East Kent maternity deaths: CQC considered shutting unit, BBC learns

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BabyImage source, Getty Images

Image caption,

A review in October found that at least 45 babies might have survived with better care at the trust

By Christian Fuller

BBC News

A watchdog considered closing a unit of the troubled East Kent Hospitals Trust after a visit earlier this year due to safety concerns, the BBC has learned.

The Care Quality Commission instead called for "immediate improvements" at the William Harvey hospital in Ashford.

The inspection in January came just weeks after a review found at least 45 babies might have survived with better care at East Kent's two hospitals.

The trust's chief executive has apologised for its service.

The inspection of East Kent's William Harvey hospital laid bare multiple instances of inadequate practices at the unit, including staff failing to wash their hands after each patient, and life-saving equipment not being in the right place.

Days after the visit, the watchdog raised safety concerns and threatened the trust with enforcement action to ensure patients are protected.

The BBC's social affairs correspondent, Michael Buchanan, said the CQC considered closing maternity care at the hospital, given the level of concern.

However, the trust promised to make immediate improvements to care and the CQC ultimately decided that weekly monitoring of its services would suffice.

The overall CQC rating for maternity services at both the William Harvey and The Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate has dropped from 'requires improvement' to 'inadequate' following the inspection.

Key findings:

  • At the William Harvey hospital, inspectors found bloodstains on toilets
  • In day care and triage, inspectors "routinely" saw staff did not always clean their hands or use aprons and gloves while delivering care
  • Resuscitaires were not available in the right place, nor were they cleaned and checked regularly
  • Staff at the hospital did not always ensure a second opinion was sought
  • Staff morale was low across both hospitals
  • At The Queen Elizabeth the Queen Mother Hospital, equality and diversity were not always promoted

Deanna Westwood, the CQC's director of operations south, said the watchdog has now used "urgent enforcement powers" to "require immediate improvements" at the trust.

The CQC highlighted particular concerns around the use of resuscitation equipment.

"Babies needing emergency resuscitation were taken to a resuscitative device - however, in some cases, these were outside the labour room and in the corridor," Ms Westwood said.

"This could potentially result in delays in vital care and treatment for newborns, as well as separation from the mother and an increase in the potential for babies to be mis-identified."

Image source, PA Media

Image caption,

Trust chief executive Tracey Fletcher

Tracey Fletcher, East Kent Hospitals trust chief executive, said: "I am sorry that despite the commitment and hard work of our staff, when they inspected in January, the CQC found that the trust was not consistently providing the standards of maternity care women and families should expect."

She said the trust has since increased doctor staffing in the triage service at William Harvey. The trust also said it has ensured better access to emergency equipment and improved cleaning.

Ms Fletcher added: "We recognise that, despite the changes that have been made to the service so far, there is a lot more to do to ensure we are consistently providing high standards of care for every family, every time."

October's independent review, which was chaired by Dr Bill Kirkup CBE, examined an 11-year period from 2009 at the two hospitals.

It found that of the 202 cases that were examined, up to 45 babies might have survived if they had received better care from the trust.

The review uncovered a "clear pattern" of "sub-optimal" care that led to significant harm, and said families were ignored.

Analysis

By Mark Norman, health correspondent, BBC South East

It is another awful report from inspectors.

More condemnation of managers and a reminder that the trust doesn't have enough maternity staff or medical staff with the right qualifications, skills, training and experience.

But two things concern me.

This inspection came two months after the publication of Dr Bill Kirkup's report. It begs the question why simple safety changes had not been initiated by senior managers in the weeks following that report.

Secondly, NHS England have had "maternity improvement advisors" supporting the trust for the last four years. It's worrying that with a huge amount of support and scrutiny that these problems still exist and don't appear to be improving.

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