CQC takes action to protect patients using maternity service in Birmingham's City Hospital
The maternity services at City Hospital in Birmingham have been rated requires improvement.
Last updated 29th Nov 2024
The Care Quality Commission (CQC) has rated maternity services at City Hospital, part of Sandwell and West Birmingham Hospitals NHS Trust, as requires improvement and taken action to protect people, following an inspection in June.
This inspection was carried in part due to concerns raised by whistle-blowers about poor culture, staff shortages, long waits to be induced, and a lack of thorough investigation of serious incidents.
As well as the service’s overall rating dropping from good to requires improvement, so has the rating for how well-led the service is. The safe rating has declined from good to inadequate. How effective the service is, has been rated requires improvement, which is the first time this key question has been inspected since maternity became a standalone service. Caring and responsive were not included in this inspection and do not have a rating as they also have not been inspected since maternity became a standalone service.
Following the inspection, CQC issued the service with a warning notice to focus their attention on making significant improvements around the environment, equipment, safeguarding, use of interpreters, and staffing.
The service has moved to the new Midland Metropolitan University Hospital since the inspection took place. The service’s new ratings don’t affect the trust’s overall ratings, which remains rated requires improvement.
Charlotte Rudge, CQC deputy director of operations in the midlands, said: “When we inspected maternity services at City Hospital, we found leaders needed to rapidly improve a number of areas to make care safer for women, people using the service, and their babies.
“Staffing was a significant problem. Many staff had to cancel their training and midwives with a specialist role said they were frequently pulled from those roles to cover staffing shortages in other areas, which could put people at risk. Also, when we looked at reasons why staff were leaving the service, it was due to low staffing levels and feeling they were unable to give people the best possible care they would like to.
“We had concerns around the environment and equipment. Daily checks of emergency and lifesaving equipment weren’t effectively carried out, and leaders hadn’t made sure all parts of the service had an effective process in place for checking emergency equipment. We also found the triage area didn’t have a resuscitaire and the environment didn’t provide people with privacy and dignity as it was cramped and private conversations could be overheard.
“We heard staff were working hard to put systems in place to include people in their care and to support equality, diversity and inclusion. Staff used flash cards to communicate with people who were deaf or had a learning disability, and they were also trying to produce handy guides when caring for people living with anxiety, deafness, blindness, and those who identified as trans or non-binary to help with communication concerns.
“We issued the trust with a warning notice to focus their attention on making improvements to maternity services. Since the inspection they’ve produced an action plan to address our concerns, and have completed all actions.
“We’ll be monitoring this service closely, including through further inspections, to make sure people receive safe care while these improvements are implemented.”
Inspectors found:
• Opportunities for learning were not always recognised or embedded.
• Women, people using the service and their babies, did not always receive care in line with national guidance and documents were not always completed to the required standards.
• Staff felt they did not always have time to carry out safeguarding procedures due to not having enough time.
• Staff were not always appropriately trained.
• Women and did not always receive interpreting services as appropriate.
• Some staff reported that not all members of the senior leadership team were visible or approachable.
• Some policies were out of date and the trust did not always ensure practice was in line with national guidance or their own policy.
However:
• The service used feedback to try and improve.
• Staff were aware of escalation pathways.
• Staff consistently recorded risk factors in people’s records.
• Partner organisations gave positive feedback about working with the service.
We've contacted the Sandwell and West Birmingham Hospitals NHS Trust for a comment.