In a detailed report released by the Care Quality Commission (CQC), Nottingham University Hospitals NHS Trust’s (NUH) maternity services have come under significant scrutiny following unannounced inspections.
The inspections took place at Queens Medical Centre (QMC) on June 18, 2024, and City Hospital Campus on June 19, 2024, as part of a new single assessment framework for maternity services.
Inspection Overview
The CQC say that the unannounced inspections were triggered by concerns about insufficient numbers of suitably qualified, competent, and experienced midwifery staff to meet the care and treatment needs of patients. These concerns were substantiated during the inspections, with several critical areas identified for improvement.
Key Findings
- Staffing and Skill Mix:
- Both sites reported insufficient staffing levels and skill mix. This was a major concern as it directly impacts patient care and safety.
- Equipment and Monitoring:
- There were notable gaps in monitoring fridge temperatures and checking critical equipment at both sites, highlighting a potential risk to patient safety due to possible equipment failures or storage issues.
- Curtains and Hygiene:
- Inspectors found a mixture of cotton and disposable curtains with no clear indication of when they should be changed, raising hygiene concerns.
- Positive Feedback:
- Despite these issues, staff at the Queens Medical Centre were universally praised as “fantastic”, and there was positive feedback from mothers, improvements in documentation, and progress in inclusivity and diversity initiatives.
Immediate Actions and Plans
In response to these findings, a comprehensive action plan has been submitted to the CQC. This plan includes immediate actions already taken and follow-up steps to address the identified issues. Key measures include:
- Enhanced monitoring and oversight by the new Perinatal Improvement, Assurance, and Oversight Group.
- Regular updates to be provided in the Trust’s engagement meetings with the CQC.
The action plan aims to ensure that areas of concern are addressed promptly and effectively. The Quality Assurance Committee will oversee the monitoring process to ensure compliance and improvements.
Context
Previously, the CQC had inspected NUH’s maternity services in April and June 2023, leading to the removal of two section 29A warning notices and a section 31 notice related to staffing levels, training compliance, triage, and governance. These earlier inspections also marked an improvement from an “inadequate” rating to “requires improvement.”
Recommendations
The CQC has emphasised the need for transparency, recommending that the Trust board publicly share the high-level feedback received from these inspections. This step is crucial to maintaining public trust and ensuring accountability.
Next Steps
The board is urged to consider the findings of this report and the immediate actions taken. This consideration is essential for ongoing improvements and for meeting the expectations outlined by the CQC.
The recent CQC inspections have shed light on significant challenges within NUH’s maternity services. While the dedication and positive impact of the staff have been acknowledged, the identified areas for improvement must be urgently addressed to ensure the safety and well-being of patients. The Trust’s commitment to implementing a comprehensive action plan and the CQC’s continued oversight will be vital in driving the necessary changes.
