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  1. ITV Report

Pregnant women should have a personal NHS budget, review finds

Mothers-to-be should be given a personal budget which could allow them to appoint their own midwife, a major review into maternity services has found.

Pregnant women should be given a budget of around £3,000 to choose what care they receive, the authors said.

The proposal aims to give women more choice over how and where they have their babies - a key decision considering half of maternity services in England are deemed "inadequate" or "require improvement" in terms of safety.

Under the proposed scheme, women would be told about all local providers of NHS care and the services they offer.

Women would also be able to pick between a number of providers, for instance, they could pick a hospital near their workplace for routine scans and a hospital closer to home for the birth of their child.

The authors of the National Maternity Review likened the scheme to personal health budgets, where people with long-term conditions and disabilities are given a say over how NHS money is spent on them.

Some have criticised the personal health budgets scheme for being open to abuse, with reports of people using their budgets to buy holidays or computer consoles, but the review's authors said only accredited providers would be eligible under this scheme.

The review highlights some concerns over the safety of maternity services, even though there have been drastic improvements in the last decade.

At present, hospitals are not always admitting when something has gone wrong, the authors said.

It is clear that under-reporting of safety incidents is widespread.

Safety is inconsistent across maternity services, and there is scope for significant improvement in many.

The quality of maternity services has been improving but not all are provided to a consistent, high level of quality. The safety of maternity services must be improved.

– The report

The review calls for a national standardised investigation process so lessons are learned after things go wrong.

Many families who lose a child feel as though they have to go through litigation channels to get answers about their baby's death, the authors said.

They called for a "rapid redress" scheme where families whose babies suffered harm could make a claim without the need to go through the courts.

The independent review ... rightly argues that the NHS could and should raise its game on personalised support for parents and their babies, better team working, better use of technology, and more joined-up maternity and mental health services.

– Simon Stevens, chief executive of NHS England