New maternity standards to improve consistency and quality of care
Clear information about the standards women and their families can expect during their maternity care has been published by Healthcare Improvement Scotland.
The standards set out that patients should receive safe and compassionate care throughout pregnancy, birth and the postnatal period, regardless of where they live or their individual circumstances, and that care should be responsive to each woman’s individual needs.
The standards cover all aspects of maternity care, from antenatal appointments through to postnatal support, emergency care, mental health and wellbeing, and bereavement care. They apply across all settings, including hospitals, community services, midwifery units, and home births, and support NHS boards to actively work to reduce health inequalities and improve outcomes for women and their babies.
Once implemented, Healthcare Improvement Scotland will use the standards to drive this improvement, informing inspection and assurance activities across NHS boards.
Public Health and Women’s Health Minister Jenni Minto said: “The safety of women and babies is paramount.
“We commissioned Healthcare Improvement Scotland to develop the Maternity Care Standards, and I am grateful for their work to improve the quality and consistency of maternity care for women, babies, and families across Scotland.
“Every woman deserves to feel safe, supported and listened to during pregnancy and beyond. These standards recognise that some women face additional barriers to getting the care they need and set out a clear commitment to making sure maternity services work equally well for everyone — whatever their background or circumstances.”
Melissa Dowdeswell, Director of Nursing and Integrated Care, Healthcare Improvement Scotland, said: “We are pleased to have published maternity care standards that set clear expectations for how maternity care should be delivered in Scotland.
“The standards aim to promote consistency and improve the quality of maternity services across the country. They set out a blueprint for what good maternity care looks like and detail the levels of high-quality care and support that all women should expect to receive before, during and after birth.
“During the development of the standards, we spoke to women from many different backgrounds, who shared their experiences of being pregnant and giving birth in Scotland. Their voices were central to the creation of the standards.
“We heard that women need to feel confident that a high-level of safe, effective and person-centred care will be consistently delivered in all maternity units across Scotland regardless of individual circumstances or needs.
“The development of these standards is a commitment to making sure this happens.”
Healthcare Improvement Scotland: Inspection report Royal Infirmary of Edinburgh, NHS Lothian
Healthcare Improvement Scotland today (Wednesday 29 October) published a report relating to a Maternity Services Safe Delivery of Care inspection visit to the Royal Infirmary of Edinburgh, NHS Lothian.
We carried out the unannounced inspection of maternity services at the hospital on 23-24 June 2025.
Speaking of the report, Donna Maclean, Chief Inspector, Healthcare Improvement Scotland, said: “During our inspection of the maternity services we saw staff working hard to provide compassionate and responsive care in very challenging circumstances. All interactions observed during inspection between women, babies and families were positive and respectful.
“We saw good teamwork and innovation within the maternity triage department involving extended members of the multidisciplinary team including obstetricians, midwives and the healthcare support team.
“However, during the course of this inspection, we escalated serious concerns within NHS Lothian to senior staff and Scottish Government. These concerns related to culture, oversight of patient safety and staff wellbeing within Edinburgh Royal Infirmary maternity services.
“Some staff were complimentary and described their line manager as supportive. However, the majority of the multidisciplinary team we spoke with were frustrated at staffing levels and told us this presented a safety risk, which they’d raised on multiple occasions with managers.
“They shared their concerns and feelings of being overwhelmed, unsupported and not listened to. They said this has impacted staff confidence to escalate staffing concerns.
“During the inspection we observed delays to the induction of labour process of up to 29 hours and other delays to women who required ongoing care within the labour ward due to lack of staff availability, capacity and the complexities of patient conditions.
“Staff described suboptimal skill mix and challenges in providing and maintaining one to one care for women within the labour ward, as well as delays to observations or escalation of clinical concerns.
“Our inspection has highlighted gaps in incident reporting and a reluctance to submit incident reports, with staff describing a culture of mistrust. These are concerning issues that may have significant impact on the learning from adverse events in the system and reduce opportunities to improve safety.
“Women told us of mixed experiences within the hospital, whilst some were complimentary of their care, they also informed inspectors of poor communication that left them feeling uninformed and with no ‘voice’ in their care.”
Other areas for improvement identified included fire safety requirements, safe storage of cleaning products and improvements to the environment.
Speaking of our expansion of Safe Delivery of Care inspections into maternity services, Eddie Docherty, Director of Quality Assurance and Regulation, said: “In response to Healthcare Improvement Scotland’s Neonatal Mortality Review in 2024, we made a commitment to expanding our Safe Delivery of Care inspection approach to include inpatient maternity services.
“The maternity inspections will provide women, and families with an assessment of the quality of care provided by their local maternity service and an independent review of any required improvements.
“Our organisation is also producing a set of standards for maternity services, which will in time support our inspection process for maternity services.”
The maternity services inspection at the Royal Infirmary of Edinburgh resulted in five areas of good practice, two recommendations and 26 requirements.
An improvement action plan has been developed by NHS Lothian to meet the requirements for maternity services.
The full Lothian maternity inspection report is available to view at:
Pre-empting the report, NHS Lothian issued a statement yesterday:
KEY MESSAGES FOR PATIENTS
You are likely to read or hear some stories in the media this week about maternity services in NHS Lothian.
A new BBC documentary will air on Tuesday and will explore challenges in maternity services across Scotland. It is looking at situations and cases in the bigger units of Glasgow and Edinburgh and is following up on the improvement work that is already underway in NHS Lothian.
Then on Wednesday, Healthcare Improvement Scotland (HIS) will publish a report into Women’s Services following two unannounced visits in June.
You might understandably have some questions or concerns about what is going on. It is also to be expected that you may feel more anxious than normal.
