Lawyer's concern as maternity services at South Tees Hospitals NHS Foundation Trust told to improve

Since 2022, the Care Quality Commission has undertaken a maternity inspection programme with the aim of helping services improve, both at a local and national level. 

In October 2023, the CQC’s State of Care report was published raising concerns that at that time 10% of maternity services were rated as inadequate overall, while 39% were rated as requires improvement.

James Cook and Friarage Hospital maternity inspections published

The inspections at James Cook University Hospital and Friarage Hospital took place in August 2023 and reports have now been published. They highlight issues in the care provided to those receiving maternity care at both hospitals.

CQC also previously told hospitals in Newcastle, Sunderland, and County Durham to also improve  

The criticisms echo those made by the CQC of other maternity services in the North East. Both South Tyneside and Sunderland NHS Foundation Trust and Newcastle upon Tyne Hospitals NHS Foundation Trust were recently assessed as requires improvement. Meanwhile, County Durham and Darlington NHS Foundation Trust’s services were deemed inadequate. 

James Cook University Hospital Middlesbrough

For James Cook University Hospital the CQC rating was made on the basis that: 

• The service wasn't always able to staff areas to the desired levels. Staffing levels didn't always match the planned numbers, putting the safety of women and babies at risk. The report states that staff raised that they didn't get breaks; they were rarely fully staffed and were burned out. 
   
• There were various aspects of the environment that weren't fit for purpose. This had implications for safety, efficiency, privacy and dignity. In this respect, the inspection found areas of concern needing urgent improvements. An example of this was there was no birthing pool on the delivery suite or on the midwifery led unit. Staff were instead using a standard bath which was unsafe.
   
• Staff assessed risks to patients but didn't always act on them to remove or minimise risks.
   
• Leaders didn't consistently operate effective governance. They didn't always manage risk, issues and performance well. They didn't consistently monitor the effectiveness of the service, identify and escalate risks and issues and manage these. 
   
• Though staff wanted to improve services, they didn't always have the opportunities and resources to do so. The report elaborates that while leaders monitored waiting times, they couldn't always make sure women could access emergency services when needed and received treatment within agreed timeframes and national targets. 

The Friarage Hospital in Northallerton

For the Friarage Hospital this rating was made because: 

• The service didn't always have enough midwifery staff, or they were frequently redeployed to James Cook University Hospital. The report found this has caused disruption and unpredictability to those who planned to give birth at The Friarage Hospital as well as the team who chose to work there. 
   
• Leaders didn't operate effective governance systems. They didn't consistently monitor the effectiveness of the service and didn't always manage risk well. 
   
• The unit was frequently closed for births, which made it difficult for staff to promote the service and women, to plan to birth there. Staff told the inspectors that they had frank conversations with mums  and advised them they couldn't guarantee a member of the team would be available to look after them in labour.
   
• Leaders were aware the model of care at the Friarage Maternity Centre wasn't viable, but they hadn't been proactive in identifying solutions or promoting the unit. The report states that whilst the Trust had commission an external maternity staffing review in 2022, and a recommendation had been made to remodel community midwifery and the FMC, nothing substantive had followed. 

The impact of maternity care failings

As a medical negligence solicitor, I too often see the tragic impact that substandard care has on individuals. Many of the cases I deal with relate to issues in maternity care, either resulting in the death of a baby or children sustaining serious injuries with life-changing consequences for both them and their families. 

Following such incidents, families are often left not only needing answers but access to specialist support and therapies. 

Therefore, it's very worrying to read of the apparent prevalence of issues within maternity services in the North East. I hope that prompt improvements are made for both patients and staff.

Find out more about Irwin Mitchell's expertise in supporting families affected by issues in maternity care at our dedicated birth injuries section.