On The Edge: Staffing shortages in maternity care | Medical Negligence and Personal Injury Blog | Kingsley Napley

Concerns about maternity services in the UK are never far from the headlines and the urgent need for improvement is widely acknowledged. This month sees a new Care Quality Commission (CQC) report rating the safety of maternity services inadequate within Bedford Hospitals NHS Foundation Trust and highlighting concerns surrounding midwife shortages.

Meanwhile, in June there was an unannounced CQC inspection of some services within Nottingham University Hospitals NHS Trust with the report now awaited. Separately, there is an ongoing independent enquiry into maternity failings in the Trust, led by midwifery expert Donna Ockenden.

The Bedford report found that there were not always sufficient nurses or midwives to keep women and babies safe. In addition, it was said that staff did not always check emergency equipment in line with policy, there was a lack of learning from incidents and a failure to effectively manage cultural issues raised by staff. Moreover, staff were found to be not always up to date with mandatory training and did not always complete risk assessments for each woman.

The report detailed a delay in the treatment of women waiting to be induced on the first day of the CQC inspection. It also stated that in November last year alone (within the Luton and Dunstable Hospital) there were 102 ‘red flag events within maternity’. A red flag event is described as being a warning of an issue with staffing – such as missed or delayed care.

It is our experience at Kingsley Napley that delays in treatment related to childbirth can have devastating outcomes. For example, a delay in recognising and acting upon fetal distress may lead to a hypoxic brain injury (where a baby does not have sufficient oxygen). This in turn can lead to conditions such as celebral palsy. Given what is at stake, the importance of proper care is inarguably never stronger than in a maternity setting.

While the Bedford report concedes that most staff recognised and reported the majority of incidents and near misses, the CQC nevertheless found that there was not an open culture of incident reporting in relation to all types of incident, particularly where racism and discrimination were concerned.

Although the recent CQC report following the inspection at Nottingham University Hospitals NHS Trust is still awaited, it would appear that there are concerns there around staffing levels. Donna Ockenden has been reported by the BBC as stating that the the Trust was over-relying on newly-qualified midwives.

Another report – from the Maternity and Newborn Safety Investigations (MNSI) – has highlighted the negative impact of inadequate staffing on patient safety, noting that ‘when work demands exceed capacity, staff may be required to make a trade-off between efficiency and thoroughness’. It goes on to say that ‘the mismatch between demand and capacity often resulted in delays in care and / or safety-critical monitoring tasks during a woman’s labour’.

Clearly, resolving staffing issues is imperative for preventing and reducing incidents of harm to babies and their mothers. We hope that this is a priority for our new Government.

If you have concerns around maternity treatment or birth injuries, please do not hesitate to contact our sensitive and specialist medical negligence team for a no obligation discussion.

More information on maternity and birth injury claims is available on our web pages here: Brain injury Claims, Celebral Palsy Claims, Pregnancy / Gynaecology Injury Claims.