A Care Quality Commission (CQC) report published today has found that half of maternity units (50%) were rated as ‘inadequate’ or ‘requires improvement’ in 2023.

This represents a year on year increase since over the last two years (from 31% in 2021 and 39% in 2022).  

The worrying decline in the safety and quality rating of maternity units is happening despite numerous initiatives that have been introduced to improve safety.

The report highlights persistent problems with culture and leadership, inadequate staffing levels, women and birthing people not being listened to, as well as inequalities in care. 



Overall services and staff are under huge pressure. Measures announced by Government and the NHS are clearly not having an impact on maternity safety quickly enough and in some services it is getting worse. In fact, the CQC rated 15% of services as ‘inadequate’ for their safety in 2023.   



Crucially the report again raises concerns that women and birthing people are not listened to, an issue Sands has repeatedly sounded the alarm about. Good communication with parents is at the heart of providing safe maternity care, because it means they have the information they need to make informed choices about their care, and are treated with genuine compassion.    

“Today’s report shows yet again the urgent need for everyone to work together to improve maternity safety. We all know from the many previous reports and inquiries what is wrong and needs to change. Although there are many hard-working midwives and other frontline NHS staff who go the extra mile every day, they are facing an uphill struggle and cannot on their own overcome the failures that are embedded in the system.



"Crucially we know that parents are often not listened to, that staffing levels must be addressed, and the importance of embedding the right culture and leadership. But the NHS, together with Government, now needs to move beyond diagnosing the problems to taking action that results in measurable improvements for parents and for healthcare workers.



“We know how difficult today’s news will be for many people affected by pregnancy loss or the death of a baby. We are here to offer emotional support to anyone who needs this, particularly anyone who is pregnant after a previous loss.”



- Clea Harmer, Sands' Chief Executive

Persistent inequalities must be tackled

Data published this year by MBRRACE-UK and the Office for National Statistics has shown stark and persistent inequalities for Black and Asian babies, and those from economically disadvantaged backgrounds.

Today’s CQC report makes clear that not speaking English as a first language is linked with worse experiences of care – with staff ‘not bothering to try’ to communicate and not enough priority given to ensuring people understand the information.

Midwives spoke of how care was affected by racial stereotypes and lack of cultural awareness which led to negative experiences and potential safety issues. There is a real risk that poor experience leads to people not attending appointments and not seeking care when needed.

In May this year the Sands and Tommy’s Joint Policy Unit  published the first Saving Babies’ Lives progress report which showed how the pressure that staff are under is impacting on the NHS's ability to deliver safe, personalised, care for everyone.

Currently there are no national targets to reduce inequalities between ethnic groups or areas of deprivation, despite multiple reports highlighting the impact of racism and discrimination which some individuals experience when engaging with health services.

We need to see a strong commitment from the Government to reducing inequalities and tackling the ongoing crisis in NHS staffing, and an urgent evaluation of the impact that these approaches are having as well as identify any barriers to delivery.

This report must be a wake-up call for leaders in Government and the NHS to make the fundamental changes that will save babies’ lives.

Support for you  

We understand that announcements like this can be incredibly difficult, and we are always here to support anyone affected. If you, or someone you know, needs emotional support after loss, find out  all the different ways we offer support.