It is most definitely due to staff shortages why some trusts are coming out at the bottom.
Have just downloded my trust ratings and the one i had my last baby on and ive surprised at some of the 'ratings' out of 5. For my trust we have a rating of 2/5 for womens choices in labour which im shocked at. We are very much for active childbirth(generally) so as i have been with the trust for several yrs, i would totally disagree. Probably not very pro active though when understaffed(most of the time) and are looking after 2 or 3 labourers.
However, we did get 5/5 for the extent that staff are trained in core midwifery skills. Clearly, due to the fact that im off on mat leave at present.