Care Quality Commission raises concerns about maternity services at Croydon University (formerly Mayday) Hospital
The Care Quality Commission has published the results of its review of the maternity unit at Croydon University Hospital.
They found that it was not meeting six essential standards including:
- care and welfare: while the majority of births at the unit are safe, they say they are concerned at recent occurrences of maternal deaths and the unit’s ability to ensure optimum care when an emergency high risk situation occurs. They found evidence that the maternity unit may not always be able to provide 1:1 care on the labour ward, that there isn't a process to ensure timely and effective provision of epidurals in all cases and that an anaesthetist may not be available at all times;
- safe and accessible surroundings: they say they are concerned about the lack of separate showers for women using the birthing pools and the lack of provision of beds in amenity rooms for partners;
- safety and suitability of equipment: they say equipment in the unit was not always available when needed, especially during busy periods, and was not always repaired in a timely manner;
- staffing: the hospital was in the process of recruiting additional midwives at the time of their review; however, they are concerned that there were insufficient numbers of midwives giving direct clinical care to ensure people who use the services were safe and their health and welfare needs were met;
- supporting staff: they say people who use the service may not receive treatment from competent staff as there is evidence that mandatory staff training was not up-to-date; and
- quality checking systems: the hospital has implemented clinical governance and procedural changes following recent incidents and developed an action plan to improve the service; however they are concerned that it has not yet delivered effective learning from past incidents where there are high risk mothers or birth complications gained from effective root cause analysis, assimilation of learning from incidents and transmission of learning to all staff, including midwives, midwifery assistants, anaesthetists and consultants.
Colin Hough, the Director of the CQC in London says, “The Maternity Unit at Croydon University Hospital is not meeting all of the essential standards people should be able to expect. We have told the trust where it needs to do more to comply. We will continue to monitor the trust’s progress, to make more unannounced visits if necessary and to take any further action that we deem necessary to make sure the trust gets it right. We have asked the trust to reply within 28 days of receiving CQC’s report, setting out the action they will take to improve. We will follow up to make sure that the improvements have been made.”
I have received a briefing from Nick Hulme, the Chief Executive of the Trust, which says that:
- 14 qualified midwives will be starting work within the next few months and any remaining vacant posts will be filled in September when a group of student midwives qualify;
- 96% of maternity staff have had mandatory training and the remaining 4% have dates booked. The maternity unit has CNST level 2 accreditation and the results of the Maternity Service Review in 2010 showed significant improvement in many areas; and
- there is no evidence of a “trend” in deaths related to maternal care. The Trust has reported six maternal deaths (using the nationally set guidance) in the last 2 years. Of these, four women presented with life-threatening conditions not related to their pregnancy or delivery and in one other case a review found no concerns with maternity care. The other case is the death of a woman after an elective caesarean, which is subject to an inquest.
I have asked for a meeting with Nick to discuss the report in more detail. If anyone has feedback about their experience of the maternity unit, I would be interested to hear it.