The Care Quality Commission (CQC) has told Buckinghamshire Healthcare NHS Trust that improvements are needed in maternity services at Stoke Mandeville Hospital.

The service was inspected in June 2023 as part of the CQC’s national maternity services inspection programme. This is intended to provide an up to date view of the quality of hospital maternity care across the country, and a better understanding of what’s working well to support learning and improvement.

This was the first time Stoke Mandeville’s maternity service has been rated on its own. Previously, maternity and gynaecology services were inspected and rated together.

Five key questions

The CQC considers five key questions in order to assess how well a service is working.

These are:

  • Is the service safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive?
  • Is it well led?

The rating awarded for each question affects the overall rating a service receives.

‘Requires improvement’

The maternity service at Stoke Mandeville Hospital was given a rating of ‘requires improvement’ for safety. It has therefore been rated ‘requires improvement’ overall.

Leadership at Stoke Mandeville’s maternity service was rated ‘good’.

The inspection did not consider how effective, caring or responsive the service was.

The overall ratings for Stoke Mandeville Hospital and Buckinghamshire Healthcare NHS Trust both remain as ‘good’ overall.

What inspectors found

Carolyn Jenkinson, the Care Quality Commission’s director of secondary and specialist healthcare, said:

When we inspected maternity services at Stoke Mandeville Hospital, it was encouraging to see leaders had the necessary skills and abilities to run the service. They also understood and managed the priorities and issues the service faced, and staff spoke highly of them. However, there were areas where improvements needed to be made.

Inspectors identified high vacancy and sickness rates, and people explained that the low numbers of staff made them feel like aspects of the service could be unsafe. Sickness rates were increasing as staff became more stressed, though leaders in the service took action to manage change when risks were identified.

The CQC also noted that the environment in the triage area “made it impossible” to maintain confidentiality during any telephone calls, face to face conversations or assessments. This meant the safety of people using the service could be compromised, and that people might be put off from telling staff when they were at risk.

The space limitations in the triage area created trip hazards because equipment wires fell onto the floor between each bed space. The workload of staff in triage was also affected by the need to source suitable equipment from other areas, and they had no immediate access to medication. Staff did not report any of these issues as incidents because they had become so normalised.

Inspectors were told that a quality improvement project around triage had begun in February 2023 and is expected to improve the flow of patients, ensure timely risk assessments take place and improve the environment.

Elsewhere, the CQC found that staff did not always manage medicine effectively or correctly. They also reported that the layout and design of the maternity environment was not always suitable for the services provided. For example, the dedicated bereavement suite for families who had experienced a baby loss was situated on the labour ward. This meant that bereaved families might have been able to hear babies crying or families celebrating.

Good leadership

Inspectors reported that the maternity service at Stoke Mandeville Hospital managed infection risk well. Staff felt respected, supported and valued.

Leaders at the service were visible and approachable, and they escalated and managed risk effectively.

The CQC also said that staff understood how to protect women and people using the service from abuse. You can read the CQC’s full report on its website.

In response to the inspection report, Buckinghamshire Healthcare NHS Trust has issued a statement.

Neil Macdonald, Chief Executive of Buckinghamshire Healthcare NHS Trust, said:

We would like to thank everyone working hard in our maternity service for what they do every day to look after the women, birthing people and babies in their care. We are proud that the CQC recognised our maternity team is focused on the needs of those receiving care.

However, it is important to acknowledge that the CQC also found significant areas for improvement. The safety of those using our services is our priority and there are a number of actions required to make the necessary improvements. In the short term work is already underway to address the issues that have been raised, including plans to improve maternity triage, to recruit and retrain more staff and to maintain supplies of adequate equipment.

In the longer term, we will look at how we can address the challenges of improving the maternity environment in our current buildings.

Share your view

Don’t forget – if you or a loved one have experience of care from Stoke Mandeville Hospital you can rate and review the service through our rate and review centre.

Feed back now

Published on 24 Oct, 2023 (updated 9 Jan, 2024)

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