PERFORMANCE: Divisions between senior medical staff contributed to maternity services at University Hospitals Morecambe Bay Foundation Trust failing to meet essential safety standards, the Care Quality Commission has warned.
Unannounced spot checks, which took place in July, were sparked by a number of concerns brought to the attention of the regulator, including findings from a hearing into the death a newborn baby.
The CQC ordered urgent improvements after the inspections identified “major concerns” with staffing levels, risk management and outdated facilities.
Inspectors also highlighted clinical leadership issues and said relationships between senior medical staff in certain areas “did not demonstrate a joined up approach to joint working”.
Inspectors visited maternity services at three hospitals including Furness General, where baby Joshua Titcombe died from a lung infection in October 2008.
The visits came a month after the coroner who looked into the child’s death issued an official notice to the trust to take action to address failings in care. Team working was one area highlighted in his letter to the trust.
The CQC, which carried out joint inspections with the nursing regulator the Nursing and Midwifery Council, found the trust had failed to meet six essential standards.
Inspectors said patients may have been put at risk and care delayed due to the lack of a back-up out-of-hours emergency team. They also criticised the “outdated care environment”.
“We found that the medical team do not always work effectively within the clinical governance and leadership arrangements across all three sites,” said the CQC. “This means that clinical leadership and integrated working does not always achieve consistent approaches.”
Long-term inconsistencies and divisions between colleagues would “increase the risk of a two tier services which will not meet nationally recognised care pathways”, they warned.
The CQC also found fault with aspects of record-keeping, hygiene and infection control and failings when it came to respecting and involving patients.
The CQC also issued a formal warning notice for the failures in risk assessment stating that further action would be taken if improvements were not made within a two-month deadline.
The trust has until November 21 to ensure it is fully compliant with Regulation 10, which covers the assessment and monitoring of the quality of services.
In a statement, the trust said it had made “vast improvements” since the Titcombe case, which had prompted an internal review of maternity services, and that it was working on plans for a new maternity unit.
The trust also said it had set up a forum to ensure medical staff across the three hospitals were involved in discussing and agreeing guidelines and policy.
“The trust recognises that making sure its medical teams from across the Bay work together is essential to provide safe and joined-up care to patients,” said the statement.
CQC press release (see attached, right)
9 September 2011