Maternity services at Worcester Royal Hospital "require improvement", says Care Quality Commission
A report says longstanding staffing issues have contributed to low morale on the unit
The Care Quality Commission (CQC) has told Worcestershire Acute Hospitals NHS Trust to make improvements to its maternity service at Worcestershire Royal Hospital.
An inspection was carried out on December 9 2020 following concerns from whistleblowers.
Inspectors found that staffing levels were often lower than planned, with midwives reporting that this led to them being frequently moved within the department.
Midwives also said morale was low due to longstanding staffing issues, and that they felt their concerns and views were not being considered by management.
Any staffing shortages should have been reported on an incident reporting system. However, staff told inspectors that they did not have time to do this and assumed that senior staff would do it.
But the report states that there was no clear process to identify if staffing gaps had been left vacant or filled by bank staff.
The report goes on to explain how the service’s managers were aware of these issues. They had held meetings to listen to staff concerns and formulate their response.
However inspectors say they also saw areas of good practice, including evidence that healthcare professionals from different disciplines worked as a team to support each other to provide good care for women and babies.
Staff understood how to protect women from abuse, and they implemented infection prevention and control measures effectively.
Justine Jeffrey, Divisional Director of Midwifery & Gynaecology Nursing at the Trust, said:
"We accept the recommendations within the report and have already begin actioning them.
"We'll cross reference the recommendations in the report with the actions we've already begin taking to make sure there aren't any additional ones we aren't already working on.
"We continue to monitor the action plan, work with our staff and make the improvements they've recommended".
CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“When inspectors visited the maternity department at Worcestershire Royal Hospital, they found areas where improvements were needed.
“We fully appreciate that hospitals are facing a particularly challenging time currently. However, it is crucial that women get the safe and personalised birth experience they are entitled to and that midwifery staff feel supported and valued in order to achieve this.
“The service must ensure that any risks are identified, and safety incidents are correctly shared and reported to reduce their impact.
“Staff should never feel that their concerns are not listened to and we are pleased service managers have initiated meetings to listen to staff with a view to taking action in the problem areas.
Following the inspection, the maternity service’s overall rating went down from Good to Requires Improvement. It was rated Requires Improvement for being safe and well-led, and Good for being effective.
Here are the main improvements the CQC has asked the Trust to make:
The service must seek and engage with staff for feedback to make any improvements without delay when they are identified.
• There must be a process for monitoring if substantive staff working bank shifts worked additional hours to ensure no staff member is working excessive hours.
• Senior leaders must have oversight of staffing, in order to deal with concerns.
• Staff must recognise and report all incidents and near misses; and learning must be shared effectively from incidents.
• The service must assess, monitor and mitigate the risks relating to the health, safety and welfare of patients; including ensuring the risk register reflects all risks.
The full report can be found here.