Two more NHS maternity units have been criticised by the care watchdog over concerns about safety, with inspectors highlighting poor cultures and bullying as well as staff shortages leaving midwives visibly upset.
The Care Quality Commission has published two reports into inspections at maternity services in Queens Hospital, in Romford, Essex and at Walsall’s Manor Hospital.
Both hospitals have been told they must make improvements and the latest criticism from CQC follows its decision to inspect dozens of maternity units amid fears over the safety of maternity care throughout England.
At Queen’s Hospital inspectors downgraded the unit from good to requires improvement and warned women were not getting safe care and there was a negative culture.
Inspectors found staff were not always completing risk assessments and there was no clear record of whether consultants were attending to women suffering bleeding after giving birth. Heart monitoring traces were not always double checked and guidance was out of date.
They also found some training was not up to date and when things had gone wrong learning from incidents was not shared with staff. The CQC said staff did not always feel respected or valued by the leadership team.
Nigel Acheson, CQC’s deputy chief inspector for hospitals, said: “This lack of learning meant some incidents were repeated as there had been no steps taken to mitigate ongoing potential risks to women and their babies.
“This was also compounded by the fact that staff did not always feel able to speak out about concerns. They also told inspectors that even when they did, they didn’t always receive feedback or were told what, if any action had been taken as a result of raising these concerns.
“Staff also told us that they did not feel supported or listened to by senior leaders and there was a poor culture in the department which included bullying.”
Since the inspection the trust has brought in a psychologist and appointed an obstetric lead to tackle the culture in the medical team.
At Walsall’s Manor Hospital the CQC said it found that staff were supporting each other but that there was evidence that understaffing was causing a drop in the quality of care provided.
Fiona Allinson, CQC’s deputy chief inspector of hospitals, said: “Some staff and midwives were visibly upset and frustrated when talking about their experiences, with each area we visited identifying low staffing as the main risk. The number of vacancies had been exacerbated by staff having to self-isolate due to Covid-19.
“Managers did not always accurately calculate and ensure there were sufficient numbers and grades of midwives, nursing assistants and care support workers needed for each shift in accordance with national guidance.
“This meant specialist midwives were often moved from their roles to cover vacant shifts elsewhere which left gaps in specialist services. We saw two incidents where infant feeding midwives were unable to provide support to mothers and babies as they were working elsewhere.”
Some midwives reported that concerns were not always acted on due to ineffective relationships with leaders while others reported that no support was offered when they did raise concerns.
The CQC has called for improved leadership in maternity services after its inspections. The regulator has warned more than two fifths of NHS maternity units in England need to improve their safety.
Its concerns come as the government is facing mounting calls to invest more money in maternity services. NHS England has increased spending this year by £95m to help fund 1,000 more midwives and invest in safety training.
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