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42 The NHS maternity care dilemma: balancing the need for care against the risk of overdiagnosis and overtreatment
  1. Francesca (Fran) Quattri
  1. University of Leicester, Leicester, UK


Objectives The study aims to explore the challenges faced by NHS midwives and obstetricians in avoiding overdiagnosis and overtreatment in maternity healthcare services. The objectives include understanding the concerns and perceptions of healthcare providers when trying to do less rather than more in their practice, analyzing the features of the NHS’s structure that obstruct the avoidance of defensive practices, and providing viable solutions for quality improvement based on the study participants’ input. By gaining insight into the experiences and worries of the participants, the study seeks to contribute to a deeper understanding of the issues of overdiagnosis and overtreatment in NHS maternity healthcare services.

Method The study is qualitative and involved 35 semi-structured interviews with NHS midwives and obstetricians at various levels of experience and practice. Participants were asked to share their experiences, insights, and perceptions regarding overdiagnosis, overtreatment, and defensive practices. The research outcomes represent a comprehensive investigation of the themes that emerged from these interviews. The study participants’ experiences and insights provide a valuable source of information on the challenges faced by healthcare providers in maternity healthcare services.

Results The study’s results shed light on the challenges that NHS midwives and obstetricians face when avoiding overdiagnosis and overtreatment in maternity healthcare services. The findings highlight the influence of social, cultural, and political factors on healthcare practices, making it challenging to balance patient care with adherence to guidelines and regulations. The study participants’ proposed solutions, including better training on shared decision-making principles, involving patients more in the decision-making process, and clearer guidelines on when and how to intervene, are feasible and could lead to significant improvements in patient care and the NHS maternity healthcare services.

Conclusions The study underscores the importance of addressing the issues of overdiagnosis and overtreatment in the NHS to ensure the delivery of high-quality care. By analyzing the factors that obstruct efforts to avoid defensive practices, the study provides guidance on how the NHS can improve patient outcomes and quality of care. The findings contribute to a better understanding of the critical issues in the NHS maternity healthcare services and provide insights to develop effective strategies to address them.

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