Heartlands Hospital maternity services safety issues: 10 things that need to change following CQC report

Maternity services at Heartlands Hospital in Bordesley Green have been found to be “inadequate”, according to the latest Care and Quality Commission (CQC) report.

Published today (Wednesday, June 7), the report said that the safety of women and birthing people and babies were at risk at the hospital.

The hospital is managed by University Hospitals Birmingham NHS Foundation Trust - which has faced issues in the past. In previous CQC assessments, the medical care (including older people’s care) and surgery were found to “require improvements” while urgent and emergency services were found “inadequate”.

In March 2023, a NHS Birmingham and Solihull Integrated Care Board report revealed major issues at the NHS Trust. The review took place after several organisations and leaders raised concerns of “bullying and poor behaviours at UHB”. The report had revealed that patient safety was one of the key concerns at the NHS Trust.

The CQC report published on June 7 was regarding maternity services and for that, 25 staff were interviewed - including senior leaders, matrons, midwifes, obstetric staff, specialist midwives, clinical governance and the patient safety team.

10 key findings & things that need to change at Heartlands Hospital maternity services, according to the CQC report:

1. Women and birthing people were at risk of harm. The report said: “Staff completed and updated risk assessments for each woman but did not always take action to remove or minimise risks. Staff did not identify or act quickly when women and birthing people were at risk of deterioration.”
2. There was inadequate midwifery staff across the service. The service had issues with recruitment, retention and sickness of staff. Staffing levels did not always match the planned numbers putting the safety of women and birthing people and babies at risk.
3. The service was unable to demonstrate that staff were fully competent for their roles. Not all staff had completed an annual appraisal or were fully up to date with their mandatory training.
4. The service did not have enough medical staff with the right qualifications, training and experience to keep women and birthing people and babies safe from avoidable harm and to provide the right care and treatment. Women and birthing people were not seen and reviewed in a timely manner by medical staff in the Pregnancy Assessment Emergency Room (PAER).
5. Staff kept records of women and birthing people’s care and treatment. However, records were not always detailed, stored securely or audited.
6. The service used systems and processes to safely prescribe, administer, record and store medicines although they were not always used effectively.
7. The service managed safety incidents although there were delays in reviewing incidents. Staff recognised but did always reported incidents and near misses due to time constraints. When things went wrong, staff apologised and gave women and birthing people honest information and suitable support.
8. No consistent leadership: Due to a period of instability there had been a lack of consistent leadership within the service and a number of senior posts remained vacant, leading to delays in improvements being implemented. New and interim leaders had started to support staff to develop their skills and take on more senior roles. However, they were not always visible and approachable in the service for woman, birthing people and staff. Executive leaders did understand the priorities and issues the service faced, although these were not always managed effectively.
9. Staff morale: Staff did not always feel respected, supported, and valued due to workload and staffing levels. Staff tried to focus on the needs of women and birthing people receiving care. The service did not always promote equality and diversity in daily work.
10. Systems to manage performance were not always used effectively. Where identified, leaders escalated relevant risks and issues and identified actions to reduce their impact. However, it was not always clear if action had been taken or followed up. The full report can be viewed on the CQC Website.