Scotland's Maternity Crisis: Commissioner proposes key changes

Karen Titchener, Scotland’s inaugural patient safety commissioner, has described the nation’s patient safety landscape as one that is “improvement-rich” but “asssurance-light” - a problem that is prevalent in maternity and neonatal care.

She has said that the country needs a “robust” and ”independent” assurance process for maternity services that is centred on the experiences of women and “acts with urgency.”

In her most recent annual report, Ms Titchener, who has more than two decades of senior leadership experience within the UK-wide health service, said that interim findings from significant national reviews, including the current independent review, should be routed through a formal assurance function. This, she believes, would allow safety-relevant themes to be tracked, and their resolution monitored independently, rather than only being assessed at the conclusion of a review process.

Such a function, Ms Titchener has said, could include formal assurance receipt of interim findings, providing independent oversight of whether idenƟfied safety themes are being acted upon, rather than assessing progress only once a review has concluded.

Ms Titchener, who has designed maternity and neonatal safety as one of six national priority areas, also said that in her first year in the role, said concerns raised by parents, families, clinicians, and stakeholder organisations highlighted the importance of effective oversight through stronger national assurance arrangements, greater transparency, timely learning, and improved mechanisms for identifying and responding to safety concerns across Scotland.

She has welcomed the establishment of the independent review, and said the experiences shared with her office have “reinforced the importance” of ensuring that women's voices, family experiences and frontline perspectives are “reflected throughout the review process.”

It remains to be seen how Ms Titchener’s proposals will dovetail with the review and other work being done by the government, but already, there have been calls for her office to receive bolstered powers in order to investigate failing maternity services.