Maternity unit at Basingstoke hospital 'requires improvement' as midwife shortages bite

The maternity unit at Basingstoke and North Hampshire Hospital has been ordered to improve following an inspection by the Care Quality Commission (CQC).

The commission, the regulator for health services in England, made an unannounced visit to the hospital on November 16 last year after concerns over the quality of care within the unit were raised by whistle-blowers, patients and other regulatory bodies.

The commission reduced the rating of the service from ‘good’ to ‘requires improvement’ – the second lowest of the four ratings a service can receive, meaning the service “isn’t performing as well as it should be”.

The hospital overall, which is run by the Hampshire Hospitals NHS Foundation Trust, maintains a ‘good’ rating.

During the inspection – which involved inspectors observing routine activities, visiting clinical areas, speaking to staff and reviewing records – the commission found the service “did not have enough staff to care for women and keep them safe and staff did not always have time to complete training in key skills”.

It continued: “The service did not manage safety incidents well and ensure changes in practice were shared widely.

“The service did not ensure essential equipment checks were completed and the environment did not meet national guidelines.”

It added that leaders “did not have reliable, up to date information and understanding to ensure risks and priorities in the service were managed” and “senior leaders were not always visible and approachable in the service.”

The report added that sepsis was not always identified and treated in line with national guidance, citing one incident whereby a woman on the labour ward recorded two separate temperatures, but “this did not trigger the sepsis protocol despite staff handing over that the patient had commenced antibiotics when they had not”.

Inspectors gave the hospital a 13-point plan of things it needed to do to comply with its legal obligations and improve services.

These include ensuring “all staff identify and treat sepsis in a timely way,” ensuring the environment is cleaned effectively, conducting regular checks on emergency and essential equipment, and ensuring security arrangements for the maternity unit and staff only areas of the maternity unit keep women and babies safe.

The report acknowledged staffing pressures on the service, saying it was “a nationally recognised concern”.

Midwife vacancies within the trust had risen to 11 per cent at the time of the inspection, up from 6.6 per cent in August 2021.

On the day of the inspection, nine midwives were required to staff the antenatal, postnatal and labour wards – however, only five registered midwives were on duty at the start of the shift due to staff illness.

By 11.15am, nine midwives were on shift after being redeployed from elsewhere.

The Royal College of Midwives has said there are “chronic understaffing” issues across the sector, with an estimated shortfall of 2,000 midwives nationwide.

It added that the shortages had been worsened by the impact of the pandemic, with staff off sick, self-isolating or burnt out from the pressure.

Plans for all frontline health care workers to be fully vaccinated, thus exacerbating the crisis, were scrapped earlier this week after the secretary of state for health, Sajid Javid, ruled that the measure was no longer proportionate.