Asked by: Kwasi Kwarteng (Conservative - Spelthorne)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has had discussions with NHS England on ensuring that (a) reviews, (b) investigations and (c) complaints processes relating to maternity services include consideration of the (i) impact of ethnicity on the care received and (ii) potential role of (A) racism and (B) discrimination.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England, along with the devolved administrations and the Crown Dependencies, funds Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries to collate ethnicity data, in relation to all perinatal and maternal deaths across the United Kingdom. They publish annual surveillance reports which provide comparators of rates of mortality for women and babies from different ethnic groups. They also publish confidential enquiries, assessing care provision along the whole care pathway, to identify areas requiring improvement.
The Maternity and Newborn Safety Investigations programme provides independent, standardised, and family focused investigations to provide learning to the health system. This includes analysis of data to identify key trends, and collaboration with system partners to escalate safety concerns.
Asked by: Bell Ribeiro-Addy (Labour - Streatham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to paragraph 4.2 of the report entitled A comparison of the care of Asian and White women who have experienced a stillbirth or neonatal death, published by the MBRRACE-UK Perinatal Confidential Enquiry on 14 December 2023, whether her Department has had discussions with NHS England on taking steps to improve how ethnicity data is recorded.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department has regular and ongoing discussions with NHS England, and other relevant bodies, on improving neonatal and maternity data quality. This includes discussions on how to improve the recording of ethnicity data. NHS Equity and Equality Guidance, produced as part of NHS England’s three-year delivery plan for maternity and neonatal services, includes ethnic coding data completeness to better understand local populations and their health outcomes. Ethnic coding data completeness has improved year on year, from 85% in 2019 to 93% in 2022.
Asked by: Anum Qaisar (Scottish National Party - Airdrie and Shotts)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce the number of (a) maternal and (b) perinatal deaths for women and children from migrant and refugee backgrounds.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
On 6 September 2021, NHS England published ‘Equity and equality: Guidance for local maternity systems’, which focuses on actions to reduce disparities in health outcomes for women and babies. Local Maternity Systems have been asked to plan interventions to improve equity for mothers and babies, which will benefit inclusion groups such as migrants and refugees. The guidance asks Local Maternity Systems to ensure equity in access, experience and health outcomes and address the leading causes of perinatal mortality and morbidity for babies from black, Asian and minority ethnic groups and those living in the most deprived areas. NHS England has provided £6.8 million to support Local Maternity Systems to implement these plans.
The Office for Health Improvement and Disparities’ guidance ‘Language Interpreting and Translation: Migrant Health Guide’ gives advice on health needs of migrant patients for healthcare practitioners. The guidance states it is the responsibility of NHS service providers to ensure interpreting and translation services are made available to patients free at the point of delivery. Healthcare employers should advise staff on the arrangements for local interpretation services.
Asked by: Matt Vickers (Conservative - Stockton South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to (a) reduce rates of stillbirth and neonatal deaths and (b) address racial inequalities in stillbirths and neonatal deaths; and if his Department will launch an inquiry into the rates of stillbirth and neonatal death among Asian and Asian British babies.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Department has funded the National Health Service to implement a range of initiatives to reduce stillbirths and neonatal rates, including the Saving Babies Lives Care Bundle which standardises five evidence-based elements of care demonstrated to reduce stillbirths and neonatal deaths; reducing smoking in pregnancy; risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction; raising awareness of reduced fetal movement; effective fetal monitoring during labour and reducing pre-term birth. There has been a 25% reduction in the stillbirth rate and a 29% reduction in the neonatal mortality rate for babies born after 24 weeks gestation since 2010.
NHS England and NHS Improvement published ‘Equity and Equality: Guidance for Local Maternity Systems’ on 6 September. This guidance asks Local Maternity Systems (LMS) to produce an analysis on health outcomes by 30 November 2021 and an action plan for mothers and babies from minority ethnic and other backgrounds. The guidance is supported by £6.8 million for LMS to implement these plans and targeted and enhanced continuity of carer. LMS are being asked to include four interventions to prevent avoidable deaths of babies in their action plans:
- targeted and enhanced continuity of carer for 75% of women from black, Asian and mixed ethnic groups by 2024 and additional midwifery time to support women from the most deprived areas;
- smoke-free pregnancy pathways for mothers and their partners;
- breastfeeding strategies to improve breastfeeding rates for women living in the most deprived areas; and
- culturally-sensitive genetics services for consanguineous couples.
