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Mothers are to be asked under a government scheme to comment on the quality of care they and their babies received from midwives and doctors. Photograph: Christopher Furlong/Getty Images
Mothers are to be asked under a government scheme to comment on the quality of care they and their babies received from midwives and doctors. Photograph: Christopher Furlong/Getty Images

New mothers will rate midwives and doctors on childbirth care

This article is more than 11 years old
Publishing results of 'friends and family test' can help women make vital decisions, says Royal College of Midwives

Every woman who gives birth is to be asked to rate how the NHS looked after her, as part of a new government drive to improve the quality of maternity care.

All 700,000 women a year who have a child will get the chance to give feedback on how doctors, midwives and nurses cared for them, during one of the most stressful periods of their lives. The ratings will be then published as a way of encouraging hospitals and birth centres to ensure women get high-quality care.

Confirming the plan to the Observer, health minister Dr Daniel Poulter, who still works part-time as an NHS obstetrician at a London hospital, said it was part of the move to introduce a "friends and family test", under which patients will be asked if they would recommend the care they have received to their loved ones. "This will introduce scrutiny and transparency into the quality of maternity care women receive," said Poulter.

"It will bring under the spotlight the satisfaction and quality of care that mothers feel they have received at that particular maternity unit, whether that's an obstetric unit in a hospital or a birthing centre where midwives are in charge. The idea is that hospitals really listen to what women say. If the feedback says that local women wouldn't recommend it as a place to give birth and that there are concerns about that unit, then that's a very strong lever to encourage or force improvements in care," he said.

The "friends and family test" will first be brought in for all patients who arrive in A&E or are admitted as acute cases from April. They will be asked: "How likely is it that you would recommend this service to friends and family?"

Mothers, though, are to be asked more detailed questions, or to rate the care they have received at different stages throughout their pregnancy. The areas will include how they were treated by antenatal staff during their labour and how they were counselled over key tasks in the days after birth, such as learning how to breastfeed and any emotional support they may have received.

The feedback will cover a woman's entire experience of the NHS, from when her 12-week scans confirms the pregnancy to the help she gets if she ends up suffering postnatal depression, and support from community midwives after she returns home.

The Royal College of Midwives, Department of Health and the new NHS Commissioning Board, which will assume responsibility for running the health service from April, are devising exactly what questions should be asked, how and when. The new scheme will be tested in early 2013 in four hospitals, including St Thomas's in central London, which already use questionnaires to collect mothers' opinions. It will then be introduced from October at all 150 hospital trusts which provide maternity care.

Cathy Warwick, chief executive of the RCM, which represents the 30,000 midwives in England, agreed that the move would help women decide where to give birth. "It will lead to women choosing places where they believe they will get high-quality care or go for a home birth or to a midwife-led unit, if these are rated positively by women. Last year's birthplace study showed that women with low-risk pregnancies were more satisfied if they had a home birth or used a midwife-led unit than an obstetric unit", said Warwick.

Sally Russell, a co-founder of the Netmums website, welcomed the move. "What prospective parents want to know is about the experience others have had, not just the facts and figures around quality of care", she said. The NHS needed to collect in a more systematic way the sort of patient experience data, both positive and negative, currently collated by Netmums and the Patient Opinion website.

Mothers should be asked for feedback when they are being discharged or soon after they get home, as they may feel reluctant to be honest while still being cared for in case that affected their treatment, Russell added.

Midwives may feel "threatened" by mothers giving their views, she added. "It's normal for people to feel concerned when something like this happens. But feedback should help them to learn when mistakes have happened and identify what's important for patients," said Russell.

The feedback will inevitably highlight the ongoing shortage of midwives, which the RCM warns is hindering the efforts by the NHS to properly look after the growing number of women giving birth during a decade-long baby boom, added Russell.

But Poulter said that midwives and other maternity staff should not be anxious. "From working in maternity care myself, I welcome feedback from women and their families. As a doctor or midwife you want to know if you can do better. You need to know that", he said.

More on this story

More on this story

  • GPs' patient satisfaction tests 'can act as flashing light', says Cameron

  • Independent midwives: why we can't afford to lose them

  • A day in the life of... Elsie Gayle, independent midwife

  • GPs should be subject to patient satisfaction tests, says David Cameron

  • Is Call the Midwife anything like the profession today?

  • GPs in crossfire as separated parents seek access to children's records

  • A cathedral for GPs: the south London health centre with big civic ambition

  • Childbirth: why I take the scientific approach to having a baby

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