THE trust which runs Basingstoke hospital said an “error” was published in its meeting papers regarding caesarean sections after serious concerns were raised.

As previously reported, figures from Hampshire Hospitals Foundation Trust (HHFT) board of directors showed that more women have caesareans to deliver their baby at its hospitals than the national average.

According to the report, it had failed to meet its target set against a ‘monthly goal’ for every month since February 2020.

However, two weeks after the Gazette published an article on this, the trust has now released a statement to say the papers incorrectly referred to a ‘national benchmark’ for caesarean sections.

The error was noticed after the trust received a letter from Maureen Treadwell, who is on the government’s Maternity Transformation Stakeholder Council, who highlighted the “dangers” of setting caesarean section targets.

She told the trust: “Caesareans should be offered when they would benefit the mother or baby i.e. when there is a clinical indication or where the mother makes an informed decision to give birth by caesarean.

“They should never be restricted because of 'targets'. It is immensely dangerous and can lead to brain damage and death in babies and serious harm to women because it risks 'tilting' clinical judgement and denying choice. Litigation claims for brain damage and obstetric harm in the NHS are the highest of all specialisms.”

Ms Treadwell, from Stockbridge, who is also a collaborator on two major NHS funded research programmes focused on reducing maternal and neonatal harm, said she had written to NHS England more than once about setting caesarean targets, and said it confirmed there are none.

She added: “Many trusts have the misguided belief that caesareans cost more. In fact, taking litigation into account, the reverse is true. Most brain damage, although rare, arises as a consequence of complications of non-caesarean birth.

“I would suggest trusts who attempt to reduce caesareans on the basis of a misunderstanding of their costs also review their equality policy. Penny pinching on women's health is not acceptable.”

The trust papers refer to a ‘monthly goal’ for caesarean sections listed as 29 per cent.

Any months which exceed 29 per cent are graded as red or amber on the trust’s internal traffic light system quality scorecard.

Some measures listed on the scorecard are not given a traffic light rating, such as the number of full-term babies admitted to neonatal units, suggesting there is no target for this.

It is not clear why caesareans are given a score on the traffic light system. The Gazette has asked the trust for clarification on this.

HHFT said its maternity services “do not set targets around the number of caesarean sections performed each month” and that the national benchmark in the report was an error.

The figures show that for the last year more than 30 per cent of births at the trust have been caesareans, with the highest percentage in November 2020, when 38.6 per cent of births at HHFT hospitals were caesareans.

The most recent figures for February 2021 show 35.3 per cent of births were caesarean.

The data contains both elective and emergency caesareans.

Julie Dawes, chief nurse at HHFT, said it is seeing a “pattern of more caesareans taking place”.

She added: “The maternity services at the trust has an internal measurement to predict the number of elective and emergency caesarean sections in the coming year, and a ‘traffic light’ system is used to code each months’ data in line with the accuracy of this estimation.

“Tracking this activity helps us to identify trends and understand the needs placed on our services, which informs how we can continue to provide the best possible care to the women we look after. At the moment, we are seeing a pattern of more caesareans taking place, which could be for a variety of reasons.

“We are currently reviewing how this indicator is calculated and used and are undertaking a series of focus groups as part of this work.”

Maternity services at HHFT includes a birth centre at Andover War Memorial Hospital, which can be chosen by women if they are first assessed by their midwife to have a ‘low risk’ birth.

Women with a higher risk of complications are cared for at Basingstoke or Winchester hospital, which is where all caesarean sections take place.

Ms Dawes added: “Providing the best possible care to our women and their families remains our top priority – each next step is decided based on clinical need and supporting those in our care to have the best possible experience.”