Nottingham hospitals maternity services 'inadequate'

In a letter, midwives had warned understaffing was "the cause of a potential disaster"

The maternity units at Nottingham's two main hospitals have been rated inadequate by inspectors.

The Care Quality Commission (CQC) found "several serious concerns", including staffing, poor leadership and a culture that did not learn lessons.

It comes after Nottingham University Hospitals NHS Trust was criticised for errors that led to the death of Wynter Andrews, minutes after she was born.

The trust said it had made changes, including hiring extra midwives.

In October, Nottinghamshire assistant coroner Laurinda Bower said Wynter's death was "a clear and obvious case of neglect".

She also revealed a letter from midwives at the unit to bosses at the trust in 2018 outlining concerns over staffing levels as "the cause of a potential disaster".

Managers said they wanted to provide "the best maternity services for local people"

The CQC carried out the unannounced inspection at the Queen's Medical Centre in October "in response to concerns raised from serious incidents, external investigations... and coronial inquests".

It found some staff had not completed training in key skills and "did not always understand how to keep women and babies safe".

Inspectors added there was "limited evidence of managers monitoring the effectiveness of care and treatment and driving improvement".

The CQC said: "All staff we spoke with across the service, told us that there were not enough staff to provide safe care.

"At times, staff reported that they had been unable to attend mandatory and/or essential training sessions as there were insufficient staff on duty to enable them to be released for training.

"Staff said they frequently missed breaks and worked over their hours due to the low staffing levels."

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The report found the impact of this was that jobs were missed and standard of care was poor.

Staff did not always use a nationally recognised tool to identify women at risk of deterioration and record keeping was not joined up, inspectors also found.

However, the watchdog said the service "mostly had enough medical staff with the right qualifications... to keep women and babies safe from avoidable harm".

'Very sorry'

The CQC rated the safety, effectiveness and leadership of maternity care as inadequate.

It also imposed conditions on the registration of maternity and midwifery services at both the Queen's Medical Centre and Nottingham City Hospital, under Section 31 of the Health and Social Care Act.

In addition a warning notice was handed to the trust over "concerns found around the documentation for risk assessments and IT systems".

The notice gives the trust three months to make improvements.

Tracy Taylor, chief executive at the trust, said: "We want to provide the best maternity services for local people, and the priority of our maternity team is to provide safe care to the families they come into contact with every day but we know we haven't always got this right, and we are very sorry.

"We accept the report from the CQC and have already made some immediate changes and will continue to make further improvements."

Changes include hiring extra midwifery staff, additional training and management support and IT improvements.

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