Whittington Hospital urges health watchdog to reconsider ‘requires improvement’ rating for its maternity service

The Whittington Hospital. Photograph: Mark Hillary / Flickr

Bosses at the Whittington Hospital are asking a health watchdog to review its verdict that the maternity unit “requires improvement”.

The Care Quality Commission (CQC) highlighted concerns following an unannounced inspection in January, but still rated the unit’s leadership as “good”.

The Whittington cares for patients across north-east London, and last year its staff delivered 3,044 babies.

The latest inspection was part of a national look at maternity units following the Ockenden review into the death of newborns at Nottingham University NHS Trust.

Prior to that, a combined inspection in 2016 rated the gynaecology and maternity units “good” overall.

The CQC’s maternity inspection programme lead, Carolyn Jenkinson, said of January’s visit to the Whittington: “Women in triage weren’t always being prioritised according to their clinical need using best practice guidance which could put them at risk.”

The inspectors said staff “identified and quickly acted upon women and birthing people at risk of deterioration”.

Jenkinson also highlighted issues with the bereavement suite, which inspectors noted was not “adequately decorated or furnished with the facilities needed to support people through bereavement”.

The Whittington trust has just been granted planning permission to build new maternity facilities, including an area for bereaved mothers and their families away from the labour ward.

The watchdog wants to see a “more suitable environment for women who have had a baby loss until the formal plan for the bereavement suite comes to fruition”.

Inspectors also called for rethink on some of the furnishings in bathrooms that could “pose a risk” to people with mental health concerns.

They noted that the bereavement midwife has been shortlisted for the national Mariposa bereavement midwife of the year award.

The surprise visit also found that “women needed to use communal showers and toilets which didn’t always meet the needs or the privacy and dignity of women”.

Inspectors were concerned that only 60 per cent of maternity staff had done all their mandatory training, below the trust’s own target of 90 per cent.

Not all of the staff had completed specific training on recognising and reporting abuse.

However, the trust said it was ensuring that safeguarding training is done as part of its staff’s mandatory training.

Inspectors found that “staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with other agencies to protect them”.

Jenkinson, who is also the CQC’s deputy director of secondary and specialist healthcare, said: “We found a leadership team that had the skills and abilities to run the service. They had a clear understanding of the challenges within the service, and we need to see them using those skills to take action to address the issues we found at this inspection.”

The watchdog also highlighted outstanding practice, including the first Covid vaccination hub in London for mothers, a pioneering interpretation service, and work with airline pilots to develop simulation training during the pandemic.

The hospital trust has asked the CQC to re-evaluate its rating, arguing that the maternity unit was only assessed on two of the CQC’s criteria: ‘safe’ and ‘well led’.

In the other three areas – ‘effective’, ‘caring’ and ‘responsive’ – the unit remained rated as “good” from the 2016 inspection.

With four areas rated highly, the trust said it is “asking the CQC to clarify why we have been rated ‘requires improvement’ overall”.

The hospital’s overall rating remains “good.”

Chief executive Helen Brown said: “Whilst we have requested a review of our overall rating by the CQC, there is much to be proud of in the overall report of the partial CQC review of the service – in particular our strong focus on our service users, women and families, staff morale and a strong new leadership.”

She said the team will “focus its attention on making improvements” highlighted in the report.

“We already have ambitious plans for completely renovating maternity around the needs of our service users and staff, with all labour rooms having ensuite facilities, and are just about to complete a refurbishment of our midwife-led birthing centre,” she added.