Exclusive: Trust diverted at least 120 women in labour in four years

East Kent Hospitals University Foundation Trust is likely to face criticism at an inquest into the death of Archie Batten, who died last year after his mother gave birth at home because her local unit was closed.

She was told the maternity unit at Queen Elizabeth, the Queen Mother, Hospital in Thanet was shut and she should travel 38 miles to the William Harvey Hospital in Ashford. A pre-inquest review was held in February and a full inquest is expected to be held later this year.

Now, a Freedom of Information Act response to HSJ has revealed the two units were closed more than once a fortnight from 2016 to 2019, leading to at least 120 women in labour being diverted.

Many maternity units close or divert for short periods. An FoI request in 2018 found almost half of responding trusts closed at least once in 2017, with one trust closing a unit 29 times. Only 11 had closed more than 10 times. However, in that year, the East Kent units had more than 20 closures. 

The reasons given for the East Kent closures over the four-year period were usually capacity, activity and staff shortages. In five cases, only the midwife-led unit at one site was affected, but 111 diverts involved both the consultant-led labour ward and the midwife-led unit, forcing women to travel to the other hospital.

‘Anxiety inducing’

On one occasion in February 2016, both units were closed for around six hours. During this time, the nearest maternity units for the 700,000 population of East Kent would have been at Maidstone and Medway, which are more than 40 miles away.

On other occasions, one unit would divert for a few hours, reopen, only for the other unit to go on divert shortly afterwards.

Regular closures at any trust raises serious questions, said Rebecca Schiller, cofounder of advocacy organisation Birthrights. “It is understandable that any services can be overwhelmed. Having to [divert] so much raises questions about the safety of the service.”

She added it was “anxiety inducing” if a woman suddenly had to make her way to a different unit than the one she had chosen and labour could progress rapidly in the time needed to travel the extra distance.

Maternity services at East Kent FT are already being scrutinised by Bill Kirkup after the Department of Health and Social Care ordered an independent investigation, following the inquest into Harry Richford, who died shortly after birth.

Dr Kirkup, who has also led several other maternity investigations, began work last week and will look at incidents dating back to 2009.

Changes made

In a statement, the trust said: “Sometimes high levels of activity in one unit mean that it is safer for a woman to give birth in the other East Kent unit.

“This decision is made if the maternal or neonatal beds are becoming full, or if there are a number of complex cases in one unit and not enough staff to safely care for more women in labour, or newborn babies, in the woman’s chosen unit.

“If a woman were in an emergency situation in labour, she would continue to be taken to her nearest unit even if a divert to the other east Kent maternity unit were in place, and this requirement is taken into account in any decision to implement a divert.”

The trust said it had recently made changes to safety processes within its maternity units, which include:

• An updated escalation guideline to ensure each unit’s capacity, activity and staffing is formally reviewed at each shift change;
• A new out of hours multidisciplinary safety meeting that takes place every night to ensure early escalation of any capacity issues on each site; and
• A midwifery manager on call 24/7 to advise on appropriate and timely plans to meet demands on the service.

It added: “These changes mean any potential need for a divert between maternity units can now be identified and acted upon earlier.”