NHS maternity unit standards ‘unacceptable’

A BRITISH NHS maternity unit, which hit the headlines after a series of high-profile baby deaths, suffered from “unacceptable” professional relationships between consultants, and an acute shortage of midwives, a government report said yesterday.

The Commission for Health Improvement launched an investigation, in June of last year, into maternity services at Ashford and St Peter's Hospital's NHS Trust, which has sites in Surrey, following what it described as a "number of serious incidents".

These "incidents" culminated when a man whose partner and baby died at the unit, in 2000, had another child die there when his new partner underwent a forceps delivery.

The Commission for Health Improvement's report said the maternity unit had serious problems and "poor working relationships between consultants", which had a damaging impact on the quality of care.

The report said: "these difficult circumstances have diverted management time, and have been a barrier to more effective team-working within the service. The situation is unacceptable, poses a risk to the quality of patient care, and requires urgent resolution."

The investigation found that midwives and external agencies were aware of the tensions, and of poor professional relationships between consultants.

Liz Fradd, the CHI's director of nursing, would not specify the problems between the obstetric and gynaecological consultants, but said they did not function as a team.

The CHI said that during its investigation clinical staff at the maternity unit had made it aware of allegations of bullying and harassment.

Some staff said they had been criticised for having raised concerns about patient safety.

The CHI found the unit had the second highest midwife shortage in the country, serious problems with staff recruitment and retention, and had been forced to rely on locum doctors and agency midwives.

Despite this, Ms Fradd said, mothers should be confident about using the unit, as it did not have a higher than average number of baby deaths.

"Any mother going in there should feel as confident, going in there, as any where else," she said. Our concerns are about broader issues of the quality of care."

The CHI investigated 41 births at the maternity unit, focusing on 13 cases where there was an "adverse outcome" for example the death, or disability, of the baby involved.

The CHI said it found no evidence of a direct link between the poor working relationships and the death of any baby at the unit.