The Care Quality Commission (CQC) has told Hampshire Hospitals NHS Foundation Trust that it must make improvements to its maternity services.
In November, CQC carried out an unannounced focused inspection of the trust’s maternity services at Royal Hampshire County Hospital and Basingstoke and North Hampshire Hospital. The inspection was undertaken in response to concerns received about the safety and quality of the services. These included staff whistleblowing, patient complaints and information from other healthcare partners.
Due to the focused nature of the inspection the overall rating of the trust did not change and remains good, but there were changes in rating to maternity services, which has dropped from good to requires improvement.
Amanda Williams, CQC's head of hospital inspection, said:
“During our inspection of maternity services at Hampshire Hospitals NHS Foundation Trust, both hospitals we visited were incredibly busy and we saw the impact that staff shortages were having on the service.
“Staff were seen to be working above and beyond the call of duty and some staff told inspectors that there were not enough midwifery staff to keep people safe and that they were exhausted. The practice development team were frequently asked to cover for clinical staff which stopped them from fulfilling their function as an education resource. This meant that meetings were often unattended or postponed and training was put on hold so staff could focus on clinical care. However, the trust leadership team has now put steps in place to ensure there were enough staff in the departments.”
“We were also concerned to see that staff did not always treat sepsis in a timely way or follow national guidance. This was raised as an urgent issue to the trust and it has now put an action plan in place to address our concerns.
“The trust leadership team knows what it must do and they have assured us that action plans are in place to drive the improvements needed. In the meantime, we will continue to monitor the trust to ensure it is putting the improvements that are needed in place.”
Throughout both maternity departments, inspectors found the following:
- Staff did not always identify and treat sepsis in line with national guidance. Inspectors saw an incident where delayed communications affected time critical sepsis actions. There had also been a recent serious incident where sepsis screening and treatment did not follow trust policy
- The service had not successfully implemented the four recommendations from the Chief Midwifery Officer for England to reduce the additional risk of COVID-19 for women from black, Asian and minority ethnic (BAME) groups
- The service did not have enough nursing and midwifery staff to keep women and babies safe. Several staff members mentioned the unit sometimes felt unsafe due to staffing numbers and the numbers of women on the unit. Midwives had been going above and beyond to work in extremely challenging circumstances and spoke of low staffing levels and exhaustion
- The majority of managers had the skills and abilities to run the service and understood the issues the service faced. However, they were not always able to manage effectively.
However, inspectors also found:
- The service had an inclusive culture which ensured family or partners could support women throughout their pregnancy journey
- Staff adhered to personal infection control procedures and the service ensured measures to reduce transmission of COVID-19 were implemented across maternity services
- Staff felt there was a no blame culture across the service
- Managers recognised that there was a significant pressure on the staff in the unit and had started making changes to address this.
Read the report published on the CQC website:
Royal Hampshire County Hospital
Basingstoke and North Hampshire Hospital
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