A health board's maternity services which were once described as "dysfunctional" and put babies and mothers at risk of harm have been taken out of special measures. Health Minister Eluned Morgan said she was satisfied that "clear progress" had been made in delivering improvements in "challenging circumstances".
In 2019 an investigation by the Royal College of Obstetricians and Gynaecology (RCOG) and the Royal College of Midwives - prompted by a consultant midwife who was concerned by an apparent under-reporting of serious incidents, including deaths of babies - unearthed a series of wide-ranging concerns about maternity care at Cwm Taf Morgannwg University Health Board.
They discovered that maternity services at two of its hospitals - the Royal Glamorgan in Llantrisant and Prince Charles in Merthyr Tydfil - were "under extreme pressure", "dysfunctional", and were putting families and babies in danger. As a consequence the health board's maternity services were placed in special measures by the Welsh Government in April 2019 - the highest level of government control - and an independent panel was set up to oversee improvements.
Read more: A third of stillbirths in Cwm Taf maternity units 'could have been prevented', review finds
Reports from the panel have been published ever since with the latest, published on Monday, noting that the maternity service felt markedly different last September when compared to the services and conditions it observed in 2019. It found that the health board's longer-term improvement plans are sustainable going forward.
"Three-and-a-half years on from the Royal Colleges' review, the panel believes that the health board's maternity services are now being delivered to the standards which the women and families who use them are entitled to expect. In some areas, most notably in the way that the service is now engaging with women and families, the health board is setting standards for others to aspire to" the report states.
"The vast majority of the Royal Colleges' recommendations have now been delivered in full and the few which remain work in progress, for the most part those related to complex issues like staff culture, leadership, vision and strategy, have been incorporated into the health board's longer-term organisational improvement plans."
The report concludes: "The panel believes that its terms of reference have now been discharged and that the time is now right for the health board to continue its improvement journey without independent external oversight and support from the panel."
Cwm Taf Morgannwg UHB's maternity services have now been placed under target intervention, one step down from special measures. Health Minister Eluned Morgan, who announced that the oversight panel would be disbanded at the end of the year, said: "This clear progress is testament to the dedication and resilience shown by health board staff at all levels in delivering service improvements within challenging circumstances.
"It is also important to recognise the resolve demonstrated by families who have and continue to ensure their experiences help shape service design and delivery. I want to thank staff and families for their clear commitment to ensuring maternity and neonatal services meet the expectations of local communities."
She added: "A degree of oversight and support will continue to be required; this is particularly true for the neonatal service, which still has some way to go in its improvement journey. Under targeted intervention, we will continue to work with the health board to ensure all the necessary improvements are made and embedded in practice.
"I expect the health board to maintain the momentum over recent months in delivering the remainder of the neonatal improvement plan in line with proposed timescales."
Last year the panel looked at 63 stillbirths at the two hospitals between January 1, 2016, and September 30, 2018, and discovered that 21 (33%) of them had at least one "major modifiable factor", meaning the stillbirth could potentially have been avoided.
Commenting on the latest oversight panel report, Suzanne Hardacre, director of nursing and midwifery at Cwm Taf Morgannwg UHB, said: "Over the last three-and-a-half years our teams in neonatal and maternity services have shown outstanding commitment to our improvement journey and to making positive change for our families.
"Today's report demonstrates very clearly the progress we have made, however, we also recognise that this is a journey of continuous improvement, and that there is still more work to do.
"Women and families have always been at the centre of our drive to improve, and it is essential that we continue to listen, learn and improve from their experiences."
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