The Care Quality Commission (CQC) has found improvements in the maternity services at William Harvey Hospital (WHH) in Ashford and at Queen Elizabeth The Queen Mother Hospital (QEQM) in Margate. The overall rating for maternity at both hospitals has improved from inadequate to good following an unannounced inspection in December. Both services are run by East Kent Hospitals University NHS Foundation Trust.
At William Harvey Hospital CQC inspected maternity to see if they were still in breach of regulations from the previous inspection. The department had made significant improvements and were no longer in breach of any legal requirements. The inspections at WHH and QEQM were also carried out to follow up on the urgent conditions CQC imposed upon the trust that required it to take action to ensure significant improvements were made to safety, leadership, culture, the environment and staffing levels. CQC found significant improvements had been made.
At Queen Elizabeth The Queen Mother Hospital, the overall rating for maternity services had improved from inadequate to good as have the ratings for how responsive and well-led it is. How effective and caring the service is has improved from requires improvement to good. The service had also made a some improvement in safety, with this rating moving from inadequate to requires improvement.
At William Harvey Hospital the overall rating for the maternity unit has also improved from inadequate to good, as have the ratings for how responsive and well-led it is. How effective and caring the service is has improved from requires improvement to good. The service had also made a some improvement in safety, with this rating moving from inadequate to requires improvement.
The trust’s overall rating and the overall rating for both hospitals all remain unchanged and rated as requires improvement.
Serena Coleman, CQC’s deputy director of operations in Kent, said:
“When we inspected maternity services at both William Harvey Hospital and Queen Elizabeth The Queen Mother Hospital, we found significant improvements and a better quality service for women, people using the service and their babies. Our experience tells us that when a service isn’t well-led it’s difficult for them to provide good care in other areas. This turnaround in ratings across both services demonstrates what can be achieved with strong and capable leaders who focus on an inclusive and positive culture.
“We saw the positive impact of improved staffing and culture at both hospitals. Women told us about feeling well-supported throughout birth, with one QEQM mother describing how a midwife stayed after her shift finished to provide continuous support during a difficult labour.
“Leaders had taken steps to improve the physical environment across both hospitals where they were able to, and safety risks posed by the estate and ward environment were being managed and mitigated more effectively. However, concerns remain about the size of the labour rooms which were not always big enough to include essential equipment such as infant resuscitaires*.
“Resuscitaires were now located directly outside each labour room to ensure quick access and avoid mothers and babies being separated for lengthy periods of time in situations where babies required resuscitation following birth.
“Leaders had similar problems at QEQM hospital. The small room size and lack of air conditioning impacted on women’s comfort and as at WHH, their ability to move around freely during labour.
“However, the trust has made good progress and now need to demonstrate that they can embed, sustain and build on these improvements going forward.”
The trust, across both hospitals had prioritised seeking out people’s detailed feedback by calling all women six weeks post-birth. Over 12,000, a very high number, provided feedback, with over 90% willing to have another baby at either hospital. Staff dedication at all levels deserves recognition, as women and babies now receive more effective, compassionate care.
Inspectors found at William Harvey Hospital:
- The new maternity leadership team had created a culture where staff felt empowered to speak up about concerns without fear. Staff told CQC the culture had changed from one of blame to learning and improvement. At WHH, staff told us they now feel listened to and valued, with 86% reporting they’d feel confident raising safety issues compared to just 32% previously.
- Leaders had implemented a comprehensive safeguarding approach including a Kent-wide safeguarding alert app and multidisciplinary team including social workers, named midwives, and perinatal mental health specialists.
- Leaders had significantly improved staffing levels, with vacancy rates reduced from 32% to just 8% for midwives through successful recruitment and retention initiatives. They had also implemented a well-established mandatory training programme that 92% of staff had completed which included safety training, including foetal monitoring and obstetric emergencies meaning people using services were safer.
Inspectors found at Queen Elizabeth The Queen Mother Hospital:
- Leaders had implemented a new multidisciplinary approach to handovers which had significantly improved communication between teams, with staff reporting greater confidence in the continuity of care which had improved the experience of mothers.
- The introduction by leaders of a dedicated perinatal mental health support (the time towards the end of a pregnancy and just after childbirth) had been integrated with psychosocial assessments, risk assessments for self-harm/suicide, and access to mental health liaison services for vulnerable women. Waiting times had also been reduced from four weeks to under seven days.
- Leaders had received funding for a bereavement room for early pregnancy loss. Families who experience baby loss now received comprehensive, compassionate care from specially trained staff.
- The trust had created a new neonatal room and implemented a new care co-ordinator post. This dedicated space is where the required Newborn and Infant Physical Examination checks took place. These checks are a physical screening of a baby’s eyes, heart, hips, and testes and are completed before discharging the baby after birth.
- There was only one dedicated obstetric theatre which was not in line with national guidance which required two obstetric theatres to be available. As part of the hospital’s plans to rebuild in 2025, the planned re-build included a second obstetric theatre.
- Staff completed daily checks of specialist equipment. Records showed these checks had been consistently completed for the 3 months before the inspection. Baby resuscitation equipment on the labour ward was checked daily. Checks on the adult resuscitation and emergency trolleys were fully completed.
- Queen Elizabeth The Queen Mother Hospital has plans to start a rebuild of the maternity unit in 2025.