Quality inspection raises concerns regarding maternity care at NHS Trust
Posted on June 5th 2020
The Care Quality Commission (CQC) have recently rated two hospitals under the East Kent Hospitals NHS Foundation Trust as “requiring improvement”. Investigations were launched into the hospitals’ maternity departments as practices were identified as potentially posing risks to expecting mothers and their babies.
In the William Harvey Hospital, the CQC noted that, due to shortages of doctors, high risk women were being left to be assessed by midwives only, in cases where senior intervention was required under practice guidelines. It was also found that junior doctors with limited experience were making decisions when reviewing and discharging high risk patients, instead of senior doctors.
Escalating emergency cases to senior practitioners was made difficult as many midwives, often junior midwives, were left to work alone in day care. This also led to a lack of reporting, which meant that avoidable events were left ignored as they had not been escalated appropriately to management. This inevitably created a knock-on effect in that improvements were not being made as management are not being made aware of the existence of such problems.
In the Queen Elizabeth Queen Mother Hospital under the same Trust, a worrying lack of guidelines and risk assessments were found not to have been implemented or used in high risk and emergency cases. It was found that midwives were relying on their professional judgment, rather than following the normal risk rating scores and pathways, and determining themselves whether pregnant women should be seen in triage, be admitted to the labour ward or be told to stay at home.
It was noted that medical records were not being completed appropriately or if they were, were not very clear or were not being stored correctly. National targets were noted to have been missed for completing risk assessments and giving safeguarding training for doctors.
The Trust’s maternity care has been under scrutiny since an incident in 2017 in which a newborn baby sadly passed away following complications which were deemed “wholly avoidable” by HM Coroner, which was partially attributed to staff involved having inadequate experience for the positions they were in.
The Chief Executive of the Royal College of Midwives has expressed her disappointment with the reports carried out on the East Kent Hospitals and acknowledged that there is an urgent need for action required at these hospitals to ensure the safety of all women and babies, especially with handling high risk and emergency situations.
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