CQC demands improvements to maternity service at Watford General

Inspectors from the Care Quality Commission (CQC) carried out an assessment of the maternity service at the hospital after being alerted to safety incidents.

Following its inspection on October 13, the overall rating of the maternity service at Watford General went from ‘good’ to ‘requires improvement’.

The CQC said the service was often understaffed which affected women’s birth choices.

“The trust had closed the midwife-led birthing unit to ensure safe staffing numbers, but this limited the choice for women with low-risk pregnancies as water births could not be facilitated,” Fiona Allinson, CQC’s deputy chief inspector of hospitals, said.

She added that safety incidents were managed well, but understaffing had caused recent safety incidents to occur - including delays in women receiving care once they were admitted to the department.

She also said the old hospital building created challenges due to minimal space available.

West Hertfordshire Hospitals NHS Trust, which runs the hospital, said a national shortage of midwives and the age of the building where maternity services are based have contributed to a drop in ratings.

West Herts NHS Trust runs Watford General

Ms Allinson added: "When inspectors visited the maternity service at Watford General Hospital, it was clear that staff supported one another and worked hard to deliver good care to women and their babies, but it was evident that improvements were needed across the service.

“The trust knows where we expect to see improvements. We will continue to monitor the service closely to ensure the necessary improvements are made.”

West Herts Hospitals Trust says a recent boost in recruitment, advanced plans for a new building and some important maintenance work will help its maternity service reclaim its previous ‘good’ rating.

A CGI of an approved scheme to rebuild Watford General Hospital in three blocks. Credit: West Hertfordshire Hospitals NHS Trust/BDP

Chief Nurse Tracey Carter said: “We are disappointed by the drop in the rating but we take heart from the CQC’s report which praises our safety culture and the passion that our team clearly has to provide great care.”

She added that the pandemic has made staffing difficult due to maternity staff isolating or becoming unwell.

She said: “Our maternity service is not one where we can manage the demand for our service. For the sake of safety, we have had to withdraw our home birthing service at times and temporarily close our low-risk birthing unit so that we can concentrate our midwifery skills on our delivery suite.

“We review this every single day so that we can offer choice whenever and wherever possible. Safety is always our number one priority.”

As well as ensuring there are enough midwives, the CQC felt another improvement needed was making sure the maternity wards are clean.

Ms Carter said inspectors highlighted the window frames in the delivery suite and that the casements are ‘critall’ (metal) and, despite thorough cleaning, they can appear dirty.

“A new chemical cleaning regime is now in place,” she added.

The CQC also said delivery rooms must have monitoring in place for Entonox (gas and air) levels – Ms Carter said an interim measure is being implemented and new facilities will have an inbuilt monitoring system.