QA Hospital maternity services need ‘further improvements’ says regulator ‘concerned’ about ‘blame culture’ and staff shortages

Around 5,000 babies are born every year at the Cosham hospital’s service, which was recently inspected by the Care Quality Commission.

The CQC report found staff did not always feel respected, supported and valued by all managers, and some felt there is a blame culture and poor communication around incidents.

Inspectors said that staffing levels were lower than planned due to the pandemic, and as a result the service did not always have enough maternity staff with the right qualifications, skills, training and experience.

Midwifery staff said that these staff shortages had affected morale.

Covid restrictions also meant that services have not conducted any recent baby abduction exercises or emergency evacuation drills for the birthing pools.

During the inspection, the newly introduced electronic records system experienced an outage - meaning that there was potential for inaccurate record keeping

Staff said that they had raised concerns about this, but they did not feel listened to and the issue had not been escalated or recorded.

Amanda Williams, CQC’s head of hospital inspection, said: ‘When we inspected the maternity services at Queen Alexandra Hospital, we found that the service was generally being run well, but further improvements are needed.

‘Some of the issues we found were related to restrictions and pressures on the service caused by the COVID-19 pandemic.

‘However, we were concerned that although most staff described a supportive culture within the service, some reported longstanding cultural issues which meant they felt unable to raise concerns without fear.

‘This needs to be addressed as a priority so that staff feel able to speak openly about anything that is concerning them without the fear of being blamed, and so lessons can be learned from incidents that occur.

‘After the inspection, the trust confirmed it would address this, and we will monitor their progress.’

However, CQC also reported positive findings at QA, highlighting that colleagues at the services work well together, and many feel respected, supported and valued.

It was noted that staff also have the right facilities and equipment to keep mums and babies safe, and keep detailed records of care and treatment.

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QA’s maternity services provide consultant-led care and treatment for women with high risk pregnancy, while the trust’s Mary Rose Maternity Centre offers midwife-led maternity services to women with low risk.

Professor Liz Rix, chief nurse at Portsmouth Hospitals University NHS Trust, said: ‘We are committed to continually improving and enhancing our maternity services and are pleased to see the CQC has recognised some of the improvements made.

‘The ongoing pandemic has inevitably had an impact on staffing levels and the pressures of increased demand on our services, with some women requiring more complex care, have at times had a personal impact on our maternity team - we are very grateful to them for their commitment to provide safe care and we’re looking forward to the arrival of 25 new midwives and two consultants in the autumn.’

The report also emphasised that the new leadership team have the right skills and abilities, and are visible and approachable.

Prof Rix added: ‘We have new leadership in place and we want to make sure we work with all colleagues to understand their issues, make improvements and that our policies are up-to-date and easily-accessible.’

As the service was not rated during this inspection, therefore the previous rating of ‘requires improvement’ remains.

A message from the Editor, Mark Waldron

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