Newham University Hospital maternity services have been rated as Requires Improvement by the Care Quality Commission.
In the safety domain, maternity services improved from Inadequate to Requires Improvement.
The hospital, part of Barts Health NHS Trust, provides services to women in the London Borough of Newham and part of neighbouring Barking and delivers around 6,300 babies a year and numbers are increasing.
This unannounced inspection in July 2017 focused on two areas: whether the hospital was safe for patients and well-led. Gynaecology services were not inspected.
CQC’s key findings included:
The security of babies in maternity services had previously been identified as a risk because of insufficient staff to monitor access to the unit. At this inspection the trust had implemented an electronic baby tagging system which had increased security. However, further work was required to ensure all visitors to the maternity wards were monitored and signed in appropriately.
Staffing issues continued to impact the delivery of care. Although there had been some staff recruitment, there continued to be shortages of midwifery staff at the time of the inspection. This included a shortfall in the number of experienced midwives.
At the previous inspection CQC raised concerns about record keeping. The most recent cardiotocography (CTG or baby heartbeat monitor) audit highlighted there were continuing problems with CTG record keeping, including incomplete documentation.
Plans were in place to monitor and drive improvements throughout the maternity service, however progress was slow.
Since the last inspection, some improvements had been made in assessing and monitoring the quality of the service with systems in place to improve engagement with staff.
Most staff commented there had been improvement since the last inspection with the leadership much more visible and visiting the units on a regular basis.
There was an effective training programme for midwifery staff, although some midwives emphasised the lack of time they had to engage with this.
Trainee doctors continued to be well supported and had opportunities to put their learning into practice.
The service had a plan for continuous improvement in the management of infection prevention and control, and inspectors saw good results from infection control audits. Women said they were satisfied with the standard of cleanliness.
There were areas of poor practice where the trust needs to make improvements. Importantly, the trust must:
- Take steps to ensure sufficient numbers of appropriately skilled staff are available to meet the needs of the service.
- Ensure that women receive timely treatment and pain relief, and that out of hours medical cover is effective in responding to and meeting the changing needs and circumstances of people using the service.
- Ensure all overdue serious incident reports are reviewed, actions are completed, learning is disseminated in a timely way, and processes are in place to effectively monitor progress.
- Ensure learning from incidents is used for the purposes of continually evaluating and improving services.
- Ensure that patient records are comprehensively and consistently completed and that processes are in place to evaluate this.
In addition the trust should:
- Ensure that mothers and babies are kept continuously safe from unauthorised access to the units.
- Further consider funding for staffing a second obstetrics theatre to improve waiting times for caesarean sections.
- Take further action to ensure compliance with the trust’s target of 90% completion of mandatory training, including safeguarding training.
Professor Ted Baker, England’s Chief Inspector of Hospital’s, said:
“There have been some improvements at Newham University Hospital which I am pleased about, but there are still areas of its maternity services that can provide a better standard or care."
“I was particularly pleased to see improvements to security at the hospital."
“It was good that most staff commented there had been improvement since the last inspection with the leadership much more visible and visiting the units on a regular basis.”
CQC inspectors visited all areas of the maternity unit and talked to midwives, support workers, obstetricians, senior managers, women attending the antenatal clinic and women who had recently given birth.
You can read the report in full on our website.
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