Public Release: 

Pregnant women unmoved by maternity hospital ratings, study suggests

Imperial College London

Media reports in 2008 naming the best and worst NHS trusts for maternity care did not lead to more women going to the top hospitals or avoiding the lowest, a study has found.

The NHS Constitution states that providing information to support patient choice is a major priority for driving improvement in services.

The new study casts doubt on this principle, finding that widely publicised patient survey results listing the 10 best and worst performing NHS trusts in England did not lead to more women attending the high-ranked hospitals or fewer attending low-ranked hospitals.

The study also found that satisfaction levels did not improve more quickly at hospitals named as the 10 worst compared with others with similar satisfaction levels at the start, suggesting that high-profile public reporting may not have stimulated improvements in care.

The research is published in the Journal of Health Services Research & Policy.

Dr Anthony Laverty from the School of Public Health at Imperial College London, who led the study, said: "The NHS and other health systems are increasingly trying to provide more information about hospitals' performance on the basis that letting patients make informed choices about where they go for their care will improve standards. The evidence for this is patchy, and mainly comes from cardiac surgery in the US. We wanted to test this idea by looking at maternity care in England, since pregnant women might be more proactive in seeking information and choosing in advance where they want to give birth."

The results of a survey of 26,000 women assessing their maternity care were released by the Healthcare Commission in January 2008, attracting widespread media coverage both in the national press and in local media where hospitals were rated as doing particularly well or badly.

The Imperial researchers compared the NHS trusts named as best and worst with the remaining trusts, excluding those with only a small number of maternity admissions. They looked at the number of maternity admissions for each trust and survey satisfaction levels in 2007 and 2010.

The data showed no significant difference in admissions in the three years after the media reports at the best or worst trusts.

"Our results suggest that releasing information on the quality of hospitals didn't mean that women ended up with better care. Added to other studies, the evidence suggests that public reporting is unlikely to improve the quality of health services through patient choice," said Dr Laverty.


The study was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North West London, the NIHR Imperial Biomedical Research Centre, and the NIHR Imperial Patient Safety Translational Research Centre.

For more information please contact:

Sam Wong
Research Media Officer
Imperial College London
Tel: +44(0)20 7594 2198
Out of hours duty press officer: +44(0)7803 886 248

Notes to editors:

1. A.A. Laverty et al. 'Impact of 'high-profile' public reporting on utilization and quality of maternity care in England: a difference-in-difference analysis.' Journal of Health Services Research & Policy. DOI: 10.1177/1355819615571444

2. About Imperial College London

Imperial College London is one of the world's leading universities. The College's 14,000 students and 7,500 staff are expanding the frontiers of knowledge in science, medicine, engineering and business, and translating their discoveries into benefits for society.

Founded in 1907, Imperial builds on a distinguished past - having pioneered penicillin, holography and fibre optics - to shape the future. Imperial researchers work across disciplines to improve global health, tackle climate change, develop sustainable energy technology and address security challenges. This blend of academic excellence and its real-world application feeds into Imperial's exceptional learning environment, where students participate in research to push the limits of their degrees.

Imperial nurtures a dynamic enterprise culture, where collaborations with industrial, healthcare and international partners are the norm. In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.

Imperial has nine London campuses, including Imperial West: a new 25 acre research and innovation centre in White City, west London. At Imperial West, researchers, businesses and higher education partners will co-locate to create value from ideas on a global scale.

3. About the National Institute for Health Research

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (

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