Nottingham University Hospitals (NUH) NHS Trust is at the centre of the largest independent review in NHS history after hundreds of baby deaths and injuries.
The review, led by senior midwife, Donna Ockenden, has been ongoing for months, and is looking into stillbirths, neonatal deaths, brain damage, severe maternal harm, or maternal deaths spanning back to 2012. The cases of 2,000 families are being examined, and more than 800 staff have come forward.
However, this week, Ms Ockenden said that concerns raised by staff across NUH’s maternity services were being “shut down” by management.
Issues with the skill mix of staff
Ms Ockenden said that issues remain with the skill mix of staff across the department. She said that a number of staff who had spoken to the review described it as “very poor and very concerning.”
She went on:
“What we mean by that is the junior nature of the workforce, so it’s understandable they don’t have the full range of clinical skills…”
“Staff are raising concerns that some of the midwives that are coming to join Nottingham don’t have basic skills, things like fetal heart monitoring. It puts existing staff under huge amounts of pressure. The numbers will look right but there will be a limited number of staff who have got the right level of skills and expertise.”
“If the workforce is largely made up of newly qualified or international joiners, there will be a limited number of midwives and other staff who can care for high-risk women, poorly women, and women in an emergency.”
This follows the finding of the Care Quality Commission in the summer of “insufficient” levels of staffing at the Trust.
Concerns dismissed by management
Ms Ockenden said that staff concerns relating to the skill mix of staff across the department were being dismissed by management, which was resulting in a gap between what was happening and what the Board of the Trust heard.
“Of course, people take time to develop these skills but when they’re raising concerns with managers, they’re just shutting the conversation down saying ‘the numbers are fine, end of’…There’s this gap staff are describing between what is happening on the clinical floor and what managers either understand and present upwards.”
She also said that there remained ongoing issues with bullying and favouritism, with some staff frightened to speak out.
Critically, Ms Ockenden commented, “The culture still has to change significantly, and we’ll play our part in that.”
Making changes
Amid the ongoing investigation, Ms Ockenden feels confident that the concerns noted were being heard and understood by the Trust.
Chief Nurse at NUH, Tracy Pilcher, said:
“We welcome Donna’s feedback and feel encouraged to see that so many of our staff have engaged with the review and the opportunities it provides us to continue to improve our maternity services.
“We remain focused on our maternity improvement programme and can see that there have been real improvements in our services, but we know there is more to do. In recent months, we have recruited more than 40 new fully trained and qualified midwives, who will continue to develop through further training to support our existing staff and patients. We have recently recruited into leadership roles within maternity and more staff are staying with us for longer. Staff mix and visibility is something that we continue to monitor closely and report on regularly.
“It is clear from Donna’s feedback that some colleagues are still not feeling the benefit of this in their day-to-day work. We apologise for that and are determined to keep listening to them and are committed to continue to deliver improvements in culture and their experience.”
Comment
It is clear that NUH has been working behind the scenes to make changes that were imperative following the failures in maternity services that have come to light in recent years.
This is positive, and shows the power and importance of the ongoing investigation by Donna Ockenden in improving the experience of those using maternity services at NUH, and in preventing future issues.
However, what remains very much true is that there is still clearly work to be done, and it is disappointing to see that managers are dismissing the concerns of their staff as Ms Ockenden has pointed out.
With the ongoing review highlighting these key concerns, and the evidence that the Trust is trying to heed the advice and evidence put before them, we can only hope that this issue will be one that can be prioritised and rectified in the coming months.
This article is for information only and does not constitute legal/financial advice. Please contact us for advice tailored to your specific position. Some of the content presented on our website has been generated with the assistance of Artificial Intelligence (AI). We ensure that all AI-generated content meets our high standards for accuracy and relevance.
