'More work to do' to improve Nottingham maternity units

In a 2018 letter, midwives had warned understaffing was "the cause of a potential disaster"

More needs to be done to bring maternity units at a city's two main hospitals up to scratch, inspectors have said.

In 2020 the Care Quality Commission (CQC) found serious concerns at Nottingham University Hospitals NHS Trust and labelled the units "inadequate".

A new report concluded the trust still has "some areas to address".

The trust said it was committed to making improvements.

The trust runs Nottingham City Hospital and the Queen's Medical Centre

In October a coroner said the death of Wynter Andrews minutes after she was born was "a clear and obvious case of neglect".

Nottinghamshire assistant coroner Laurinda Bower also revealed a 2018 whistle-blowing letter from midwives to trust bosses outlining concerns over staffing levels as "the cause of a potential disaster".

In the same month "in response to concerns raised... and coronial inquests", the CQC carried out an unannounced inspection at the hospital and found some staff had not completed training and "did not always understand how to keep women and babies safe", and issued a warning notice over its concerns.

Its latest report, based on an inspection in April, found improvements in the way women at risk of deterioration were identified and found documentation and monitoring had improved.

However the CQC found a disconnect between online and paper record-keeping and said there were multiple systems in place that led to duplication and errors at times.

'Multiple missed opportunities'

Sarah Andrews told the inquest into the death of her baby Wynter she felt her concerns during labour were "dismissed" by midwives

Wynter Andrews died 23 minutes after being born on 15 September 2019 at Nottingham's Queen's Medical Centre.

Her inquest heard she may have survived if "multiple missed opportunities" had been spotted by staff.

Her mother Sarah - who along with another family had called for a public inquiry over the maternity units - said the improvements made by the trust were "positive".

But she added: "I do hope they continue to make these improvements going forward and keep them up in the future."

The CQC said the trust must ensure risk assessments and risk management plans are completed in accordance with national guidance and IT systems must be effectively used to monitor and improve the quality of care provided to women and babies.

Sara Dunnett, head of the CQC's latest inspection, said she was "pleased the trust has responded to some issues" but said inspectors will "continue to monitor the trust closely".

"It has more work to do regarding how it captures, records and uses patient information in these services so that staff have a full picture of people's healthcare needs," she said.

"This includes ensuring information about women who may be affected by serious mental health issues is appropriately escalated."

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Sarah Moppett, interim chief nurse at the trust, said: "We are wholeheartedly committed to improving our maternity service further and making it one that we can all be proud of.

"We are pleased the CQC has recognised the hard work of our teams to meet the requirements of its improvement notice.

"However, there is still a lot more to do to deliver the best care for local families and we are committed to investing the time and resources needed to achieve this."

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