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Significant concerns over standard of maternity care at Hull University Teaching Hospitals

By Jack Fox

Hull Royal Infirmary’s maternity rating, which has a dedicated Women and Children’s Hospital, has been downgraded from “good” to “inadequate” by regulator, Care Quality Commission (CQC).

Several inspections were carried out at the hospital in March and April as part of the CQC’s national maternity inspection programme, following which a report was published detailing the overall findings.  

It was identified that systems and risks in the antenatal day unit and triage department “were not well managed” leading to lengthy delays in pregnant women being seen and a “chaotic environment which was not fit for purpose”.

There were concerns surrounding staff training. There was no policy in place stating what training was mandatory and how often it should be completed. There was also a lack of training in areas where there was a known risk.  Only 51% of staff were trained to assess foetal growth using the fundal height measurement against the trust target of 90%, meaning half of the staff had not completed this mandatory training, which supports staff in identifying if babies are the expected size against gestational age.  Consequently, there were a number of incidents which demonstrated several missed opportunities by professionals in identifying babies who were small for gestational age. Only 39% of staff had completed the perinatal institute growth assessment protocol training. Many staff did not know how to evacuate a birthing pool in the event of an emergency.

The report states the “design, use of facilities, premises and equipment did not always ensure women and birthing people were safe”. There was no resuscitaire, a device used to give breathing support to babies when needed, on the antenatal day unit. There was also no plan in place for how staff could access a resuscitaire in the event of an emergency.  

Midwifery staffing levels were below the expected levels across each department of the service.

Staff also felt unsupported, the report stating: “they were not always listened to and following incidents they were not provided with compassion and support from leaders, which can be indicative of a closed culture”. Managers did not review incidents on a regular basis so that potential themes and trends could be identified and actions to identify and mitigate risk. Further, staff did not complete risk assessments and “did not always identify and act quickly to prevent deterioration of women and birthing people at risk”.

There is an expectation on healthcare professionals to provide a certain standard of maternity care, to ensure the safety of pregnant women and their babies. Fortunately, babies are mostly delivered safely and healthy, though there are of course risks. There are, obviously, much less risks when maternity hospitals are well run, and the opposite is also true.  

This report by the CQQ is disappointing, particularly as we are sadly seeing some common themes at hospitals across the country, in relation to areas of maternity care which require improvement. The birth of a child is usually a positive experience, as so many of us know first-hand. Hopefully this Trust actions the recommendations and improvements are made urgently, to ensure avoidable harm does not occur.

If you or a loved one has any concerns relating to any treatment provided by Hull University Teaching Hospitals NHS Trust, please get it in touch so that we can begin to support you, as we do with many other families.

You can see the full report here

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Jack qualified as a Solicitor in 2019. He’s a member of our Medical Negligence team.


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