Baby Loss Awareness Week

Philip Dunne Excerpts

Tuesday 10th October 2017 Commons Chamber

[The Minister of State, Department of Health (Mr Philip Dunne)]

Before I start the debate, Madam Deputy Speaker, let me say that I am delighted that you were able to pay tribute to all of our Doorkeepers and, in particular, to Trevor, on his last day here.

I beg to move,

That this House has considered Baby Loss Awareness Week.

I am personally very pleased that this debate is being held in Government time, having participated in last year’s debate on baby loss. It was one of the most moving experiences I have had in this Chamber, as Members from both sides of the House gave expression to their own experiences. That helps to send a signal outside this place of the significance that we accord this, not just within the Department of Health and the NHS; Members of this House sympathise with the many members of the public who go through such experiences. It does this House a good service when Members who feel able to do so place on the record their own experiences. It is right and important that we continue to raise awareness of the devastating impact of baby loss.

I wish to restate at the outset this Government’s commitment to providing high-quality bereavement care and to reduce the numbers of babies who are lost too soon through miscarriage, stillbirth or other causes such as sudden infant death syndrome. I pay tribute to all those who are sharing their personal experiences this week. In particular, I thank my hon. Friends the Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince), who are in the Chamber today, and all members of the all-party parliamentary group on baby loss, which they co-chair, for achieving so much in raising awareness during this past year.

I wish to update the House on some of the initiatives that the Government and the NHS have put in place since last year’s debate to improve safety, reduce stillbirths and other adverse maternity outcomes and improve bereavement care. I believe that all hon. Members support the ambition of the Secretary of State to halve the rates of stillbirth, neonatal and maternal deaths and brain injuries that occur during or soon after birth by 2030, and to achieve a 20% reduction in rates by 2020.

Shortly after the debate last October, the Secretary of State launched the safer maternity care action plan, which set out additional support for the maternity and neonatal services working to achieve that ambition. The plan set out a range of initiatives on five themes. First, there is a focus on leadership, with the establishment of local, regional and national maternity safety champions to promote professional cultures, teamwork and continuous improvement. Every trust with maternity services has pledged to appoint a maternity safety champion, and 88 out of the 134 trusts that provide maternity services now have named leads.

Secondly, there is a focus on learning and best practice. This includes the Saving Babies’ Lives care bundle to reduce stillbirths, which was launched by NHS England in March 2016. Saving Babies’ Lives brings together four elements of care that are recognised as evidence-based and/or best practice: reducing smoking in pregnancy; risk assessment and surveillance for foetal growth restriction; raising awareness of reduced foetal movement; and effective foetal monitoring during labour. The Department has also funded Sands and Best Beginnings to develop and promote the “Our Chance” campaign to give parents knowledge and confidence to maximise their chances of healthy outcomes.

Thirdly, there has been a focus on multi-disciplinary teams with an £8.1 million maternity safety training fund, which is designed to ensure that staff have the skills and confidence they need to deliver world-leading safe care. All 134 trusts with maternity units have now received funding and are implementing training packages. Many of those are being delivered by the charity Baby Lifeline, which I met this morning to learn some of the benefits that this training is bringing to improving safety, reducing error, and helping patient outcomes.

I visited Leeds teaching hospital a couple of weeks ago and heard from midwives about their multi-disciplinary training programme “Deliver me safely” in which they and doctors undergo training together in the recognition that human factors can contribute to harm in maternity systems. These simulations focus on situational awareness and team interactions, challenging some cultural hierarchical attitudes, which I am afraid can be prevalent in parts of the NHS, and encouraging everybody to speak up if they have safety concerns.

Lastly, there has been a focus on innovation, with the launch of a maternity safety innovation fund of £250,000, which has supported 25 local maternity services to create and pilot new ideas, and of the national maternal and neonatal health safety collaborative to build local capability in quality improvement and to provide structured support for local teams. One example of this is the safer films project at the University Hospitals Coventry and Warwickshire NHS Trust, which is developing staff training films, using headcam devices to show interactions with clinicians from the mother’s perspective. The patient’s view of the drills undertaken around her allows clinicians to look back at the impact that their activity, including how they communicate with women and their partners, has on the patient.

Just last month, the Secretary of State hosted a roundtable with 25 key partners across the health system to discuss evidence and current NHS clinical practice on supporting women to have safe births. There has been an enthusiastic response to the Secretary of State’s ambition, with a range of initiatives developed by national and local NHS organisations, royal colleges and charities. We will continue to work with our partners to align these initiatives with the work of the maternity safety action plan. I am happy to report that we are on track to achieve our 2020 ambition. The stillbirth rate in England has fallen from 5.1 per 1,000 births in 2010 to 4.4 in 2015. The neonatal mortality rate was 2.6 deaths per 1,000 births in 2015, down 10% from 2.9 in 2010.

I would like to touch briefly on the importance of learning from when things go wrong in clinical care. Many parents I have spoken to have made it clear they want maternity and neonatal services to learn from the deaths of their babies so that other families do not have to go through the experience of losing a much-loved and wanted child if that can be prevented. Recent publications from the Royal College of Obstetricians and Gynaecologists and MBRRACE-UK—Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK—found that some local reviews of stillbirths and neonatal deaths were of poor quality. Input from parents or independent experts is not routinely sought, and there is insufficient information to understand the quality of care provided.

To improve the quality of those reviews and to learn from them, the Department of Health, together with the Health Departments in Scotland and Wales, has funded the development of a national standardised perinatal mortality review tool to support systematic, multidisciplinary reviews of the circumstances and care leading up to every stillbirth and neonatal death. The tool, which will be available at the end of this year, will also support clinicians to talk with parents about the care review and how they can contribute to the process.

