The Care Quality Commission (CQC) has rated the maternity service at St Thomas’ Hospital in Lambeth good, following an inspection undertaken in September.
The inspection was carried out as part of CQC’s national maternity inspection programme. The programme aims to provide an up to date view of the quality of hospital maternity care across the country and a better understanding of what is working well to support learning and improvement at a local and national level. You can read more about this work on the CQC website.
In addition to being rated good following overall following the inspection, St Thomas’ Hospital’s maternity service was rated good for being well-led and requires improvement for being safe.
Ratings for Guy's and St Thomas' NHS Foundation Trust, which runs the hospital, are unchanged by this inspection. It remains good overall.
Similarly, St Thomas’ Hospital remains rated good overall.
Nicola Wise, CQC head of hospital inspection, said:
“Overall, we found women and babies were receiving good care in St Thomas’ Hospital’s maternity service.
“Behind this was the work leaders had undertaken to ensure staff received high-quality training and build a good culture. We also found people were successfully protected from the risk of infection.
“However, there were areas Guy's and St Thomas' NHS Foundation Trust should improve.
“These include addressing the service’s staffing shortage, which was causing women to wait too long for assessment and treatment, compromising women and babies’ safety, and leading to poor feedback.
“While staffing challenges are affecting the NHS and wider care sector across the country, every trust and healthcare provider must do all it can to ensure its care isn’t undermined by staffing constraints.
“We have reported our findings to the trust so it can build on what it’s getting right and address what needs improvement.
“We continue to monitor the service, hospital and trust – including through future inspections – to support the safe and effective care and treatment people have a right to expect.”
The inspection found:
- Staff had training in key skills. They worked well together for the benefit of women and understood how to protect women from abuse
- Infection risk was controlled well
- Safety incidents were well managed and used to drive learning
- Leaders ran services well using reliable information systems, and they ensured staff were competent and supported to develop their skills
- Most staff felt respected, supported and valued
- Staff were clear about their roles and accountabilities
- The service engaged well with women and the community to plan and manage services, and staff were committed to continually improving services
- The trust was quick to respond to CQC’s concerns and appointed a new midwifery matron shortly after the inspection to provide additional leadership within its medical assessment unit (MAU). The trust also appointed four obstetric clinical fellows to the MAU to a provide medical presence from 9 am to 9 pm
- Inspectors were assured feedback from women and families would be prioritised to improve their experience.
However:
- There were not always enough staff to respond to and support mothers and babies
- Women often had to wait a long time to be triaged for a medical review or to be admitted for treatment in the maternity assessment unit (MAU)
- The environment in triage and the maternity assessment area meant staff could not always maintain women’s privacy and dignity
- Records were not always stored securely
- Although the trust received very positive results for its Friends and Family Test, a patient feedback tool, showing over 90% of respondents reported a positive experience, CQC received 268 feedback forms from women who had recently used the hospital’s maternity service and almost 70% reported a negative experience. This was generally related to women not feeling listened to in labour, feeling pressured to have an induction of labour, inadequate staffing numbers and waiting times in the triage area.