Whittington Hospital maternity unit 'requires improvement' says watchdog

Maternity unit at hospital was rated ‘good’ before the latest CQC inspection resulted in a downgrade, reports Julia Gregory, Local Democracy Reporter

Whittington Hospital (credit Google) — Whittington Hospital in Archway (credit Google)

Hospital bosses are asking a health watchdog to review its verdict that the maternity unit ‘requires improvement’.

The Care Quality Commission (CQC) highlighted safety concerns during an unannounced inspection at Whittington Hospital’s maternity unit but rated it ‘good’ when inspectors considered if it was well led.

Last year staff delivered 3,044 babies at the maternity unit, which has two dedicated operating theatres, birthing pools and a home birthing team, as well as antenatal and postnatal wards and day assessment. The last CQC inspection in 2016 also included the gynaecology unit, when the combined services were rated as ‘good’ overall.

This latest inspection is part of a national look at maternity units following the Ockenden review into the death of new-born babies at Nottingham University NHS Trust.

The CQC’s maternity inspection programme lead Carolyn Jenkinson said the visit to the Whittington in Archway found that: “Women in triage weren’t always being prioritised according to their clinical need using best practice guidance, which could put them at risk.”

But the inspectors also said staff “identified and quickly acted upon women and birthing people at risk of deterioration.”

Jenkinson also highlighted issues with the bereavement suite as bereaved families are cared for in quieter areas on the labour ward or birth centre. The CQC said the area was not “adequately decorated or furnished with the facilities needed to support them through bereavement” and it wants to see a “more suitable environment for women who have had a baby loss, until the formal plan for the bereavement suite comes to fruition”.

Inspectors also want a rethink on some of the furnishings in bathrooms “which could pose a risk” to people with mental health concerns.

But they noted the bereavement midwife had been shortlisted for the national Mariposa ‘bereavement midwife of the year award’.

The unannounced CQC inspection also found that “women needed to use communal showers and toilets which didn’t always meet the needs or the privacy and dignity of women and birthing people” as the labour ward rooms did not come with en-suite facilities.

CQC inspectors were concerned that just 60% of maternity staff had done all their mandatory training, below the trust’s own target of 90%, and that not all of the staff had completed specific training on recognising and reporting abuse.

However, inspectors found that “staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with other agencies to protect them”. They also knew how to make a safeguarding referral and who to tell about any concern.

Jenkinson, who is also the CQC’s deputy director of secondary and specialist healthcare, said: “We found a leadership team that had the skills and abilities to run the service. They had a clear understanding of the challenges within the service, and we need to see them using those skills to take action to address the issues we found at this inspection.”

The inspection did highlight some ‘outstanding’ practices, including the first Covid vaccination hub in London for mothers and a pioneering interpreting ‘on wheels’ service. It had also set up an ‘Ockenden cafe’ so staff could discuss and learn from that report.

Whittington Health NHS Trust has asked CQC to look at the overall ‘requires improvement’ rating for maternity services. It does not agree that it is line with the health watchdog’s methodology and said the service was only assessed on two of the CQC’s criteria of ‘safe’ and ‘well led’.

The other three criteria of ‘effective’, ‘caring’ and ‘responsive’ remain as ‘good’ from the last CQC inspection of its maternity services, the NHS trust pointed out. With four areas rated good “we are therefore asking the CQC to clarify why we have been rated ‘requires improvement’ overall.”

The hospital’s rating overall remains ‘good’.

Whittington chief executive Helen Brown said: “Whilst we have requested a review of our overall rating by the CQC there is much to be proud of in the overall report of the partial CQC review of the service – in particular our strong focus on our service users, women and families, staff morale and a strong new leadership.”

She said the team will also “focus our attention on making improvements” highlighted in the report, adding: “We already have ambitious plans for completely renovating maternity around the needs of our service users and staff, with all labour rooms having en-suite facilities, and are just about to complete a refurbishment of our midwife-led birthing centre.”

Whittington Health NHS Trust has just been granted planning permission to build new maternity facilities, including an area for bereaved mothers and their families – away from the labour ward.

Local news needs your support

We are proud that we were at the forefront of reporting on the recent local elections. We can’t do this without the support of our readers.

Independent news outlets like ours – reporting for the community without rich backers – are under threat of closure, turning British towns into news deserts.

If our coverage has helped you understand our community a little bit better, please consider supporting us with a monthly, yearly or one-off donation.