Regional variations in care

Differences in the care received by women giving birth in hospitals across England are highlighted in a new RCOG report.

It states that 55% of all first-time mothers had some form of intervention during labour and delivery.

It found “substantial variation” in practice between maternity units, and said this may suggest not all women get the best possible care.

Some variation in care is to be expected and may reflect a service that is tailored to the specific needs and preferences of individual patients or populations.

The results have been adjusted to control for risk factors that are beyond the control of individual trusts, such as a woman’s previous birth history, age and level of social deprivation.

However, the authors caution that some of the observed differences could be due to differences in the quality of the data submitted by trusts, as well as differences in patient characteristics that were not possible to control for, for example smoking and obesity. Nonetheless, the variation may also suggest that not all women are getting the best possible care across the country or that NHS resources are not being used in the most efficient way.

The report, which was released today (23 March), was carried out by RCOG in collaboration with the London School of Hygiene and Tropical Medicine.

Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“The RCOG is dedicated to creating a culture of openness and transparency within maternity and gynaecological care. With this information, maternity services, alongside commissioners, will be able to move towards identifying priority areas for reducing variation and further improving the safety and quality of care provided to women and their babies.”

“Since we started sharing these findings in 2013, we have already seen excellent examples of trusts using the data to identify clinical issues and make improvements. Providing data to empower individual trusts to take action is exactly why we undertook this project.”

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