Nottingham maternity services get warning letter from watchdog

Maternity services at a hospital trust have been issued with a warning notice by a health watchdog

Nottingham University Hospitals (NUH) NHS Trust was reinspected earlier this month, having already been rated as 'inadequate' last year.

The notice - issued when care "falls below what is legally required" - relates to care within triage services and monitoring once admitted.

The trust said it was "disappointed" by the move.

Maternity services at the trust are the subject of a review following criticism linked to baby deaths.

'Residual cultural issues'

According to the Local Democracy Reporting Service the Care Quality Commission (CQC) issued the notice on 21 March.

Its letter said "women attending triage were not consistently reviewed within 15 minutes" at both the City Hospital and Queen's Medical Centre (QMC).

It also highlighted "increases in stillbirths" at City Hospital but said "no apparent rationale had been established".

CQC inspectors also found some midwives "may have been acting outside of their competency in respect of reviewing scans" and that "there were some residual cultural issues, but there appeared to be improvements".

The inspectors also noted both QMC and City had made a number of improvements in other areas including record-keeping and handovers, and almost all patients and relatives "were very positive about their care"

The letter said further improvement must be made by 16 May.

Staffing bolstered

Responding, the trust said there were "fluctuations" in the stillbirth rate but there was "no suggestion" there was an underlying concern.

At a trust board meeting, director of midwifery Sharon Wallis said those who were not seen within 15 minutes were seen "within 16, 17, 18, 20 minutes".

She added from April, the triage service will be separated physically from the day case area, which is anticipated to bring about improvements, and triage staffing had also been increased from two midwives to three each day.

Chair of the board Nick Carver added: "'It is unarguable from CQC evidence that you've made significant improvements, it is unarguable that there is more to do and it is unarguable that we want to go faster."

A full report and rating is expected to be published by the CQC in April.