The head of Nottingham University Hospitals NHS Trust (NUHT) has said he is “pleased” by the progress made in maternity care but said its improved rating is “not good enough”, with families affected by maternity failings calling for more to be done.
Anthony May OBE, chief executive of NUHT, said he was “encouraged” by the Care Quality Commission’s (CQC) latest report on the trust, which deemed its under-review maternity services are no longer inadequate but still requiring improvement.
The Nottingham Families Maternity Group, which is involved in the independent review into maternity care, said the improvements were a “small but crucial step” but that there was “clearly much more that needs to be done”.
The CQC said the quality and safety of maternity care had improved at the trust’s two hospitals, as had the culture and leadership at the trust.
I'm pleased and reassured that we've made this level of improvement but it's not good enough— Anthony May, chief executive of the Nottingham University Hospitals NHS Trust
However, it raised concerns over staffing levels, NUHT’s adherence to statutory responsibilities and that some staff feared reprisal for speaking out.
Mr May said: “I’ve been here a year, and I’m pleased and reassured that we’ve made this level of improvement but it’s not good enough.
“Requires improvement is not good enough, for NUHT and for local people.
“We’re very focused on our maternity improvement programme, and my People First initiative to get to good as soon as we can.
“We are laser-like focused on further improvement. We want to get from requires improvement to good.
“We’re pleased not to be inadequate any longer for maternity or leadership and culture, but we know that’s not yet good enough.”
The trust’s two hospitals, the Queen’s Medical Centre and Nottingham City Hospital, had their maternity services inspected in an unannounced visit by the CQC in April.
The overall rating of maternity care, and of its safety, at both sites was upgraded from inadequate to requires improvement.
NUHT also had its rating for how well it is led increased from inadequate to requires improvement.
Sharon Wallis, director of midwifery at the trust, said: “I think the overall assessment of requires improvement for both sites is a fair one. I think it’s where we’ve put ourselves too.
“We want to take the time to recognise the hard work and the improvements that we’ve made, but not to rest on our laurels.
“We need to continue our improvement. We have a maternity improvement programme that continues, it’s entering a new phase [and] we’ve got an awful lot of work to do.
“We take a minute to breathe [and] reflect, but to continue.”
The report comes as three separate investigations into maternity care failings at the trust continue.
An independent review, led by Donna Ockenden, is already speaking to around 1,800 families and 700 staff, while Nottinghamshire Police and the CQC are individually investigating potential criminal culpability.
We hope the board examines who it is that is feared and takes appropriate action— Nottingham Families Maternity Group
The Nottingham Families Maternity Group, formed by those affected by care failings, said it was still contacted by families who had negative experiences and that it was “concerning” that the CQC identified “critical and basic issues”.
It said: “We note the report also raises concerns about the duty of candour, an issue we recognise even now in correspondence shared by recently harmed families.
“Some staff say they did not always feel able to raise concerns without fear of retribution.
“We hope the board examines who it is that is feared and takes appropriate action.
“We acknowledge the enormous challenges faced by the new CEO and chair of the board, Anthony May and Nick Carver. They are ensuring that changes are made.
“We wonder if they are asking themselves who allowed these failings to manifest at NUH for so long and without redress, despite prior warnings from families and their own staff. We are pleased they are co-operating fully with the police.
“The lack of accountability is glaring, and we say would not be tolerated for a week in another business, let alone for years.
“We reiterate there are still very senior leaders at NUH who have had the chance to enact change yet are still in post despite what are clearly huge failings in care and review of that care.”
Dr Jack and Sarah Hawkins, whose daughter, Harriet, died during childbirth in 2016 due to medical negligence by NUHT, said the issues highlighted should have previously been rectified.
Mr Hawkins said: “Why has it taken so much family time, family pressure, involvement of the press and involvement of a public enquiry to get them to do some things that feel to us basic, that should have been done a long time ago?”
Discussing the concerns raised by the CQC, Mr Hawkins said: “They’re big deals. It’s a big deal, and it feels basic, so I guess we are more worried by what we have read in the report than we are positive.”
Mrs Hawkins said: “The families welcome that there may be some improvements, but we really want to stress that it seems like it is the bare essentials.
“The trust still requires improvement and that’s not anything to be celebrated.”
