Obstetrics department’s rating has declined due to lack of staff

The maternity ward was called for improvements after a whistleblower complained that low staffing levels meant midwives were too exhausted to keep patients safe.

The Care Quality Commission (CQC) downgraded the maternity service at Hampshire Hospitals NHS Foundation Trust (HHFT) from ‘good’ to ‘requires improvement’, although overall reliability remained good.

Inspectors made an unannounced visit to the maternity ward in November after concerns were raised by a staff whistleblower and complaints from patients.

It was found that the service did not have enough staff of nurses and midwives to keep women and babies safe.

A CQC spokesperson said: “Some staff said the force sometimes felt unsafe due to the number of personnel and the number of women in the force.”

“Midwives have worked harder than ever under extremely difficult circumstances, and have spoken of low staffing levels and exhaustion.”

The report also raised concerns that administrators “are not always able to manage effectively”.

Other issues include a lack of implementation of recommendations to reduce the further risk of COVID-19 for black, Asian and ethnic minority (Bame) women, and staff not always following national guidance. Another reason is that sepsis was not identified and treated.

However, inspectors found there was an “inclusive culture where families and partners were able to support women throughout their pregnancies”.

Amanda Williams, head of hospital inspection at CQC, said: “During our inspection of maternity services at Hampshire Hospitals NHS Foundation Trust, both hospitals we visited were incredibly busy and staff shortages were impacting on services. I found out that it was having an effect.

“Staff appear to be working above and beyond their duties, with some telling inspectors that there are not enough midwifery staff to keep people safe and that they are exhausted.

“The practice development team was frequently asked to replace clinical staff and was unable to serve as an educational resource.

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“This meant meetings were often closed to the public or postponed and training was disrupted so staff could focus on clinical care.

“However, the Trust’s leadership team is currently taking steps to ensure each department has sufficient staff.

“We were also concerned that staff were not always treating sepsis in a timely manner or following national guidance.

“This has been raised as an urgent matter for the Trust and the Trust is currently developing an action plan to address our concerns.

“The Trust’s leadership team understands what needs to be done and has assured us that an action plan is in place to drive the necessary improvements.

“In the meantime, we will continue to monitor whether the trust is implementing the necessary improvements.”

HHFT head nurse Julie Dawes said the trust had been forced to redeploy staff from their usual workplaces over the past 18 months, as well as suspend training and education to focus on patient care. .

She said: “This report is disappointing as safe and quality maternity care is a top priority for us.

“Our maternity teams work tirelessly to support the women in our care and are working hard to implement the CQC’s recommendations.

“We are grateful for the CQC’s insights that have helped us improve the care we provide to women and infants.

“Our continued investment means that since the inspection our staffing levels have increased with ongoing recruitment and training programs and additional training has been delivered.

“This is a very informative report that supports our vision of providing excellent care for our patients, and we are committed to resolving all issues raised.”