidisciplinary working, ring-fenced, team-based education and training, and the timely recognition and management of deteriorating mothers and babies. These themes are all too familiar to those working in maternity services and reflect challenges faced across the NHS. 

We welcome the report’s focus on workforce planning, higher levels of (enhanced) maternal care and multidisciplinary learning. Safe care depends not only on the commitment and expertise of individual clinicians, but also on having sufficient staff, time, resources and facilities to meet the needs of women and babies. Maternity care is delivered by teams, and ensuring those teams are appropriately supported is essential if women are to receive the care they deserve.

The report also recognises the important contribution made by anaesthetists within maternity services, particularly in the care of women with complex medical conditions, those requiring higher levels of care, and those experiencing obstetric emergencies. Obstetric anaesthetists are an integral part of multidisciplinary maternity teams, providing care around the clock and supporting some of the most seriously unwell women in maternity units.

We are particularly encouraged by the report’s emphasis on enhanced maternal care and the need for regular, ringfenced, multidisciplinary training to support the recognition and management of deteriorating and critically ill women. These are areas in which anaesthetists play a central role and where continued investment has significant potential to improve outcomes for women and babies.

While it is important that organisations and systems learn from failures in care, it is equally important to recognise the many dedicated maternity staff who work tirelessly every day, frequently under pressure to achieve the impossible with limited resources and staff available. The overwhelming majority of clinicians come to work wanting to provide the best possible care for women and families and are deeply affected when systems fail to support them in doing so. Improving outcomes requires not just individual excellence but healthcare systems that are adequately staffed, resourced and supported.

The RCoA and OAA remain committed to working with women, families, professional organisations, NHS England and maternity services across the UK to support the implementation of the report’s recommendations and to continue improving the safety and quality of maternity care.

Every woman deserves the most effective, safe, compassionate and personalised maternity care, and every family deserves confidence that lessons will be learned when care falls short of that standard. We look forward as a profession to engaging with others in future work to improve standards in maternity care.