Maternity services are among the areas that have been identified as especially challenged in the latest Care Quality Commission (CQC) report on the state of care in England. Even though the problems the report has identified are shocking, they come as no surprise at a time of high-profile organisational failures and soaring clinical negligence claims. In an editorial for the BMJ, Mary Dixon-Woods, Zenab Barry, James McGowan, and Graham Martin discuss some of the issues affecting maternity services in England.
We suggest that for a regulatory model to work, three elements have to work well: standard setting, monitoring, and mechanisms to secure improvement. Currently the third component – making improvement – demonstrates significant weakness. A hard look at how “improvement” is currently being done and where efforts can add most value is much needed.