Recommendation 20

Evidence from the Royal College of Obstetricians and Gynaecologists suggested that the maternity workforce is struggling under the pressure of delivering increasingly complex care, with more than half of births involving medical intervention, such as a caesarean section or the use of instruments such as forceps.47 Similarly, evidence from Sands and Tommy’s Joint Policy Unit raised concerns that inadequate training, poor workforce planning and failure to adhere to staffing requirements have created the conditions which result in clinical negligence claims being filed.48 NHS England told us it carefully monitored trusts with high levels of maternity related clinical negligence claims and around 30 trusts are taking part in its maternity support programme.49 However it accepted that it had struggled to reduce maternal mortality rates in recent years, pointing to increasing maternal risk factors such as obesity and age.50 NHS England told 41 The Rehabilitation Code is a voluntary framework offered by insurance companies in the context of personal injury claims: Rehabilitation Code (Code of Best Practice on Rehabilitation, Early Intervention and Medical Treatment in Personal Injury claims, 2015 42 CCC (by her mother and litigation friend MMM) (AP) (Appellant) v Sheffield Teaching Hospitals NHS Foundation Trust (Respondent) 43 Qq 46, 48 44 Qq 43, 48 45 C&AG’s Report, para 3.23 46 Q 48 47 Royal College of Obstetricians and Gynaecologists (CCN0021) 48 Sands and Tommy’s Joint Policy Unit (CCN0003) 49 Q 84 50 Q 51 15 us that it expects the final part of the Amos Review into England’s maternity and neonatal services in 2026 but this did not mean it was waiting to act in its recommendations.51 Disproportionate legal costs