The Care Quality Commission (CQC) has this week said that more needs to be done to improve the safety of Leicester’s NHS maternity and emergency care services.
Significant concerns
During their latest inspection, the CQC found Leicester Royal Infirmary and Leicester General Hospital did not always have enough maternity staff to keep mothers and babies safe.
This comes following the CQC issuing a warning last year to the University Hospitals of Leicester NHS Trust (the Trust) requiring it to take urgent action to address risks to mothers and babies in its care.
Both the Leicester Royal Infirmary and Leicester General Hospital saw a drop for maternity services in their CQC rating last year from ‘good’ to ‘requires improvement’.
The outcome of the report led to many families coming forward and sharing their experiences of maternity care in Leicester’s hospitals and ultimately calls were made for a neonatal review to ensure that lessons were learnt.
More needs to be done
In 2023, the CQC’s inspection revealed particular concerns related to induced labours. The CQC found that, in the six months between August 2022 and January 2023, 834 midwifery red flags had been reported at the Leicester General Hospital, this is a warning sign that something may be wrong with midwifery staffing.
During the same period, there were 1,002 red flags at the Leicester Royal Infirmary.
The majority of these red flags related to induced labours, with 637 relating to delays in continuing induced labour once it had begun, and 13 for delays between admission and the start of the induction process.
Following on from the significant concerns found in 2023, CQC inspectors carried out follow up visits of both maternity and emergency services at the hospitals in January 2024 and, whilst they noted some improvements had been made, the CQC concluded that more needed to be done.
What were the findings?
Inspectors found that there were still issues with understaffing in maternity services. Of particular concern was the finding that there were not enough staff to keep people and their babies safe.
Staff shortages also meant that employees did not always have the time to report incidents as they should. This ultimately leads to opportunities for learning being missed.
However, some improvements were noted.
Triaging in maternity had improved at the latest inspection, and new approaches to meeting staff shortages meant that one-to-one care in labour was now maintained.
Despite this, it was clear that more still needed to be done.
For Leicester General Hospital maternity services, the overall rating remained ‘requires improvement’ because:
- Staffing levels did not always match the planned numbers, putting the safety of women and birthing people and babies at risk.
- Staff did not always assess and identify risks to women and birthing people and act on them and did not always keep good care records.
- Action plans in response to the CQC’s last inspection were in progress, but not all tasks had been completed and reviewed.
For Leicester Royal Infirmary, the overall rating is ‘requires improvement’ because:
- Staffing levels did not always match the planned numbers, putting the safety of women, birthing people, and babies at risk.
- The Trust had a higher number of extended perinatal deaths when compared to other similar hospitals.
- Staff didn’t always report all incidents, so there were potentially missed opportunities to learn from them.
- Although staff kept equipment and the premises visibly clean in most areas, some essential building works had impacted on this.
- The Women’s governance board did not always monitor data specific to each hospital location.
- Although there were improvements since the last inspection, there were further development and actions to embed improvements across the service.
Deputy Director of Operations for the CQC in the Midlands, Charlotte Rudge, said:
“When we inspected University Hospitals of Leicester NHS Trust, we found some improvements had been made, although more changes were needed to improve the standard of care people were receiving.”
The Trust’s chief nurse, Julie Hogg, said:
“We fully acknowledge we have much more to do to ensure our services are of the standard we want them to be and that our patients have a right to expect.”
You can read the full reports and summaries on the CQC’s website here.
Comment
Whilst it is of course good to see that improvements are starting to be made within maternity services at the Trust, this is just the tip of the iceberg and clearly, there remains a long way to go.
Safety of mothers, birthing people, and babies is paramount and continued action must be taken to ensure that this rating is improved going forward.
The Trust will remain under close scrutiny going forward, rightly so, and we look forward to seeing the continued improvements necessary to bring the Trust’s maternity services up to where they ought to be.
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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.
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