North Middlesex University Hospital

The North Middlesex University Hospital is a medium-sized hospital with 633 beds and employs just under 4,000 staff, serving a population of around 640,000 people living across Enfield and Haringey. As of 1 January 2025, North Middlesex University Hospital has become part of the Royal Free London group. Maternity services are provided at this site. North Middlesex University Hospital’s maternity unit comprises of a consultant led labour ward, a midwife led birthing unit and a joint maternity antenatal and postnatal ward. Outpatient services are also provided in the maternity day unit, triage unit, antenatal clinic and in the community. From January to December 2024, there were 3,387 babies born at this hospital.

We last inspected maternity services at North Middlesex University Hospital on 24 May 2023 as part of the national maternity inspection programme. We inspected the safe and well-led domains and rated both as inadequate. The trust took immediate action to address the concerns, and we received information to demonstrate this.

We conducted this unannounced focused inspection on 28 and 29 January 2025 as a follow-up of the inadequate rating in 2023.

We spoke with various members of the maternity team including maternity assistants, junior doctors, registrars, consultant obstetricians and anaesthetists, student midwives, band six and seven midwives, specialist midwives, consultant midwives, safeguarding and perinatal mental leads for maternity, matrons and the quadrumvirate. We received feedback from two women and birthing people who had used the maternity service

Safe:

The service did not always have a good learning culture. Managers did not always make sure medical staff completed mandatory training. Managers did not always manage incidents appropriately. Red flag data was not always submitted accurately. The facilities did not always meet the needs of people. Control of substances hazardous to health standards were not always followed.

However:

Managers made sure midwifery staff received mandatory training and regular appraisals to maintain high-quality care. People were protected and kept safe. There was enough equipment to meet the needs of people. Which were improvements from the last inspection.

Well-led:

Staff did not always feel supported to give feedback and were not always treated equally, free from bullying or harassment. The service did not manage cultural issues raised by staff in a timely manner. Governance systems were not fully embedded. People with protected characteristics did not always feel supported.

However:

Leaders and staff had a shared vision and strategy. Leaders were visible and knowledgeable. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas. Which are improvements from the last inspection.

Continued breaches were; medical staff training compliance, timely data submission to external bodies, leadership, poor culture within the service and the absence of a fully operational governance team.