The Care Quality Commission (CQC) has told Royal Free London NHS Foundation Trust that it must make significant and immediate improvements to the maternity services at The Royal Free Hospital in Hampstead, London, and has served the trust with a warning notice.
CQC carried out an unannounced focused inspection of the hospital’s maternity services in October, after concerns were raised following the death of a pregnant woman in February. After the inspection, the service was rated Inadequate overall and Inadequate in relation to whether it was safe or well-led.
CQC’s Deputy Chief Inspector Hospitals for London, Nigel Acheson, said:
“We inspected the Royal Free Hospital’s maternity services following the death of a pregnant woman in February, as we were not given assurance that the trust had learnt from the incident and introduced systems to keep patients safe.
“We were also concerned that important information to help people using the maternity services was only available in English.
“We fully appreciate that hospitals in London are facing a particularly challenging time at the moment. However, due to the serious nature of our concerns, we served the trust with a warning notice in November. We have told the trust it must make significant and immediate improvements to ensure safety procedures are in place to protect patients and that details are shared with all staff.
“I am pleased to report that, since then, the trust has developed a detailed improvement plan. We will continue to monitor the service and will not hesitate to take further action if required, in accordance with our legal powers.”
Inspectors rated the service Inadequate for the following reasons:
- There was no clear vision or strategy. Leaders could not give assurance that they understood and managed the priorities and challenges that the service faced. Senior staff did not show sufficient understanding of potential risks and issues.
- The service did not use effective processes to enable it to continually assess and improve the quality of care provided. There was no robust process in place to manage risks.
- Systems to manage safety incidents were not always reliable or effective. The service response following serious incidents was sometimes delayed and inefficient. Learning from incidents was not always fully embedded.
- There were no written records to show that the trust had apologised to families and patients when things went wrong. People should be informed about the incident and provided with support, truthful information and an apology when things go Wrong. This should also be recorded by the trust.
- Issues with connectivity to the WiFi network on the labour ward meant that the service was not able always able to collect reliable data on the electronic patient record system.
- Staff did not always display a good understanding of the people who use their maternity services. The service did not have patient safety information leaflets available in other languages. This meant that women with a limited understanding of English were at higher risk of missing warning signs about their own, and their baby’s, health.
The trust is one of the country’s biggest, incorporating Barnet Hospital and Chase Farm Hospital, as well as the Royal Free. The trust’s overall rating is Requires Improvement.
Full details of the inspection are given in the report published on the CQC website here.
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