Northwick Park maternity rated 'inadequate' by CQC after eight baby deaths in five weeks

Northwick Park Hospital's maternity unit has been rated inadequate

Northwick Park Hospital's maternity unit has been rated inadequate - Credit: Archant

Northwick Park Hospital’s maternity provision has been rated ‘inadequate' by health chiefs after shortcomings that included eight reported baby deaths in five weeks. 

A damning Care Quality Commission (CQC) report, published on Friday (June 25), described a ‘poor culture’ in the department with multiple allegations of bullying. 
In one case an inspector was shouted at by a staff member who mistook them for a colleague.

The CQC found the Watford Road infirmary, which is run by the London North West University Healthcare (LNWU) NHS Trust, is still rated ‘requires improvement’ overall.
An unannounced inspection of the maternity service was carried out in April in response to information of concern received about the care of mothers and babies in the department.

Following the inspection, the overall rating for the maternity service went down from ‘requires improvement’ to ‘inadequate’ - the lowest rating. 

The trust reported 13 serious incidents between March 2020 and March 202. These included eight perinatal (baby) deaths over a five-week period, during July and August last year, which the CQC said is a "very high number over such a short period". 

The trust had an improvement plan put in place to identify issues raised by the North West London Integrated Care System (ICS) in its report.

During the CQC inspection, concerns were raised regarding delays in the induction of labour for women and an allegation that some women were waiting more than 72 hours to be induced.

Audits of patient records in April showed only half of the women were induced within 48 hours.

An LNWU spokesperson said: "We recognise that we must make significant improvements in our maternity service, both to improve the care we offer our local communities, and to make it a better place to work."

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The CQC report says inspectors were not assured the trust had effective systems in place to ensure medical and midwifery staff had the "competence, skills and experience to safely care for and meet the needs of women and babies within all areas of the maternity service".

The report added: "Staff did not always complete and update risk assessments for each patient and did not always remove or minimise risks.

"We found domestic violence was not always documented."

They were not assured the leaders "had the skills and abilities to run the service" or that patient safety incidents were managed well.

The ‘caring’, ‘effective’ and ‘responsive’ domains were not rated during this inspection.

Nicola Wise, CQC’s head of hospital inspection, said: “We were very concerned by our findings at Northwick Park hospital’s maternity department.

"There was a poor culture overall and there were multiple allegations of bullying amongst the staff.

"This is completely unacceptable. Nobody should have to work in an environment where they feel intimidated."

They were told about a consultant who refused to help a junior midwife when asked, and other consultants who went home instead of discharging patients, "and a midwife shouting at a patient because she could not understand English".

There were accusations the senior management team did not listen to staff, who in turn were afraid to speak out for fear of repercussions. 

“Some claimed they had been told by management only to say good things when asked,” the report added. 

They acknowledged the LNWH chiefs were "implementing improvements".
Inspectors said critical care, end of life care, outpatients and surgery were 'good', but medical care and services for young children 'require improvement'.

The emergency department was not rated during this inspection, so the previous rating of ‘requires improvement’ remains in place.

Lisa Knight, chief nurse, said: “We have already made several immediate improvements and are working rapidly to put in place further changes. 

“As a local maternity service which delivers more than 4,000 babies each year, we are fully committed to offering a safe, compassionate birth environment.”

Cllr Ketan Sheth, chair of Brent Council's community and wellbeing and scrutiny committee, said: "The CQC’s rating for maternity services is naturally a serious concern. 

"I am reassured to learn that the trust has developed a comprehensive maternity improvement plan, and the new leadership has already undertaken a significant amount of work to change maternity services for the better.”