The Care Quality Commission (CQC) has issued the Gloucestershire Hospitals NHS Foundation Trust with a Section 31 notice, putting conditions on its registration, and demanding urgent improvement following concerns with the provision of maternity care within the Trust.

The maternity service remains open but has several reporting conditions in place to ensure improvements are made in a timely manner. The service is required to report progress to the CQC on a monthly basis.

The improvements required include:

  • Ensuring fetal heart rate monitoring is accurately assessed and escalated to senior clinicians in a timely manner to ensure it complies with national guidance;
  • Ensuring pregnant women are assessed and appropriately managed for the risk of haemorrhage;
  • Ensuring staff carry out blood clot assessments;
  • Ensuring agency staff are given proper inductions on the maternity unit.

Midwives under pressure

The Trust has also requested an external review of maternal deaths at its hospitals following a recent episode of BBC Panorama in which whistleblower midwives spoke out about the maternity care crisis that is putting women and babies at risk.

A team from an arm of the CQC, Maternity and Newborn Safety Investigations, has been asked to examine all maternal deaths since 2018 to see if there are lessons the Trust can learn.

The Panorama investigation highlighted the tragic deaths of two babies and a mother at the Trust and heard from midwives about an unsafe working environment, where maternity services are chronically understaffed, and midwives are suffering from burnout. It highlighted inadequacies in learning and responding to tragic incidents, and listening to and acting on concerns about care.

Services in Stroud and Cheltenham

The Gloucestershire Hospitals NHS Foundation Trust has confirmed their maternity services in Stroud and Cheltenham will not open this year due to staff shortages. The ongoing temporary closure puts extra strain on the already stretched services provided at Gloucester.

Lucy Wells, Clinical Negligence Solicitor at Ison Harrison, expresses compassion for anyone affected by the maternity crisis in Gloucester and across the UK. She said:

“All women should receive safe and compassionate care throughout their pregnancy, labour and following delivery. They should be, and feel, informed and supported when they are at their most vulnerable.

“The effects of poor care caused by inadequate infrastructure, understaffing and lack of training can result in preventable deaths, physical injury, and mental trauma. The impact of which can be far reaching. Unfortunately, the issues we are hearing about at Gloucestershire Hospitals NHS Foundation Trust are not an isolated issue, maternity services across the UK are facing similar issues with understaffing, underfunding and toxic working environments.”

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