Maternity services at Bedford and Luton and Dunstable Hospitals remain 'inadequate'

The Care Quality Commission (CQC) has again rated maternity services at both Bedford Hospital and Luton and Dunstable Hospital as inadequate, following inspections in June and July last year.

Both hospitals are run by Bedfordshire Hospitals NHS Foundation Trust - which has apologised.

The unannounced inspections were carried out to follow up on the progress of improvements CQC told the Trust to make previously.

The watchdog found that only minimal improvements had been made, with the services remaining in breach of regulations around staffing and good management of the service, and were now also in breach of regulations relating to safe care and treatment.

In September, the CQC placed conditions on their registration requiring them to outline how they were going to make rapid improvements to risk management, how they were effectively governing the service, and ensuring staff completed the necessary mandatory training requires to keep women and their babies safe.

The Trust submitted an action plan that reassured CQC it was going to take immediate action.

'Low staffing level was having the biggest impact on women’s experiences'

Carolyn Jenkinson, CQC deputy director of hospitals in the East of England, said: “We were deeply concerned that improvements in maternity services were happening too slowly, with little change since our previous inspection. While we found caring staff, poor leadership meant both they and the women using the services were being let down.

“At this inspection, low staffing level was having the biggest impact on women’s experiences. Access to services was often delayed at both hospitals. The triage service was frequently understaffed, and at Bedford, our inspectors saw 451 calls out of 2,097 went unanswered or abandoned by the caller due to wait times, putting women at risk of not receiving the care they needed.

“Low staffing level also limited women’s choices. At Bedford Hospital, the elective caesarean service for women who were high risk and unable to labour was paused 32 times over a six-month period because there weren’t enough staff to support those who didn’t require emergency care. At Luton and Dunstable Hospital, women also experienced delays to elective caesarean sections as well as induction of labour. We also saw frequent diversions to other hospitals due to staffing shortages, which may lead to distress for women who had made specific plans at their chosen hospital."

Women described staff as attentive and respectful of their privacy and dignity - according to the CQC report.

They were also able to share their experiences and provide feedback through the local maternal and neonatal voices partnership, which regularly feeds back to the trust.

But the report also highlights how staffing issues at Luton and Dunstable were affecting staff morale and contributing to increased sickness absence, 'which in turn affected the safety of services.'

It added that leaders didn’t ensure staff completed mandatory training or risk assessments, and services were not learning effectively from incidents.

Some incidents remained open for more than 60 days. At Luton and Dunstable Hospital, more than 1,500 incidents were open at the time of our inspection, with over 1,100 overdue for investigation or closure, increasing the risk of incidents being repeated.

'We are sorry. Women and babies deserve consistently safe, high‑quality care.'

Bedfordshire Hospitals NHS Foundation Trust says it acknowledges the CQC’s reports and it 'was reassuring' to hear that the CQC reported that the feedback from the women the CQC spoke to indicated that “the service provided high quality, compassionate and responsive care. Women consistently reported their privacy and dignity were respected and that midwives were attentive in monitoring them and their babies.” and “overall women reported a positive experience with the service and staff.”

It also said it accepts the findings that maternity services 'did not consistently meet the standards of care we aspire to give and where our service has fallen short', adding 'we are sorry. Women and babies deserve consistently safe, high‑quality care.'

Since the inspections last year, the NHS Trust says its maternity teams — supported by colleagues across the organisation — have delivered significant improvements focused on staffing, staff development and wellbeing, and estates and facilities.

That includes a dedicated telephone triage midwife and a private triage area at Bedford Hospital, wellbeing check‑ins for staff and a move to more modern, purpose‑built maternity spaces 'improving access, privacy, and choice.'

David Carter, Chief Executive at Bedfordshire Hospitals, said: “As a Trust committed to delivering excellent care, the latest CQC inspection rating for our maternity services was disappointing for us to hear but we remain focussed in our effort on ensuring that our maternity services consistently meets the standards of care we aspire to give.

"We are sorry where care has not met the standard our community rightly expects, and our leadership teams will continue to work hard in removing obstacles to allow our maternity colleagues to provide the best care.

"Since last summer’s inspection we have strengthened staffing and senior clinical oversight, expanded staff development and wellbeing support, and opened state‑of‑the‑art maternity facilities in our new Acute Services Block at the L&D. At Bedford, we’ve introduced a dedicated telephone triage midwife, new ‘mini switchboard’ phone triage service and a private triage area to improve access, privacy and dignity. We will keep our community updated as we deliver further improvements.”

The CQC says it will continue to monitor the services closely, including through further inspections, 'to ensure improvements are delivered quickly and people are kept safe.'

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