Maternity unit's improvements 'on track' after damning report

Prince Charles Hospital's expanded special care baby unit and six en-suite delivery rooms

Improvements in maternity services in the south Wales valleys are now "firmly on track," after a damning report branded them "dysfunctional".

One year ago, Cwm Taf health board's service was described as a "distressing" experiences for mothers.

Now, the independent team overseeing improvements said the health board was on-track to deliver on recommendations.

It has now acted on more than half of an action plan, including the most important changes.

The rate of progress means the team will now report again in six months, but the panel is worried about the "great uncertainty" due to coronavirus.

Its main concern is that managers can "maintain the longer-term focus and commitment that is now needed to build upon the solid platform which has been created".

A review by royal colleges was prompted by 25 serious incidents, including stillbirths and neonatal deaths.

The health board had already started to make improvements, but the Welsh Government put its maternity services at Royal Glamorgan and Prince Charles hospitals - in Llantrisant and Merthyr Tydfil respectively - into special measures.

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In its third progress report, the independent panel said it believed the health board could, in time, "deliver a maternity service which they, their staff and their communities can be proud of".

What is the panel doing now?

• Six review teams - led by experts from outside Wales - are looking at the individual cases of 140 mothers and babies between 2016 and 2018. Each family will receive their own report

• There are another three phases of review: Mothers who were taken into intensive care, sudden stillborn baby deaths and neo-natal care. These include looking at mortality patterns

• There may be more cases going back to 2010 looked at eventually, with 40 families already coming forward looking for answers

• Another 16 recommendations have been delivered since January, bringing the total to 41 out of 79 in the action plan

• There has been "significant progress" on remaining issues, including new training and developing a "maternity vision" for the future

• With Covid-19 challenges, the aim is to provide focus and momentum to improvements "from a distance," while maintaining communication and a regular flow of information with women and families

Panel chairman Mick Giannasi said there had also been a "sea change" in the relationship between mothers and those providing the service.

He pointed to the new Tirion birth centre at the Royal Glamorgan Hospital, officially opened in March, where families "spoke passionately" about their care and a "palpable sense of pride and shared ownership".

Mr Giannasi also said there had been a "fundamental difference" in the culture of leadership, after a "quiet evolution" of new senior appointments and "it seems staff have got their mojo back."

He said staffing levels and ways of working had improved, resulting in people "starting to get their confidence back and to feel valued".

Precisely a year ago we were digesting one of the most damning ever reports published about the Welsh NHS - listing a catalogue serious failures in maternity care in the Cwm Taf area.

A year on and the chairman of the independent panel brought in to drive through improvements says families can be confident that services for mothers and babies are now safe.

But the job is far from complete.

Many families will be waiting many months, if not years, for the results of clinical reviews into their particular cases.

And the processes to guard against failings of this scale from ever happening again will take time to bed-in across the organisation.

All of this at a time of when the health board, like all others, is dealing with its biggest ever challenge.

The hope is the momentum of maternity improvements won't be lost in the battle against Covid-19.

The health board said it wants to make sure "continual improvements are in place for the future"

"There's still work to do but the time frame is appropriate and we're moving at pace," midwifery director Val Wilson told BBC Radio Wales.

"I've only been here a short while but there's some excellent work going on. I'm very confident about the senior team.

"From the feedback we're receiving it's overwhelmingly positive - especially in what's a difficult time for the health service. People are talking about kindness, compassion and about how their needs are being met. It's very different from the language you read in the [Royal Colleges] report."