A confidential enquiry into perinatal deaths of Black/Black British babies is currently being undertaken by the MBRRACE-UK Maternal, Newborn and Infant Clinical Outcome Review Programme. The Department has no current plans to concurrently establish an inquiry into the rates of stillbirth and neonatal deaths among Asian and Asian British babies.
Asked by: Marsha De Cordova (Labour - Battersea)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce the disparities of race and ethnicity enclosed in the latest still birth data published by the ONS.
Answered by Nadine Dorries
The Chief Midwifery Officer for England is leading work to reduce health inequalities around maternal and perinatal mortality. NHS England and NHS Improvement are also working to develop an equity strategy that will focus on reducing disparities. In January, the Department launched a £7.6 million Health and Wellbeing Fund which aims to reduce health inequalities among new mothers and babies.
Asked by: Lord Bishop of London (Bishops - Bishops)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when they expect to publish a report on the work to reduce health inequalities around maternal mortality rates, in particular the higher rate of death in childbirth for Black women, led by Professor Jacqueline Dunkley-Bent OBE; and what action will be taken as a result of this report.
Answered by Lord Bethell
NHS England and NHS Improvement are working with a range of national partners, led by the Chief Midwifery Officer for England and the National Specialty Advisor for Obstetrics, to develop an equity strategy which will focus on women and their babies from black, Asian and mixed ethnic groups and those living in the most deprived areas.
The National Perinatal Equity Strategy is in its final stages of development and will be published in the coming months. Following the publication, the Local Maternity Systems will be asked to submit an equity analysis covering health outcomes, community assets and staff experience and a co-production plan by 30 September 2021. Local Maternity Systems will then co-produce equity action plans by 31 December 2021.
Asked by: Thangam Debbonaire (Labour - Bristol West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of the findings of the Maternal, Newborn and Infant Clinical Outcome Review Programme's 2019 publication entitled Saving Lives, Improving Mothers' Care, on the elevated risk of maternal death for Black and Asian women.
Answered by Nadine Dorries
Analysis of maternal deaths, stillbirths and neonatal deaths, undertaken by MBRRACE-UK, shows that poor outcomes are much higher for mothers and babies from Black/Black British and Asian/Asian British ethnic groups and women living in the most deprived areas of the country.
Work to reduce health inequalities around maternal and perinatal mortality rates is being led by Professor Jacqueline Dunkley-Bent OBE, Chief Midwifery Officer. This includes understanding why mortality rates are higher, considering evidence about what will reduce mortality rates and taking action to reduce mortality rates. The work is multi-disciplinary and involves a range of stakeholder groups, including users of maternity services.
Asked by: Lord Taylor of Warwick (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the report by the Maternal, Newborn and Infant Clinical Outcome Review Programme Saving Lives, Improving Mothers’ Care, published November 2019, which concluded that "black women still have more than five times the risk of dying in pregnancy or up to six weeks postpartum compared to white women".
Answered by Lord Bethell
Analysis of maternal deaths, stillbirths and neonatal deaths, undertaken by MBRRACE-UK, shows that poor outcomes are much higher for mothers and babies from black/black British and Asian/Asian British ethnic groups and women living in the most deprived areas of the country.
Work to reduce health inequalities around maternal and perinatal mortality rates is being led by Professor Jacqueline Dunkley-Bent OBE, the Chief Midwifery Officer. This includes understanding why mortality rates are higher, considering evidence about what will reduce mortality rates and taking action to reduce mortality rates. The work is multi-disciplinary and involves a range of stakeholder groups, including users of maternity services.
Asked by: Ruth Jones (Labour - Newport West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of the MBRRACE-UK maternal deaths and morbidity statistics 2014-16 showing that (a) Asian women are nearly twice as likely, (b) mixed race women are twice as likely and (c) black women are five times as likely to die during or up to six weeks after pregnancy than white women.
Answered by Jackie Doyle-Price
The NHS Long Term Plan takes a concerted and systematic approach to reducing health inequalities and addressing unwarranted variation in care. NHS England and NHS Improvement are leading the work through the Maternity Transformation Programme to support maternity services to provide high-quality maternity care for all women.
Targeted and enhanced continuity of carer can significantly improve outcomes for women from ethnic minorities. The NHS Long Term plan sets out that 75% of black women will receive continuity of carer from midwives by 2024.
The Department is also funding research to investigate the factors associated with the excess perinatal mortality experienced by black/black British and Asian/Asian British ethnic groups and identify the factors associated with the excess risk of maternal death for black and South Asian women.