Unsafe staffing levels, low morale and allegations of bullying have been uncovered by health inspectors at two hospital maternity departments after whistleblowers raised the alarm.
Independent regulator the Care Quality Commission (CQC) visited maternity services at Ipswich and Colchester hospitals in March and April this year after six staff raised concerns about staffing, leadership, incident management and culture.
In reports published today, inspectors said both hospitals did not have enough nursing and midwifery staff to keep women and babies safe.
Nick Hulme, chief executive of both hospitals, said the trust accepts the CQC's findings and has already taken action to improve staffing, leadership and the way maternity services are managed.
“We are investing in recruitment for our maternity services, and are pleased that a new expert senior midwife will be joining us shortly to lead our service, with an additional 30 midwives due to join us over the next few months,” he added.
An extra 10 midwives a month will be joining the trust from July onwards, as part of a European midwife pilot announced earlier in June, plus additional maternity support staff.
'Tired, burnt out and in tears'
Just a day before the CQC inspected maternity at Ipswich Hospital, on April 6, it was put on a ‘black’ alert for unsafe staffing.
Both units had a dependency on bank staff and relied on regular employees working extra hours, which inspectors found led to burnout and high levels of sickness absence.
Several maternity workers were found to be “visibly tired, with some burnt out and tearful” during the CQC’s visit to Colchester Hospital.
And while inspectors found staff worked well together and felt respected by their peers, bullying was reported within the department at Ipswich Hospital.
Some workers told inspectors that morale was low and they did not always feel respected, supported or valued by senior leaders, which affected the care they provided.
Philippa Styles, the CQC’s head of hospital inspection, said that despite staff shortages at both units, women were supported by committed workers.
She thanked the whistleblowers, who raised concern about staffing at Colchester Hospital and prompted inspections at both units, adding: “We are grateful to these whistleblowers as we found the number of midwives and healthcare assistants were below levels required to keep women and babies safe.
“Staff across both units told us they felt let down by a lack of oversight from the trust’s board and senior leadership team, who were slow to act when issues were raised.”
Hospital chiefs said £1.4million was approved in January to fund the recruitment of more midwives and maternity support staff.
Following the inspection, maternity services at both hospitals were rated by the CQC as ‘requiring improvement’. They were previously rated good.
CQC experts noted that the departments had endured a period of instability - the director of midwifery post had been vacant at the same time as the head of midwifery had been shielding due to Covid-19.
The latter was also due to retire within six months, while a new director was expected to be in post by September 2021.
‘Red flags’ in antenatal care during Covid
This newspaper previously reported how women were missing key pregnancy checks during the Covid-19 pandemic.
The CQC found a triage system looking after women from 16 weeks into their pregnancy at Colchester Hospital was “overburdened”.
It had led to 24 ‘red flags’ between December 2020 and March 2021, which included delays in induction, missed or delayed care, rescheduled appointments, and one three-hour wait, put down to a lack of staff and capacity.
However, when things went wrong staff apologised - and gave women honest information, and suitable support.
Meanwhile, at Ipswich, it was discovered that the unit had not met national targets for providing women in labour with one-to-one care between April 2020 and March 2021.
Official National Institute for Health and Care Excellence (NICE) guidance recommends one-to-one care 100% of the time, as it aims to reduce the likelihood of problems for the woman and her baby.
Ipswich fell just short of this with 99%, while data was not available for Colchester.
Both hospitals also breached three health regulations on safe care and treatment, good governance and staffing.
Hospital chiefs said they continue to work closely with the Maternity Voices Partnership, which represents the views and experiences of those who are pregnant in Ipswich and Colchester, as they develop and improve services.
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