Departed chair at troubled London trust had raised concerns about diverting pregnant women

The cap was announced following a damning report on the quality of maternity services at the east London hospitals.

Newly published minutes of a quality and strategy meeting held on October 25, six days before the announcment of Mr Doyle’s departure, reveal: “The risks posed to labouring women by capping births, was raised by Edwin Doyle, who was concerned that there was no ‘Plan B’ proposed by the CQC.

“[Another senior manager] highlighted the need for transparency and felt that redeploying midwives to supervise new staff also posed an increased risk to the service. Pam Strange [clinical governance director] pointed out that these potential risks had been raised with the CQC and commissioners who were working with us to mitigate them.”

The trust was roundly criticised in November by the CQC for care failures in maternity. Following a CQC visit in September a plan was agreed with the outer north east London primary care trust cluster to cap births at 20 a day at Queen’s and seven a day at King George.

Performance data for November has shown that the trust “went  41 births over the cap” because women had presented in labour.

The papers also revealed 18 women were diverted to other trusts, sometimes to hospitals as far away as Chelmsford.

A separate set of minutes to the board said: “The divert process was now bedding in within the organisation, but there had been some difficulties which were outlined in the weekly performance report where the cap was breached with the full knowledge of the commissioners.

“This had occurred as other hospitals in the sector were not able to take a divert from the trust and over the weekend a few women had to be diverted to Basildon and Broomfield in Chelmsford. The commissioners were now starting to plan across the sector, as it was evident that there was a lack of capacity across the whole patch, and the trust was very involved with this.

“Following a question from Mr Langley [a non executive director] in relation to diverts, Deborah Wheeler [director of nursing] confirmed that the trust had to phone around the sector on each occasion to agree a divert. The system was updated by units every two hours, so it was possible to look at the labour status and the activity going through, but unfortunately not all units kept the system up to date in real time.

“Once a divert was agreed, the trust had to contact London Ambulance Service and advise the commissioners. When the Queen’s unit reached 15 births, it started ringing round to put a divert in place and women were then collected by ambulance and taken to another unit. Ms Wheeler confirmed that any woman arriving at Queen’s in active labour was delivered here.”