An inspection by the Care Quality Commission (the CQC) into maternity services at both Luton and Dunstable Hospital and Bedford Hospital was prompted following concerns raised by whistleblowers around the safety, culture, and management of the service.
Inspection findings
During an inspection which took place in November last year, the CQC’s inspectors found a decline in the quality of maternity services at both Luton and Dunstable Hospital and Bedford Hospital, both of which are run by Bedfordshire Hospitals NHS Foundation Trust.
Ratings for maternity services at both hospitals have declined to ‘inadequate’ as a result of the findings.
Unfortunately, this is not the first time that the CQC have found that services were not up to scratch at the Trust and previous warnings had been given by inspectors regarding staffing levels.
During the most recent inspection, the key findings across the two hospitals were as follows:
- The service did not always have enough staff to care for women and keep them safe.
- Managers did not accurately review and adjust staffing levels.
- Staff did not always check emergency equipment in line with policy to ensure this was ready, safe, and fit for purpose.
- Staff did not always complete risk assessments for each woman and/or take action to remove or minimise risks.
- There was a lack of learning from incidents and a backlog of incidents which had not been reviewed.
- Some areas which could not be cleaned effectively posed an infection risk.
- Infection risk was not managed consistently.
- Leaders did not always understand and manage the priorities and issues the service faced.
- The service provided mandatory training in key skills to all staff, however, not all staff had completed the training.
- The service did not have effective systems and processes to safely prescribe and administer medicines.
Urgent action
The CQC’s report advised that the Trust must take action to improve maternity services, and issued a warning notice asking that significant improvements on staffing and governance, and oversight of the service were made.
As a result, the Trust is required to submit an action plan and the CQC will continue to monitor progress in relation to that.
The CQC’s Deputy Director of Operations in the East of England, Stuart Dunn, said:
“At our inspection, we were concerned to find low staffing for midwives was still a significant risk to the safety of women, people using these services, and their babies despite us telling the trust they needed to address this previously. The trust had taken steps to address the issue by recruiting midwives internationally, but at this inspection we found this programme was being undermined by racism against staff, by their own colleagues, and a lack of support from leaders….
“While staff were working very hard, low staffing issues meant people could not always access services when they needed it. Capacity issues were particularly severe at Luton and Dunstable Hospital, which had to re-direct people to other hospitals on the first day of our inspection. We also saw women and people using the service at Luton and Dunstable hospital warning a long time for call bells to be answered….
“We issued the trust with a warning notice in December to focus their attention on making improvements to maternity services. Since the inspection they’ve produced an action plan to address our concerns. We’ll be monitoring these services closely, including through further inspections, to make sure people receive safe care while these improvements are implemented.”
Comment
Over the last few years, scrutiny of maternity services across the country has been significant but there has been hope that change was possible, and improvements would be on the way.
It is hugely disheartening to see yet another report in 2024 of multiple maternity services which are not only failing their patients, but also failing to act on previous warnings from the CQC.
The risk to the safety of women, people, and babies using maternity services cannot be underestimated with things as they are.
Clearly, services are struggling, and a lack of funding will play a significant role in this. However, it cannot be acceptable for Trusts to not only fail, but to continue to do so and it is now paramount that Bedfordshire Hospitals NHS Foundation Trust take the latest warnings seriously and push for vital improvements in their maternity care.
How can we help?
Danielle Young is a Legal Director in our Medical Negligence team, which is ranked in Tier One by the independently researched publication, The Legal 500, and Commended in The Times Best Law Firms 2024.
If you have any questions about the subjects discussed in this article, please contact Danielle or another team member in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online enquiry form.
Contact us