Maternity services at Swindon's Great Western Hospital 'require improvement'
The Care Quality Commission say they need improvement, following an inspection last September
Last updated 8th Mar 2024
Maternity services at the Great Western Hospital in Swindon have been downgraded by the health watchdog.
The Care Quality Commission say they need improvement, following an inspection last September.
The report's found a drop in the level of care being provided to women, people using the service and their babies under the Great Western Hospitals NHS Foundation Trust.
Inspectors also found not all staff had completed mandatory training and record keeping wasn't always consistent - ranking it as 'requires improvement'.
The rating for how well-led and how safe the service is has also dropped, however this inspection didn’t rate how effective, caring, and responsive the service is.
Great Western Hospital in Swindon provides maternity services to the population of Swindon, Wiltshire, and the surrounding areas.
The overall rating for maternity services at Great Western Hospital has dropped from good to requires improvement. How well-led the service is has declined from good to requires improvement. The rating for how safe the service is has also dropped from good to requires improvement. This inspection didn’t rate how effective, caring, and responsive the service is.
The overall rating for the hospital remains requires improvement. The overall rating for the trust remains good.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said: “When we inspected maternity services at Great Western Hospital, we found a deterioration in the level of care being provided to women, people using the service and their babies. Leaders weren’t acting quickly when issues were found, and this was putting people at risk of harm.
“Local leaders had poor systems and processes in place and lacked urgency to address risks. Inspectors saw there was a risk around transferring care records to a new system that’d been raised at previous inspections. We saw there still hadn’t been actions to address this at our most recent inspection. Other risks raised by CQC at the previous inspection had also not been addressed, such as a ventilation concern with one of the rooms often used as a second operating theatre.
“Staff weren’t always escalating incidents to other agencies or marking them as severely as they should have been. People had experienced 3rd and 4th degree perineal tears and bleeding during birth, but these had been downgraded in severity, which meant they were not investigated as thoroughly as they should’ve been to keep people safe.
“We also found staff didn’t always assess people when they arrived or note how urgently they needed support. This meant people weren’t always seen in order of clinical need and staff could miss if someone’s condition worsened. However, the trust started to make improvements to this following inspector feedback.
“Staffing levels weren’t always safe, and the service was short-staffed during the inspection, although the trust has filled some vacancies since then. Staff had raised concerns with leaders that this had led to delays in treating people who needed their labour induced. There was also high levels of staff sickness and inspectors were told this was due to stress.
“However, we found that staff were doing their best to provide good care despite the challenging circumstances and worked well together as a team. Leaders also recognised that improvements needed to be made to the service and had started to work on this.
“We will continue to monitor the trust, including through future inspections, to ensure the issues we identified are addressed so women, people using the service and their babies receive the best possible care.”
Inspectors also found:
Staff hadn’t all completed mandatory training in order to identify and protect people from abuse and manage safely well.
Record-keeping wasn’t always consistent or fully completed. Staff updated both paper and electronic notes and there was a lack of clarity as to where staff could find information.
Leaders weren’t effectively monitoring how the service performed and acting quickly to address issues and risks. Leaders didn’t always address risks which the service was aware of in a timely manner.
Women and people using the service didn’t always know where they could go for urgent help about a pregnancy. However, the trust showed inspectors proposals to address this with a streamlined contact system which may be put in place.
However, the service was working to tackle health inequalities in the local area and had engaged with a local university to train staff in Black Maternity Matters.
The environment was well-maintained, and the service managed infection risks well.
Great Western Hospital have issued the following statement:
A Great Western Hospitals NHS Foundation Trust spokesperson said:
“We are disappointed that the CQC rating for maternity services has changed from Good to Requires Improvement. We were already aware of the areas highlighted by the CQC and have been working on improvements for some time. Since the inspection was carried out six months ago, we have made considerable progress on improving the care we deliver to local people.
“Improvements introduced include a new triage system that is ensuring most women and birthing people are seen within 15 minutes, more robust processes for audits and reviews, and significant improvement in mandatory training compliance for our staff. In their report, inspectors identified good morale and teamwork, well-controlled infection risks and noted collaborative working with a university to train staff in ‘Black Maternity Matters’ as outstanding practice.
“In a recent CQC survey conducted with women and birthing people who had used our maternity services, the Trust scored third highest in the country for questions relating to antenatal check-ups and care on the ward after birth, and in the top five Trusts for questions relating to care at home after birth.
“We recognise that there is still more work we need to, and our maternity leadership team is working hard to drive forward continuous improvement to enable us to provide the very best level of service to our community.
“We understand that some local women, birthing people and families might be concerned about this rating, however we want to reassure them that our staff continue to provide high levels of care, and that maternity services are now almost fully-staffed, with a strong pipeline for new recruits. Anyone with any particular concerns should contact their named midwife for a further conversation.”