Bridgwater hospital's maternity services 'needs improvement'

Inspections at Musgrove Park Hospital, Bridgwater Community Hospital, and Yeovil District Hospital were carried out in November 2023.

Musgrove Park's overall rating has also fallen from 'good' to 'requires improvement' as a result of the inspections.

Somerset NHS Foundation Trust has apologised to families and colleagues and says it is committing to improving to provide an excellent service across the county.

The overall rating for Musgrove's maternity services has decreased from 'good' to 'inadequate', as well as the rating for how well-led it is, after the inspection.

How safe it is has declined from requires improvement to inadequate.

The areas of 'effective', 'caring' and 'responsive' retain their previous ratings of good.

At Yeovil District Hospital, the first inspection of the maternity services since becoming part of the NHS found they were 'inadequate' overall, as well as for being 'safe' and 'well-led'.

The CQC has issued a warning notice to both Musgrove Park Hospital and Yeovil District Hospital to focus the trust’s attention to 'maintain rapid and sustained improvement in the care of people using the service'.

Bridgwater Community Hospital’s Mary Stanley Birth Centre, a midwife-led unit, was rated as 'requires improvement' overall and in the 'safe' and 'well-led' categories in its first rated inspection.

Carolyn Jenkinson, CQC’s deputy director of secondary and specialist care said: “When we inspected maternity services at Somerset NHS Foundation Trust, we found a deterioration in the quality of care being provided across maternity services at all three of the locations they provide them from.

"We also had particularly significant concerns with the care being provided at Musgrove Park Hospital and Yeovil District Hospital.

“Leaders weren’t supporting staff to learn from incidents or make improvements when things went wrong.

"Incident data seen by inspectors also didn’t always match up with information provided to the trust’s board. Leaders also weren’t effectively monitoring how the services performed, or taking action when risks needed to be escalated."

Speaking further on Musgrove Park Hospital in Taunton, Ms Jenkinson said: “At Musgrove Park Hospital, we found poor systems and processes for assessing women and people using the service who needed medical attention.

"Staff weren’t using a standard method to assess and prioritise people based on clinical need when they arrived, which meant that people were being assessed differently based on the individual who saw them."

Referring to Yeovil District Hospital, she added: “At Yeovil District Hospital, we were concerned that staff weren’t always cleaning their hands when entering clinical areas to care for people, and they weren’t always following the trust’s uniform policy to help reduce spreading germs.

"Leaders also weren’t monitoring whether staff were complying with their hand hygiene policies."

Ms Jenkinson explained Bridgwater Community Hospital was instructed to employ more midwives: “There were high rates of staff sickness at Bridgwater Community Hospital and poor staffing levels meant the birth centre and home birth service had to close for five months between February and July last year.

"However, the trust had taken steps to recruit more midwives. They should also review how to ensure the service is sustainable for local women and people.

The CQC 'won't hesitate to take action' if things are not put right at the three Somerset hospitals, and are expecting large scale improvements.

“Despite these issues, across the trust we found staff were keen to improve the services and some of the problems were out of local leaders’ control," Ms Jenkinson said.

"At Musgrove Park Hospital, inspectors noted the buildings were in poor condition and required regular maintenance which posed an ongoing challenge for the quality of maternity services they were able to provide.

“We have told the trust where we expect to see significant improvements and will continue to monitor them closely while these improvements are made.

"We will return to check on their progress and won’t hesitate to take action if women, people using the service and their babies are not receiving the care they have a right to expect.”

In response, Peter Lewis, Chief Executive of Somerset NHS Foundation Trust, explained how the trust has already begun taking action to improve the quality of care across the three hospitals.

“We have received three reports from the Care Quality Commission (CQC) regarding the maternity services we provide," he said.

"These illustrate that we have fallen short of the standards we expected to be delivering, and we want to say sorry to our families that use these services and to our hard-working colleagues.

“We are committed to improve, so that we provide an excellent service that supports women, birthing people, and families in Somerset.

"We have made significant changes since the inspection and will continue to do so.

“We have strengthened our processes to provide ongoing review of quality, performance and governance, including developing a strong audit and policy programme to drive continual improvements in our services.

"All guidance and policies that were highlighted have been reviewed and updated, and we have increased scrutiny and governance around our policy processes, ensuring these are available to all colleagues.

"We have reviewed and mapped all mandatory training, strengthened our oversight, and significantly improved our compliance.

“At Musgrove Park Hospital’s maternity unit, we have put in place a new evidence-based, standardised triage process to risk assess and prioritise care based on clinical need, and have reconfigured the ward to facilitate safe and effective clinical oversight of our service users.

"We immediately sourced emergency equipment at Musgrove Park and Yeovil District Hospitals.

“The CQC report for Musgrove Park’s maternity service highlights issues that are as a result of the poor condition of the building.

"We are planning to replace this as part of the national New Hospitals Programme, but have already made improvements specifically around safety and security.

“The inspectors noted an open culture, good engagement with local communities to make improvements and plan services, good team working, and that colleagues felt valued and supported.

"We have a lot of work to do, but this does give us good foundations on which to build.

“We are here to support all those using our maternity services.

"If you have any questions, or concerns, would like more information, or to speak to someone about our service, please speak to your midwife.

"We are here to help and support you.”

Further details of all three reports can be found on CQC's website.