Newham University Hospital maternity services require improvement

Newham University Hospital maternity services have been rated as ‘requires improvement’ by the Care Quality Commission (CQC).

The hospital, part of Barts Health NHS Trust, provides services to women in the London Borough of Newham and part of neighbouring Barking, and delivers around 6,300 babies a year.

In the safety domain, maternity services have improved from ‘inadequate’ to ‘requires improvement’.

The unannounced inspection in July 2017 focused on two areas: whether the hospital was safe for patients and well-led.

CQC found that the trust had implemented an electronic baby tagging system which had increased security, but further work was required to ensure all visitors to the maternity wards were monitored and signed in appropriately, and that staffing issues continued to impact the delivery of care even though some new staff had been recruited. It also found that there were continuing problems with CTG record keeping, including incomplete documentation, and that although plans were in place to monitor and drive improvements through the maternity service progress was slow.

Since the last inspection, CQC said some improvements had been made in assessing and monitoring the quality of the service with systems in place to improve engagement with staff.

Most staff commented there had been improvement since CQC last visited with the leadership much more visible and visiting the units on a regular basis.

There was an effective training programme for midwifery staff, though some midwives emphasised the lack of time they had to engage with this, and trainee doctors continued to be well supported and had opportunities to put their learning into practice.

The service had a plan for continuous improvement in the management of infection prevention and control, and inspectors saw good results from inspection control audits.

There were areas of poor practice where the trust needs to make improvements, including: taking steps to ensure sufficient numbers of appropriately skilled staff are available to meet the needs of the service; ensuring that women receive timely treatment and pain relief, and that out of hours medical cover is effective in responding to and meeting the changing needs and circumstances of people using the service; ensuring all overdue serious incident reports are reviewed, actions completed, learning disseminated in a timely way, and processes in place to effectively monitor progress; ensuring learning from incidents is used for the purposes of continually evaluating and improving services; and ensuring that patient records are comprehensively and consistently completed and that processes are in place to evaluate this.

CQC has also told the trust they should: ensure that mothers and babies are kept continuously safe from unauthorised access to the units; further consider funding for staffing a second obstetrics theatre to improve waiting times for caesarean sections; and take further action to ensure compliance with the trust’s target of 90 per cent completion of mandatory training, including safeguarding training.

Ted Baker, England’s Chief Inspector of Hospitals said: “There have been some improvements at Newham University Hospital which I am pleased about, but there are still areas of its maternity services that can provide a better standard or care.

“I was particularly pleased to see improvements to security at the hospital.

“It was good that most staff commented there had been improvement since the last inspection with the leadership much more visible and visiting the units on a regular basis.”