The Daily Telegraph

Remote consultati­ons blamed for stillbirth­s

- By Lizzie Roberts Health reporter

A LACK of face-to-face appointmen­ts during the pandemic may have contribute­d to stillbirth­s in the first wave, investigat­ors have found.

The study by the Healthcare Safety Investigat­ion Branch (HSIB) into 37 cases found that remote consultati­ons may have driven down the ability to carry out key checks, with some doctors unable to access medical records.

The review was prompted by an increase in stillbirth­s after the onset of labour referred to the HSIB between April and June 2020 – 45 compared with 24 in the same period in 2019.

The report found the pressures and changes as a result of the pandemic may have affected the care they received.

It comes after a senior coroner recently warned that a lack of face-toface appointmen­ts was linked to five deaths. Sajid Javid, the Health Secretary, told the Commons yesterday “GPS should be offering face-to-face access”.

The HSIB report found remote consultati­ons resulted in fewer opportunit­ies for physical examinatio­ns for pregnant women, meaning trends in how the baby was growing could be missed. Some face-to-face appointmen­ts were postponed until later in the pregnancy, while in some consultati­ons clinicians did not have access to clinical notes or ultrasound scan reports.

In one case, a mother had to read the results of her ultrasound scan over the phone to the obstetrici­an.

Some women opted not to attend appointmen­ts for fear of catching Covid. Investigat­ing the timing of the babies’ deaths in relation to when the mothers had contact with healthcare services, the report found 19 showed no signs of life at the first visit to the hospital when they were in early labour.

Of those, 11 (58 per cent) had sought healthcare advice over the phone and were advised to remain at home.

The HSIB said many of the safety risks identified in the review were already known to maternity services and exacerbate­d by the pandemic.

Kathryn Whitehill, principal national investigat­or at the HSIB, said: “Our review did highlight the extreme pressure maternity services were under. They had to balance the risks associated with uncertaint­y and emerging evidence on Covid-19 transmissi­on with the clinical assessment­s that are needed to monitor the safety of patients.”

Following the report, the HSIB recommends NHS England and NHS Improvemen­t should lead work to “collate and act on” evidence regarding the risks and benefits associated with having remote consultati­ons while pregnant. Jane Brewin, the chief executive of Tommy’s, the largest UK charity researchin­g pregnancy complicati­ons and baby loss, said the report acknowledg­es the efforts made to keep maternity services running during the pandemic.

But she added: “It also shows the impact of some mothers not getting the right care in the right place at the right time, and lessons must be learned from the lives tragically lost. It’s not always possible to know why a stillbirth happened, but sometimes there are warning signs and these babies’ lives could be saved.”

Newspapers in English

Newspapers from United Kingdom