We can reassure you that your health, and that of your baby, is our main priority.
If you have any questions at all, please raise them. If your expert midwife can’t answer them, they will be able to find someone else who can help.
A phoneline has also been established to help answer any questions or concerns. It will be manned by our Patient Experience Team with a local contact in Women’s Services for any specific issues.
You can make contact on: Tel 0131 536 3370 (open Mon-Fri, 9am to 2pm) and on email: LOTH.Feedback@nhs.scot
Many of the things to note are:
We know these reports will be concerning and we apologise to women, people who use the service, and their families and can reassure them that these issues are being taken extremely seriously.
A major improvement programme began last year and is already underway across women’s services in NHS Lothian.
Many of the points we expect to be mentioned in the BBC documentary and many of the findings in the HIS report actually reinforce the work that is already underway and serve to strengthen the improvement plan.
The issues are being taken extremely seriously, and we have always been clear that wider ranging matters, such as staffing, recruitment and working culture within the department, will take time to resolve.
Significant investment and improvements have already been made, and many new posts have been filled, but there is still more to do to ensure our staff feel supported at work, safe to raise concerns and able to thrive.
We are working to enhance patient safety, quality of care and improve working conditions for our teams.
The first and ongoing phase of improvement work focussed on patient care. The second phase is focussed on staff working culture, training and environment.
As part of the programme, we have improved triage and escalation increased staffing, boosted training, altered placement rotation and created robust patient pathways.
The report highlighted some areas of good practice, particularly our maternity triage system which is one of areas already targeted by the ongoing improvement programme.
New and expectant mums in Lothian can now enjoy some family support as some of the national restrictions around maternity services begin to ease.
Pregnant women and women who have just welcomed a new baby into the world will be able to share the precious moments with some of their friends or family.
Until now, national guidance to keep mums and babies safe and to minimise the risk of COVID-19 has meant restrictions on the number of people attending maternity services.
However as from yesterday, expectant mums can now have one additional visitor as well as one birth partner, if requested, to support them whilst in labour.
Women will also be able to have a designated visitor, as well as their birth partner, to visit them whilst in the maternity ward.
Birth partners have also been advised that they can now attend with pregnant partners for ante-natal ultrasound scanning appointments.
Frances McGuire, Chief Midwife, NHS Lothian said: “We know how hard the restrictions have been for women and their partners during these most important life events and our team have tried to ensure that the experience has been as positive as possible during this pandemic.
“Our priority remains the safety of mothers and their babies, and we are very much looking forward to safely welcoming more Lothian visitors to meet our new mothers and babies.”
Ultrasound scanning departments in Lothian will do their utmost to allow one birth partner to be present at the appointment.
Waiting area capacity is still severely restricted due to the requirement for physical spacing of seating to comply with social distancing guidance. Only the one person will be able to accompany the patient into the waiting area and for the scan.
Radiology Services are planning to adjust ultrasound scanning appointment times and are assessing waiting area capacity to improve access.
Birth partners and visitors must wear a face covering at all times and maintain physical distancing where possible.
Everyone must also adhere to strict hand hygiene measures and use the alcohol gel provided.
Visiting can be arranged with ward staff on a daily basis as numbers will have to be managed due to the ward capacity and social distancing guidelines.
The Royal College of Midwives (RCM) has called on every pregnant woman to support them in keeping services open and available.
With maternity services across the country working to maintain as broad a range of services – including antenatal appointments and scans – as they can, the RCM has urged pregnant women and their families to do their bit to keep themselves healthy and protect midwives and maternity support workers (MSWs) too.
The RCM is calling on pregnant women to let their midwife know if they or anyone in their home starts to have symptoms of Covid-19 and they must also continue to attend routine appointments for antenatal care and scans.
Gill Walton, Chief Executive of the RCM, said: “It’s really important to remember that maternity services are open. Every day, up and down the country, babies are being born and new families are created. Coronavirus isn’t putting a stop to that.
“Yes, some things may be slightly different – you may see your midwife via a video screen for some appointments, for example – but you will still receive the care and support you need throughout your pregnancy.
“We want you to have a happy and healthy pregnancy and birth, and our members will support you every step of the way. What we’re asking in return is that you support them too, by reducing their exposure to coronavirus. If you or your partner has coronavirus symptoms, it’s vital that you let your midwife know before you attend an appointment.
“You’ll still get the care you need, but your midwife will be able to take the precautions they need to keep themselves as safe as possible. The same applies when you go into labour. Let the maternity unit know so they can be ready for you and help you welcome your new baby into the world.”
The RCM has applauded the maternity units that are embracing innovation to replace some face to face consultations with phone or by video calls. They have stressed the need for pregnant women to continue to attend all appointments for scans, blood pressure, urine checks and blood tests as planned.
It is also vital to contact their midwife if they have any concerns, particularly around the movement of their baby, without delay.
Gill added: “I am so proud of the work Heads and Directors of Midwifery are doing to keep services open and to make sure pregnant women still receive the care they need.
“Please support them this Easter weekend, by not taking a break from the important measures that are in place to keep you safe. Stay at home as much as you can, and if you can’t continue to observe social distancing; wash your hands regularly and avoid touching your face; and if you cough or sneeze, do it into the crook of your elbow or into a tissue.”
Figures published today by the Nursing and Midwifery Council (NMC) show an increase in the numbers of midwives and nurses leaving the NMC’s register. At the same time, the numbers joining the register have slowed down resulting in an overall reduction in the numbers of nurses and midwives registered to work in the UK.Continue reading Midwife registration fall ‘worrying,’ says RCM
