The Care Quality Commission (CQC) carried out an unannounced two-day inspection at Nottingham University Hospital’s maternity units in April and this week released the findings. This comes just days after it was confirmed that it was investigating the deaths of three babies in the trust’s care in 2021.
Nottingham University Hospital’s maternity units have been under intense scrutiny following deaths and injuries involving dozens of babies. It is currently subject to the largest review of its kind after a series of failings were found. It has also recently been reported that the Police are investigating the maternity services as well.
Improvements
It does seem that some small amounts of progress are being made by the Trust in improving maternity services. Previously, the CQC had rated Nottingham’s maternity units as inadequate. However, following their latest inspection, it found improvements and has upgraded the rating to requires improvement.
The CQC said that it had identified sufficient recent improvements to enable them to lift their long-standing inadequate rating of Nottingham University Hospital.
Deputy Director of Operations at the CQC, Greg Rielly, said:
“At both maternity services, we saw an improvement in the level of care being provided to people and their babies since we last rated both services as inadequate. It is positive to see that the Trust is now on an improvement journey to bring about better and safer care.”
Ongoing problems
It is clear that the improvements are quite small at this stage, as the CQC found that the Trust’s maternity service still had multiple issues. These included:
- It did not have enough substantive staff to care for women and keep them safe.
- Not all staff had training in key skills or assessed risks to women in a timely way.
- There were safety concerns about how medications were managed.
- Not all equipment was cleaned between uses.
- Storage of breast milk was unsafe.
- The Trust was not always complying with its statutory responsibilities for the duty of candour (this is a professional responsibility, to be honest with patients when things go wrong).
The full details of the CQC’s inspection and findings are available on their website.
Bereaved families speak out
Bereaved families commented that the CQC’s report showed a small step but felt that “much more needs to be done”.
The BBC reported that the Hawkins family, whose daughter died due to failings in 2016, said:
“It is progress and we need to be positive about that, but our concerns are it is really the bare minimum that the public should expect. Some of the outstanding issues raised are critical to safety and very basic. ‘Requires improvement’ still doesn’t mean safe and what all the families want is safe care. The families welcome that there may be some improvements, but we really want to stress that it seems like it is the bare essentials. The trust still requires improvement and that’s not anything to be celebrated.”
Ockenden maternity review
A major review of the Trust’s maternity failings is underway, led by senior midwife, Donna Ockenden.
It was established in May 2022 following the significant concerns raised regarding the quality and safety of maternity services at Nottingham University Hospitals NHS Trust and the concerns of local families.
Donna Ockenden and her team of doctors and midwives will review cases of serious and potentially serious concern in maternity services at the Trust. The review is looking at the cases of around 1,800 families. Her findings so far have even triggered Nottinghamshire Police to commence their own inquiry, which will run alongside the Ockenden review.
The official website for the review has further information and support, see here.
Comment
It has to be said that it will take a lot more than some small improvements for Nottingham University Hospitals NHS Trust to regain the trust of families.
Whilst it is, of course, pleasing to see that heed has clearly been taken and things are starting to improve, the maternity services are still rated as ‘requiring improvement’ and, as the families rightly say – that is not to be celebrated.
Rather, the Trust needs to focus attention on continued improvements on a larger scale. The families are correct to say that these small improvements are really the absolute minimum that the Trust should be doing, and there is still a mountain to climb to get back to where they should be.
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Danielle Young is a Legal Director in our Medical Negligence team, which has been ranked in tier one by the independently researched publication, The Legal 500.
If you have any questions in relation to the subjects discussed in this article, then please get in touch with Danielle or another member of the team in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online form.
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