Improvement still needed in Bedford Hospital's maternity services
It's after a CQC inspection.
Aspects of Bedford Hospital’s maternity services still need to improve after critical inspections – but staffing shortages are being addressed, a meeting heard.
Maternity services at the hospital were downgraded to ‘inadequate’ after the Care Quality Commission (CQC) found a “potential risk for baby abduction” in November 2020.
That led to a new executive director team being appointed, which has been tasked with transforming the service.
A previous inspection by the CQC in August 2018 identified several concerns and the service was rated ‘requires improvement’ overall. It was served with requirement notices for regulation breaches.
Inspectors returned for an unannounced focused inspection in November 2020, after staff raised concerns about service safety which could lead to risk of harm to patients.
Following this inspection, the overall rating became ‘inadequate’, safe and well-led also changed to ‘inadequate’, and the rating for service effectiveness was revised to ‘requires improvement’.
The CQC issued Bedfordshire Hospitals NHS Foundation Trust with a warning notice over its maternity and midwifery services, and put conditions on the trust’s registration.
The conditions required the provider to ensure staffing is effectively assessed, reviewed and escalated to maintain safe levels in the maternity unit by December 1, 2020.
The trust updated Central Bedfordshire Council’s social care, health and housing overview and scrutiny committee on progress since that CQC visit, and a further unannounced one to the maternity unit in June 2021.
Inspectors identified continued concerns with staffing levels for midwives and doctors in June 2021, which they felt impacted negatively on staff morale and ability to complete training, according to a report to the committee.
Members of the maternity leadership team and the trust executive have led an in-depth plan to address and action the recommendations made by the CQC, explained the report.
“As this inspection followed a focused methodology, it hasn’t been rated. While it’s disappointing it’s not been rated, the CQC has identified and acknowledged a significant number of areas of positive practice, and safe, effective and well-led quality care.
“The department has progressed in all areas, but the current operational climate is having a significant impact on completing mandatory training, staff appraisals and staffing levels.
“Some estate works are needed to enable the implementation of effective triage pathways, in line with national best practice guidance.
“The department will continue to monitor compliance over these issues, with a focus on those areas identified as not yet meeting the trust’s targets or needing further improvement.
“It was evident throughout the June 2021 report the CQC considered the leaders have the skills and abilities to run the service, they understand and manage the priorities and issues faced, and that staff find them to be visible and approachable.
“But, as the leadership team are relatively new, they haven’t had sufficient time to embed the changes which have taken place,” added the report.
“The trust proactively participates in the national maternity safety support programme, and a maternity improvement advisor is assigned to it and visits on a regular basis.
“The maternity team also invited regional colleagues from NHS England and NHS improvement to conduct a 60 supportive steps to safety review in November 2021.
“This provides the trust with assurance the unit meets the national safety regulations and identifies areas which require further support to improve safety.
“There were a large number of positive areas reported and a few requiring attention, which have been reviewed and cross-referenced with the quality improvement plan.”