CQC rates Northwick Park Hospital maternity unit ‘inadequate’

Northwick Park Hospital’s maternity unit has been downgraded to an ‘inadequate’ status after inspectors reported staff were being bullied and shouted at.

A Care Quality Commission (CQC) report was published yesterday (June 25) following an unannounced inspection in April.

The report states that the inspection was carried out in response to concerns of the care of mothers and babies in the department.

Before the inspection there was also a concern of perinatal deaths and the lack of senior management presence within the department.

An external review has been commissioned after reports indicate there were 13 serious incidents in the year to March, including eight baby deaths over five weeks between July and August 2020

During the inspection, a member of the CQC states they were shouted at by an NHS staff member who confused them for a colleague.

This correlated with whistleblower reports stating that staff shouted at each other and also a midwife shouting at a patient as she struggled to understand English.

The CQC report says there were “multiple allegations of bullying”, and the healthcare professionals did not always work together as a team to benefit women.

It was stated that the service did not always manage patient safety incidents well, and when things went wrong, there were concerns that there was a lack of transparency through fear of being blamed.

Nicola Wise, CQC’s head of hospital inspection, said: “We were very concerned by our findings at Northwick Park hospital’s maternity department. There was a poor culture overall and there were multiple allegations of bullying amongst the staff. This is completely unacceptable. Nobody should have to work in an environment where they feel intimidated.

“Staff told us about one consultant who refused to help a junior midwife when asked, and other consultants who went home instead of discharging patients. We were also told about staff shouting at each other, and a midwife shouting at a patient because she could not understand English. A member of staff shouted at one of our inspectors, after mistaking them for a colleague.”

She added there were concerns of “poor attitude” amongst the senior management team, and that leaders did not listen.

“Other staff said they were frightened to speak out, for fear of repercussions, and some claimed they had been told by management only to say good things when asked,” she said.

She continued: “The knock-on effect of working in such an environment, is that when things go wrong, the fear of being blamed prevents people from raising concerns and reporting incidents, so lessons are not learnt and shared amongst the wider team.”

Other concerns included reports that some women had to wait more than 72 hours for their inductions, and half of women served waited more than 48 hours.

It is said that the London North West University Healthcare NHS Trust, that manages the hospital, is making improvements – but the trust will be kept under close watch.

The trust’s chief nurse Lisa Knight has said: “We recognise that we must make significant improvements in our maternity service, both to improve the care we offer our local communities, and to make it a better place to work. The recent CQC report reinforces the need to build a supportive and compassionate culture within the service. Under our maternity improvement plan, we have already undertaken a significant amount of work to make that cultural change, with further improvements both planned and underway.

“New leaders within the service are already working closely with the wider team to set clear standards of behaviour. The team will work with an external, specialist organisational development team to improve the culture, and are collaborating with the local maternity system who are providing support and guidance. New dedicated Speak Up Champions will support them to raise concerns should they need to do so. Following the inspection, we also made a number of immediate changes to our clinical processes and systems in maternity to improve our care.”

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