England's Chief Inspector of Hospitals has told Birmingham Women’s NHS Foundation Trust that it must make improvements following an inspection by the Care Quality Commission.
Birmingham Women’s NHS Foundation Trust was rated as Requires Improvement overall following an inspection which took place in April this year.
The trust was rated as Good for being caring and safe and Requires Improvement for being effective, responsive and well-led. The trust’s inpatient maternity service was rated as Outstanding.
Birmingham Women’s NHS Foundation Trust provides a range of health care services to women and families across the West Midlands and the UK which include gynaecology, termination of pregnancy (abortion care), maternity and neonatal care, as well as a comprehensive genetics service.
CQC inspected maternity inpatient and community services, surgery (gynaecology), outpatients and diagnostic imaging, termination of pregnancy services (abortion care) and neonatal services.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“Our inspectors found that some improvements were needed at Birmingham Women’s NHS Foundation Trust but we also observed many areas of good care across several departments.
“One of our main areas of concern was within the termination of pregnancy service where we witnessed challenges around governance arrangements and risk management.
“For example, the new contract for the termination of pregnancy service had commenced in January 2015. At the time of the inspection training for staff had not been formalised despite concerns expressed by staff about the need for clarity regarding actions to be taken.
In addition, several nurses expressed concerns that they had not received training that would equip them to deal with the physical and emotional aspects of advanced gestation abortions.
“There were excessive waiting times in antenatal clinics in some cases where some women were told to attend the hospital twice in one day with split appointments for bloods and a scan.
“It must be noted, however, that our inspection team also observed many areas of good care across the trust.
“There was a positive and enthusiastic culture throughout the hospital. Staff were committed and passionate about their work and proud of the services they offered to patients.
“Staff were keen to learn and continuously improve and patients were generally very positive about the care and treatment they received at the hospital.
“We were particularly impressed by the maternity inpatient service which we rated as Outstanding. The service had developed a number of innovative symptom-specific triage assessment cards which has been adopted by other trusts nationwide.
“Since our inspection we have been monitoring the trust and working closely with NHS Improvement and other stakeholders.
“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”
Full reports for the trust have been published on this website.
Across the trust, the inspection team found some areas where improvements must be made, including:
- All community midwives must attend safeguarding supervision in line with Department of Health requirements.
- Medicines must be prescribed and stored in line with the trust policy, particularly intravenous fluids.
- The trust must mitigate the risks relating to the health, safety and welfare of service users by regularly reviewing the risk register and include a timescale in completing any risks identified.
- The trust must identify, monitor and mitigate all risks relating to developing the complex abortion service pathway. In particular, regarding the impact on staff and patients of distressing elements of late gestation termination.
- A system must be implemented to assess, monitor and improve the waiting times across clinics in the outpatient and diagnostic departments.
- The trust must reduce the waiting times in diagnostics department by having sufficient numbers of qualified staff.
Inspectors also witnessed some good and outstanding practice across the trust, including:
- Video books were available for women across acute and community services who did not speak or read English.
- Gynaecology services had been successful in becoming an accredited British gynaecology endoscopy (BSGE) centre for complex endometriosis. This is a regional specialist service whereby women with complex endometriosis are referred and includes medical, pain related and surgical management.
- The symptom specific triage assessment card within inpatient maternity services delivered consistency and clear targets for the triage process.
- The symptom specific triage assessment card within inpatient maternity services delivered consistency and clear targets for the triage process.
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