CQC publishes report on maternity care at Sandwell and West Birmingham Hospitals NHS Trust

The Care Quality Commission (CQC) has published a report following a focused inspection of maternity services at City Hospital, part of Sandwell and West Birmingham Hospitals NHS Trust.

The unannounced inspection was carried out in May after patients and whistle-blowers raised concerns regarding staffing levels and midwives not feeling supported by their leadership team.

Following the inspection, the maternity service was rated as good overall, and rated good for being safe and well-led. The overall trust rating remains unchanged as requires improvement.

Bernadette Hanney, CQC's Head of Hospital Inspection, said:

'When inspectors visited the maternity service at City Hospital, they were pleased to see that most areas were providing care that met the needs of women and babies.

'Prior to the inspection, we received information from whistle-blowers regarding staffing, particularly within community midwife teams. We are grateful to these staff for coming forward as our inspection found that managers sometimes struggled to ensure the service had enough nursing and midwifery staff to keep women and babies safe.

'Leaders understood this and took action to address it by recruiting 17 new nurses and midwives and were taking steps to address recruitment and retention issues.

'During the inspection we found that midwives and consultants worked well together for the benefit of women and their babies, and all staff were clear about their roles and accountabilities.

'All staff were committed to continually improving care and the service engaged well with women and the wider community to plan and manage services which had a positive impact on the care being given.

'We have reported our findings to the trust leadership, which knows what it must do to ensure the current level of care is sustained and further improvements are made so staff, patients and babies are fully supported.'

Despite low staffing rates and the high turnover of community midwives, staff worked hard to achieve the best outcomes for women and their babies. Managers worked hard to address any issues, including taking steps to improve the culture and making plans to attract new recruits.

The service celebrated staff through a variety of channels. For example, a video was made for social media which captured the first-hand experiences of new mothers and interviewed midwives about why they loved their jobs.

The service should also be commended for piloting the appointment of a diversity and inclusion lead midwife. They will work with culturally diverse and vulnerable groups to remove any barriers to ensure women receive safe and quality care throughout their pregnancy.

Following the inspection, the trust should ensure the following improvements are made:

• The trust should continue to address their staffing needs
• All staff should complete mandatory training
• All women should be provided with one-to-one labour care
• The trust should continue to address the low morale and negative culture in the service.

Inspectors observed the following outstanding practice:

• Inspectors saw an outstanding example of care for a woman whose labour choices were met through effective team working between the low-risk midwifery team and the obstetric team.

Full details of the inspection are given in the report published on our website.

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