Shrewsbury maternity scandal: Inspectors warn of unsafe staffing amid signs of improvement

Maternity services at Shrewsbury and Telford Hospitals Trust were 50 midwives short of what was safe, hospital inspectors have said.

A new report by the Care Quality Commission, published today, revealed the trust, which is at the centre of the largest maternity scandal in the history of the NHS, had a 26 per cent vacancy of midwives in April this year.

An independent investigation has been examining poor maternity care at the hospital since 2017 and the trust was put into special measures and rated inadequate by the CQC in 2018.

Major concerns about maternity safety led to conditions being imposed on the trust by the CQC last year and these remain in place following the latest inspection reports to be published.

Since the unannounced inspection in April the trust has recruited 29 new midwives and two new obstetricians.

Inspectors for the CQC did highlight a number of improvements in the maternity unit at the Princess Royal Hospital and Royal Shrewsbury Hospital but maternity services remain subject to conditions and a legal warning.

The CQC has the power to prosecute hospitals for safety breaches.

At the Princess Royal Hospital’s midwife led unit the CQC said the service “did not have enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.”

Inspectors said they found staffing set to “the minimum requirements” with a gap of 50 full-time equivalent midwives.

But the CQC said incident reporting had increased along with improved medical handover.

Inspectors said: “Midwives spoke positively about the changes made to provide a safer service.”

They added: “Midwives told us the increased visibility and approachability of the senior managers, matrons and deputy head of midwifery has raised morale and the culture felt more engaged and open.”

At the Shrewsbury hospital site inspectors identified poor staffing levels as well as out of date tools to check mothers were not deteriorating. The report said managers “did not always provide appropriate oversight, leadership or support to staff on the unit.

“Clinical staff often worked over and above their normal working hours to ensure appropriate staffing levels and local management of the unit was met.”

But the inspectors said staff were committed to providing good care with staff supporting each other.

The CQC was forced to change its report on the trust’s maternity services overnight after The Independent highlighted the regulator appeared to be mistakenly advocating for “normal births” – something it has previously acknowledged it should not do.

In the original report released under embargo, the CQC said SATH’s normal birth rate for January 2019 was “slightly better than” the national rate. A CQC spokesperson said this wording was a mistake that would be corrected in the final published version.

A focus on “normal births” has been singled out as a potential factor in the poor care at Shrewsbury where the trust has consistently had one of the lowest rates of caesarean births in the NHS.

It could have meant doctors and midwives waited too long to intervene in difficult births.

Paula Clark, chief executive of The Shrewsbury and Telford Hospital Trust, said: “We are pleased the CQC has found improvements in our maternity services and patients and families say staff are kind and compassionate.

“Since inspections in April we have appointed 29 new midwives, a new director of midwifery, a new care group director and two new consultants and we will continue to build on these improvements, but we appreciate there is more work still to do.”