Last month, I laid the draft health service safety investigations Bill in Parliament. This Bill will take forward the work of the current independent healthcare safety investigation branch, which came into operation last April. Under the proposals, HSIB will have far-reaching access so that it can investigate serious safety incidents or risks to patient safety; help to develop national standards on investigations; and provide guidance and training to improve investigative practice across the health service.

Earlier this year, we also consulted on proposals to introduce a system of consistent and independent investigations for all instances of severe avoidable birth injury, along with access to ongoing support and compensation for eligible babies through an administrative scheme. The public consultation into a rapid resolution and redress scheme for severe avoidable birth injury concluded at the end of May, receiving more than 200 responses. We are currently in the process of listening to people’s views, and we aim to publish a formal response soon.

Turning to bereavement care, a clear message that we heard last year, particularly from my hon. Friends the Members for Eddisbury and for Colchester and the hon. Member for Kingston upon Hull North (Diana Johnson), who I am pleased to see with us this evening, was about the need for a bereavement care pathway to ensure that all families experiencing baby loss receive the highest quality of care, no matter where they live.

Since last year’s debate, the Department has funded Sands to deliver a national bereavement care pathway. I am delighted that 11 wave 1 pilot sites were announced yesterday. I know from the experience of my friends and colleagues that care in bereavement is best described as patchy. In some cases, I could use a less flattering adjective. There is no doubt that we need to do more to raise the training of staff and the facilities available to look after families who go through a bereavement in a hospital setting, and indeed to provide care and support to those who suffer loss outside a hospital setting. That is an important initiative.

Earlier this year, Sands, NHS England and the London maternity clinical network published a new maternity bereavement experience measure. That tool aims sensitively to enable parents whose baby has died to feed back about the care they received. It also aims to support services to learn from the experiences of bereaved parents and identify where local improvements may be needed.

Sands is also working on a project for NHS England on the role of the bereavement midwife. The project will make recommendations for the remit of the role of the bereavement midwife and give guidance on the support structures required around the role.

Since 2010, the Government have invested £35 million in the NHS to improve birthing environments, including better bereavement rooms and quiet spaces at nearly 40 hospitals to support bereaved families. Whenever I visit maternity units, I ask to see the bereavement suite. I am always impressed by the quality of the suites, by the feedback from families and staff alike and by how the commitment of many families who have gone through such terrible loss has often led to them raising funds to help to create better bereavement facilities in hospitals.

[Anna Soubry (Broxtowe) (Con)]

I commend the Minister for his excellent speech. I am sure that he will join me in congratulating Forever Stars, which is exactly the sort of charity that he has described. It was started by two of my constituents, who sadly lost their baby, Emily, who was stillborn. They have raised about £200,000 for two suites. A third is on the way, and they are now fundraising for counselling services for the siblings of babies who have not survived.

[Mr Dunne]

I congratulate my right hon. Friend and thank her for drawing that to the House’s attention. That is one of the most significant examples of fundraising for such suites that I have come across. I pay tribute to the family involved and to the efforts to raise funds for the counselling of siblings, who go through a traumatic experience as well.

I conclude by reiterating that the Government are fully committed to reducing the number of babies who die during pregnancy or in the neonatal period, and to providing support for bereaved families.

--- Later in debate ---

[Mr Dunne]

I am grateful for the opportunity to respond to some of the points that have been raised during this excellent debate. It is important to recognise and welcome the cross-party support from Members, including the hon. Member for Ellesmere Port and Neston (Justin Madders). We heard 14 contributions from other Members, including five, by my count, who have personally suffered—or their families have suffered—the loss or miscarriage of a baby, as well as two from experienced doctors: my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) and the hon. Member for Central Ayrshire (Dr Whitford), who brought their particular expertise to the debate. I am grateful for the support from Members on both sides of the House for the Government’s action plan—for what we have done in the 12 months since our last debate on this subject, and for what we are planning to do.

A number of issues have been raised today. I will not go into detail about Members’ constituency concerns, although I will say to the hon. Member for Kingston upon Hull North (Diana Johnson) that when, as a Shropshire Member, I was dealing with one of my constituents who suffered an inability to find out what had happened to the ashes of the baby they had lost, which was similar to what occurred in Hull, my experience was of talking to the local authority and persuading it that this was the right thing to do. I should be happy to help the hon. Lady, if she needs help from the Department, to emphasise again to her local authority that it is indeed the right thing to do.

Members have challenged me on a couple of issues, particularly that of coroners’ reports. We are introducing a perinatal mortality review tool to allow investigations to be undertaken, with information collated in a manner that can then inform and be learned from. We will watch with interest what happens in Scotland, but at this point I think we need to get the tool working and see how it goes. In my opening speech, I mentioned the health service safety investigations branch on which we are consulting. We envisage it as having a role in looking at some of the more extreme cases, but only if it decides to do so.

A number of colleagues talked about the use of private Members’ Bills to try to drive this agenda forward. I can confirm to my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) that the Government will support his Bill on bereavement leave, which was also mentioned in the excellent speech of my hon. Friend the Member for East Renfrewshire (Paul Masterton). I cannot promise that we will support all the other measures that the all-party parliamentary group comes up with, but we will certainly look at them with interest.

Following last night’s launch of the national bereavement care pathway, I am particularly pleased, in Baby Loss Awareness Week, that that has received so much support from the APPG, the charities and the healthcare professionals who work in this field. Finally, let me say a big thank you to all the midwives, doctors and healthcare support workers who do such a fantastic job, delivering more than 700,000 babies successfully and also helping parents who, sadly, do not experience the happiness of a healthy baby.

Question put and agreed to.

Resolved,

That this House has considered Baby Loss Awareness week.