To ask His Majesty’s Government what assessment they have made of the MBRRACE-UK 2025 report Saving Lives, Improving Mothers’ Care 2025: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2021–23.
My Lords, although the maternal mortality rate has slightly decreased recently, this report makes it quite clear that further urgent action is needed. That is why this Government have launched an independent investigation into NHS maternity and neonatal services, with interim findings expected in December. Moving from care to prevention, the publication of a new maternal mortality care bundle planned for next month targets the five key areas that disproportionately contribute to maternal mortality.
I thank my noble friend the Minister for her reply. I want to ask specifically about the issue of late maternal deaths, which were significantly higher in this reporting period. Deaths linked to mental health issues, including suicide and substance use, were the leading cause of late maternal deaths. Almost half of women who died by suicide were from the most deprived areas. What can we do to stop it being the case that if you are from a poorer background, you are most likely to take your life during this period? Would the Minister consider introducing an urgent referral pathway for women with complex social needs?
My noble friend is quite right in her observation. The maternal care bundle will be a real focus for change and tackling inequalities. Maternal mental health is one of the areas that has been identified for urgent action, because of the ability to improve outcomes and reduce inequalities. Identified pathways, as she describes, are part of the solution that we have under way.
My Lords, we have another MBRRACE report and the same message. Black women are at twice the risk of dying and Asian women have a higher incidence than white women, and we are not addressing the issues that lead up to these deaths in these minority groups. Can the Minister tell us what measures the Government are likely to take in the maternity review to address this?
This Government are committed to closing the black and Asian maternal mortality gap. It is unacceptable that, in 2025, black women are twice as likely to die in childbirth. I was speaking yesterday with a clinician who said that for every woman who dies, 100 women experience a severe maternal morbidity event, such as stroke, kidney failure or acute psychosis, which can lead to lifelong health implications, as the noble Lord has referred to. The maternal care bundle, which we have developed in partnership with MBRRACE, proposes intervention on the issue of blood clots, which are three times as likely to occur in black women and can have tragic consequences.
My Lords, there are considerable concerns in Leeds about the maternity services in the Leeds Teaching Hospitals Trust, including that the investigations that are now beginning will take a considerable amount of time. Can the Minister confirm that, in the ongoing inquiry into general services, a conclusion will be brought to the investigations in Leeds as soon as possible?
I can give that assurance in respect of services across the country. The independent maternity and neonatal investigation will act at pace. It is an independent investigation and will be chaired by the noble Baroness, Lady Amos. In addition, the Secretary of State, Wes Streeting, is showing how high a priority it is for us to provide urgent action on this by chairing the maternity and neonatal task force himself. These projects will work at pace to bring about the change we need to see.
My Lords, I am pleased to hear the Minister say that this is urgent. While waiting for the review to take place, the report called for improved interagency working. While the Government are waiting for that review, are there any specific changes to information sharing and co-ordinated care pathways between maternity services, social services, specialist domestic abuse services and other statutory agencies that the Government will ask to be implemented on an interim basis, to ensure that as many women as possible live?
It is important to say that we are not waiting for the results of investigations or task forces in order to take action. A number of projects are already in train and making a difference. For example, we are rolling out maternal mental health services and specialist perinatal mental health services in every area across the country. I will give one example to address the point that the noble Lord raised. A single patient record will ensure that maternity teams have all the information they need about previous consultations. That will be of great assistance in improving safety and efficiency.
My Lords, NHS Resolution was, strangely, not collecting ethnicity data for maternity negligence claims. It is apparently doing so now—after I challenged them. This was the case even though minority-ethnic women have poorer outcomes. Can the Government provide assurances that ethnicity data is now being collected properly? What assessments have the Government made so far on maternity negligence claims for minority-ethnic women? I am happy to receive that information in writing.
I would be very pleased to make that information available in writing. The noble Baroness makes an important point. Data is key to our advances, particularly where we are seeking to address inequalities on racial lines.
My Lords, the report makes clear that many women who died experienced multiple intersectional disadvantages—as was highlighted by the noble Baroness, Lady Berger, and the noble Lord, Lord Scriven—including poverty, mental health, domestic abuse and social exclusion. Does the Minister accept that tackling maternal mortality requires an intersectional approach that brings together health, mental health and social care services, rather than treating them in isolation?
I agree with the core of the noble Earl’s observation, which is why the maternity care bundle—to be published next month and actioned next year—is so crucial. It will pick up the point he is making about the five clinical areas for urgent action. They have been chosen because of their ability to improve outcomes and to reduce inequalities, as well as their feasibility of implementation within NHS services, which I know is a matter of great interest to your Lordships’ House.
My Lords, I am pleased to hear that the Secretary of State has indicated that there will be an independent inquiry at Leeds Teaching Hospitals. Data is important, so can the Minister say what IT data in general will be collated through the NHS? More importantly, what is the governance structure for trust chairs and NHS boards in looking at risk management? Wherever we have failings, it is always a failing of leadership. How will the Government tackle this?
One of the interventions aimed at addressing inequalities—which will, I am sure, be of interest—is the delivery of what is called an inequalities dashboard. That allows local systems to monitor data usage where inequalities are in place. As the noble Baroness rightly suggests, if we do not know where there is a problem then we cannot address it. That project and those on removing racial bias from clinical education, as well as those embedding the genetic risk inquiry, are data driven and will make a difference in the way that we all seek.