Warning issued as calls for 'urgent improvements' in maternity services at Birmingham hospitals
The Care Quality Commission has called for 'urgent improvements' to be made at two of Birmingham's biggest hospitals - with a warning being issued to one of them to make the changes 'rapidly'.
It follows inspections of maternity services carried out at Birmingham Heartlands Hospital and Good Hope Hospital in February.
The University Hospitals Birmingham NHS Foundation Trust, which the hospitals are a part of, delivers over 8,700 babies and has 150,000 outpatient appointments every year across three sites.
Inspectors found the following during the inspections:
At Birmingham Heartlands Hospital:
The environment was not well maintained and in parts, not fit for purpose due to the lack of sufficient and suitable waiting space for women and birthing people.
Women and birthing people were not always assessed and reviewed in a timely manner in the Pregnancy Assessment Emergency Room.
Managers didn’t always investigate incidents thoroughly or in a timely way.
Systems to manage performance were not always used effectively.
At Good Hope Hospital:
It wasn’t always clear if action had been taken or followed up following the reporting of risks.
The service provided mandatory and maternity specific training in key skills to all staff but didn’t ensure everyone had completed it.
Staff knew how to make a safeguarding referral and who to inform if they had concerns.
Women and birthing people could reach call bells and staff responded quickly when called.
Following the inspection, the overall rating for maternity, as well as the ratings for safe and well-led at Birmingham Heartlands Hospital went down from requires improvement to inadequate.
While the overall rating for maternity at Good Hope Hospital went down from good to requires improvement, the safe domain remains requires improvement, and the rating for well-led went down from good to inadequate.
The Care Quality Commission (CQC) issued a warning notice to focus the trust’s attention on rapidly making the necessary improvements at Birmingham Heartlands Hospital.
The overall rating for the trust remains as requires improvement.
We spoke to Carolyn Jenkinson, the deputy director of secondary and specialist healthcare at the CQC:
She added in a statement; “When we inspected maternity services, it was concerning to see a deterioration in the standard of care being delivered. We saw areas where significant and urgent improvements are needed to ensure safe care is provided to women, people using this service, and their babies.
“At both maternity services, leaders need to mitigate the negative impact of understaffing. Frequent staff shortages meant people didn’t always receive timely treatment which could place them and their babies at risk. It also affected staff morale and wellbeing as many reported they couldn’t take breaks.
“Over the past year the trust reported examples where women and people using the service had experienced a delay in their care and treatment. This needs to be addressed to ensure timely treatment is given to prevent any harm or risk to people and their babies.
“However, we did also see some positive areas of care, including how well staff worked with external charities to support people who needed additional help. The maternity service employed a midwife who specialised in female genital mutilation and leaders were proud of the work she’d done to support and educate people in the community.
“Leaders recognised that the instability of the senior midwifery leadership team had impacted staff morale and several posts had been recruited to, including the director of midwifery, so we hope this helps the trust focus on making swift progress to improve care.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made in the maternity service so people and their babies receive safe and appropriate care.”
In a statement, the University Hospitals Birmingham NHS Foundation Trust said: “The care and safety of women and their families is always our priority, and we are working with our teams to provide better experiences for them, and our colleagues in maternity, and obstetrics and gynaecology.
“Whilst the service is facing significant challenges in the areas highlighted by this inspection, we have worked to make improvements, including the expansion of the Pregnancy Assessment Emergency Room, and improvements to staffing of the area. This comes alongside a £4.7m refurbishment of the Princess of Wales Women’s Unit which is already underway. These improvements will continue under the leadership of a newly appointed Director of Midwifery.
“I am pleased that areas of good practice have also been highlighted by the CQC, and we will use their valuable feedback to help us in our commitment to improve services for women, and the parents and families of over 8,700 babies who are born with us each year.”
We also spoke to Chief Nurse Margaret Garbett: