65% Of Maternity Units Classed As Failing By The Care Quality Commission

I am saddened, but not surprised by the article today reported by the BBC https://www.bbc.co.uk/news/articles/ckgvl8l5q0xo

It highlights the review by the CQC over 16 months into 131 units across the NHS, in hospitals thought to pose the least problems.

The Royal Darby and Queens Hospital have been classed as inadequate.

We are familiar with the shortcomings in maternity care flagged at Shrewsbury and Telford and East Kent where investigations found poor care may have contributed to babies dying or having life changing injuries. The review has looked at those Trusts that have not necessarily made the headlines but found a repetition of problems ranging from buildings, equipment, staffing, safety and management.

I agree entirely with the Health Secretary, Wes Streeting who said; “women deserve better -childbirth should not be something they fear or look back on with trauma.”

These investigations since March 2021 demonstrate the need for ongoing monitoring, risk assessment and strategic management of maternity services. It is clear from the findings that hospitals cannot be left to become complacent.

The familiarity of the findings is astonishing.

1.      Staff shortages and failure to have the right people doing the right jobs. New nurses were found to be doing tasks suited to more senior midwives.

2.      Equipment not fit for purpose. What good is an alarm bell that does not work? One of my clients actually delivered alone, without monitoring when she was left unable to alert someone that her baby had been born and was not crying. There were significant consequences for the mother and child.

3.      Delays in emergency caesarean sections. They are by their very nature ‘emergency’.

4.      Women left in poor conditions with blood-stained sheets and without easy access to toilets and showers. These simple issues can have a huge impact on patient safety and experience.

5.      Cramped, noisy and overheated wards.

6.      Incorrect assessment and recording of major incidents as modest, causing low or no harm. Significant blood loss is serious. How will the hospitals learn if it is not flagged with consistency?

7.      Blame culture and low moral caused by under staffing and systemic management issues.

8.      Failure to triage properly, to appoint prioritise and recognise the problem. When the real issue is missed, delay can lead to catastrophic consequences.

9.      Inadequate resources to assist women from ethnic minorities whose first language is not English. Thes women must have their voices heard.

History teaches us that to move forward we must learn from the past.

My Experience

These failings cause physical and mental trauma. One in twenty mothers that experience stillbirth develops post-traumatic stress disorder. In some cases, this can be disabling. Some women cannot face having another baby.

Of my clients who have gone on to successfully conceive and give birth the majority report an entirely different experience but feel bitter that it was not done right the first time.

We know the costs of claims against the NHS in this area was 13%. Inevitably, huge payouts are made when babies are catastrophically injured and need lifelong care. Increasingly, I see mothers needing fertility treatment and psychological treatment to successfully conceive again. Prevention is better than cure.

I support the call by Gill Walton of The Royal College of Midwives to the Government “to build maternity services we can all be proud of”.

The spread of the problems, seemingly unmanaged and undetected mirrors what I see in practice. The same problems in maternity services that arise in different Trusts throughout the country suggest that information is not properly recorded, shared or communicated. There must be a centralised educational piece and money to fund its’ implementation.

Women cannot advocate effectively whilst at their most vulnerable. I can only hope that the hospitals listen, so that lawyers, and ultimately other hospital services do not have to pick up the pieces.