During the pandemic there has been extra strain put upon the NHS, with the concern that some patients may not be receiving the appropriate level of care and treatment. It is not clear to what extent Covid 19 has impacted upon maternity services at the Queens Medical Centre and Nottingham City Hospital, but a recent report records that the maternity services at two hospitals in Nottingham have been downgraded to “inadequate”. Such a grading is likely to increase the risk of hospital negligence at Queen’s Medical Centre and the risk of hospital negligence at the Nottingham City Hospital.
Both hospitals have been identified as “Inadequate” following inspection visits of maternity services at the hospitals by Care Quality Commission (“CQC”) inspectors in October 2020. The inspections came about following concerns raised from serious incidents, external investigations performed by Healthcare Safety Investigation Branch and coronial inquests. The Healthcare Safety Investigation Branch investigate incidents that meet the “Each Baby Counts” criteria and maternal deaths of women while pregnant or within 42 days of the end of pregnancy.
The inspection undertaken at the Queens Medical Centre resulted in the CQC taking urgent action as the inspectors believed a person “would or may be exposed to the risk of harm if we had not done so”. The risk of harm includes risk to newborn babies, suffering a birth injury.
The report from the CQC recorded that “staff had not completed training in key skills and did not always understand how to keep women and babies are safe”. There were not always enough midwifery staff to keep women and babies safe, and to provide the right care and treatment. There was limited evidence of managers monitoring the effectiveness of care and treatment. Additionally, the inspectors said that the “leaders did not have the skills and abilities to effectively lead the service”. Of concern to expectant mothers will be that the maternity services did not have an open culture where staff felt confident of raising concerns without fear.
Similar concerns were reported of the Nottingham City Hospital, where it was also stated that “staff did not always risk assess women appropriately and in line with national and local guidance”. Worryingly, at the Nottingham City Hospital, inspectors also stated that incidents were not always reported due to clinical demands on staff. There was also ineffective feedback an escalation, and lessons were not being learnt.
The maternity service at Nottingham City Hospital was downgraded to “inadequate” because it did not provide mandatory training in key skills to staff and there was no system in place to ensure everyone completed it. Additionally, staff were not always sighted two potential safeguarding risks posed to women and babies.
In rating both hospitals as “Inadequate”, which is the lowest grade, the CQC is stating that the maternity services at these hospitals are performing “badly” and that the CQC has taken enforcement action.
Hopefully, both hospitals will respond promptly to these inspections and put in place measures to raise the level of care and treatment in maternity services, for the benefit of mothers, babies and the staff.