The Care Quality Commission (CQC) has told West Hertfordshire Hospitals NHS Trust that improvements are needed at its maternity service at Watford General Hospital.
A focused inspection of the maternity service was carried out on 13 October in response to safety incidents highlighted to the CQC.
As a result of the inspection, the overall rating of the maternity service at Watford General Hospital went down from good to requires improvement. The overall trust rating remains unchanged as requires improvement.
Fiona Allinson, CQC’s deputy chief inspector of hospitals, said:
“When inspectors visited the maternity service at Watford General Hospital, it was clear that staff supported one another and worked hard to deliver good care to women and their babies, but it was evident that improvements were needed across the service.
“Despite managers regularly reviewing and adjusting staffing levels, the service was often understaffed which affected women’s birth choices. The trust had closed the midwife-led birthing unit to ensure safe staffing numbers, but this limited the choice for women with low-risk pregnancies as water births could not be facilitated.
“Safety incidents were managed well, and staff recognised and reported any issues. However, understaffing had caused recent safety incidents to occur, including delays in women receiving care once they were admitted to the department.
“The old hospital building created challenges due to minimal space available; delivery rooms were small with not enough space for all the required medical equipment and limited toilet and shower facilities. Managers told us that the trust had plans for a new maternity building.
“The trust knows where we expect to see improvements. We will continue to monitor the service closely to ensure the necessary improvements are made.”
Managers were proud of their staff and how they had supported each other through the COVID-19 pandemic. Staff worked well as a team to deliver care to women despite the challenges they faced with the aged estate and ongoing staff vacancies.
The trust had challenges with the recruitment of midwives due to the national shortage in this staff group. Managers had implemented initiatives to attract midwives to the trust with salary enhancement opportunities.
Following the inspection, the trust must ensure the following improvements are made:
- Maternity wards must be clean, and the delivery rooms must have monitoring in place for Entonox (gas and air) levels
- There must be enough midwives to provide a safe service for women that does not limit their choice of delivery environment
- Policy and guidance documents must be reviewed in a timely manner.
Full details of the inspection are given in the report published on our website.
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