Maternity CQC – Frequently Asked Questions

Since the publication of the CQC report into the Lister Hospital Maternity Unit, the Trust have focused improvement efforts on the three key areas highlighted within the report; Equipment and estates, staffing and training and systems and processes.

Immediate improvements include:

Equipment and estates:

• Replacement of all delivery bed mattresses on the consultant led unit
• 10 additional CTG machines ordered and due for delivery in February
• 4 Bathrooms across Gloucester and Dacre wards have been either updated or repaired
• A new security system has been installed to in-patient areas to better monitor and manage visitors accessing the Maternity Unit

Systems and processes:

• Introduction of red / amber /green prioritisation system for triage
• Improved process and schedule for daily equipment checks in all areas
• Improved and standardised cleaning schedule in place in all clinical areas

Staffing and training:

• 17 new midwives have been recruited between October & December
• Ward clerks have been appointed for Dacre and Gloucester wards
• Midwifery led unit only diverted on one occasion in January
• Mandatory training compliance increased to over 90% in December 2022

Further improvements to findings within the CQC report are as follows, and will be actioned in the next 3 months:

Equipment and estates:

• Delivery of 20 new recliner chairs, 25 cots and cot mattresses, 40 bedside tables, and lockers for Gloucester and Dacre wards
• Replacement of call bell system across Gloucester and Dacre wards

Systems and processes:

• Streamlining of processes for ordering / replacing equipment

Staffing and training:

• Introduction of nationally recognised toolkit to improve triage risk assessment. Staff training has begun
• Open day recruitment events planned for March, June and October 2023

We would like to provide reassurance to all of our women and birthing people and their families who are booked to have their babies at Lister Hospital that our Maternity Unit is a safe place to have your baby.

We appreciate the publication of the latest CQC inspection of our maternity services may be causing families accessing our services to feel concerned about the safety of the service, and of how this may impact them. This is not what we would want for any of the women, birthing people and families accessing our services. We are committed to and are working with the CQC to ensure that all the concerns raised as part of the report are addressed and resolved.

We would like to offer further reassurance, that according to the most recent national data, we have recorded fewer stillbirths and neonatal deaths than the national average.

The maternity unit supports all modes of birth, whether you are choosing to have a vaginal birth, or you would like a caesarean section. The unit is lucky enough to have both a Midwifery Led Unit (MLU) which is onsite and has 4 birthing pools, and a Consultant Led Unit (CLU) for those who may be higher risk or would like to have an epidural in labour. There is a birthing pool on the CLU, where we can continue to monitor your baby’s heartbeat with either a handheld Doppler device or, where necessary, through continuous monitoring with telemetry (wireless monitoring).

If you are unhappy with the care or place of birth that you have been recommended, our consultant midwives provide a birth options service; you can ask your midwife / doctor to refer you and they will be happy to write an individualised birth plan with you to support the care that you would like during labour and birth.

We also support the option of home births, although this may not always be possible if the on-call midwives are already supporting a home birth or on occasions where any of our services are on divert.

Yes, you can choose the hospital that you would like to give birth in, and this may not necessarily be the hospital that is closest to where you live. At any point, you are free to change where you would like to have your baby, even if it is very close to your estimated date of delivery.

We understand that some of the findings within the CQC report may be distressing and cause concern for our women, birthing people and their families – we would like to reassure you that the Lister Maternity Unit is a safe place to birth your baby.

Most hospitals have an online booking system or a form for completion. You can always contact the antenatal clinic of the hospital that you would like to change to and explain the situation. You do not need permission or referral from anyone to change to a new hospital to have your baby. We would encourage you to discuss any concerns with your community midwife in the first instance.

We are always pleased to receive feedback from all women, birthing people and their families who use our facilities; this feedback is useful in improving the services we provide. These issues can be raised by speaking to the ward or clinic manager in which the concern has been noted. Additionally, there is always a manager on call for the maternity unit who would be happy to speak with you. We also run a ‘Friends and Family’ that we ask service users to complete – this gives the opportunity to provide anonymous feedback.

Issues may also be raised through the Lister Maternity Voices Partnership (MVP) via their Facebook page – more information is provided about the MVP below.

When you are in active labour, you will be provided with 1:1 care by a registered midwife. Depending on your care needs and the clinical situation, your midwife will carry out observations on you at least every 4 hours and in active labour your baby will be monitored closely, the method and frequency of this monitoring will depend on whether you are requiring low-risk or high-risk midwifery care.

Our staff will ensure that your observations are monitored as required, depending on your care needs. If any of our clinical monitoring are out of range the clinician will ensure escalation to the relevant Doctor and ask them to undertake a full review of your clinical needs including your medical history.

We are dedicated to providing the safest and best possible care to you and your baby. As a team we ensure daily safety checks of our equipment and environment and regular communications as a team to ensure relevant information is shared about the care needs of your baby.

Security of the ward is monitored closely by all staff and all access through the doors to our postnatal ward are controlled by staff on the ward so that access is restricted to the public. This is to ensure the safety of our women and babies on our unit.

To ensure we are fully prepared for the unlikely event of an attempted baby abduction, we run baby abduction drills each year as part of our staff training programme.

If you see anything suspicious or are concerned about you and your baby’s safety at any time, please report this immediately to a member of staff who will alert our security team.

It has been nationally recognised that there is a shortage of midwives, although we have had a positive recruitment programme this year which has significantly reduced our number of midwifery vacancies. Our staffing rotas are planned and published in advance, and we are fortunate to have a large pool of bank staff who support the service by covering shifts that are vacant due to staff sickness, for example.

We have a robust recruitment and retention strategy and have made good progress in reducing our vacancy rate over the last six months. We have recently welcomed an intake of 17 newly qualified midwives, many of whom undertook their training with us, and we continue to increase our student numbers to ensure a strong and sustainable future pipeline. In addition to this, we have also recruited staff in support roles such as ward clerks, midwifery support workers, a dedicated pharmacist and physiotherapist to support patient care in all areas, and we are also in the process of recruiting a further 7 international midwives.

We are committed to the continued improvement of midwifery and medical staffing levels to ensure we can provide 1:1 care to all women and birthing people.

All women have a contact number for their community midwife throughout their pregnancy and from the time they first book in with us they are signposted to the relevant contact numbers provided on the front of their notes.

Women can discuss what they need during their pregnancy with their community midwife and will be referred as needed to specialist services for support, which includes a birth options clinic, preterm birth pathway, diabetes, mental health midwives etc. where they can access relevant specialised support

When women are in our inpatient care, they receive information about the department and where things are, they’re also shown how to use the call bell, encouraged to ask for any support they need. We are committed to ensuring all women have 1:1 care in labour and birth areas from a registered midwife.

We are working closely with our estates team to promptly address the concerns raised within the report. We have improved our cleaning standards and have a dedicated cleaning team who work to a daily cleaning schedule in each of our clinical areas. We have undertaken works to improve the bathroom facilities on our antenatal and postnatal wards and have undertaken a replacement programme for old furniture and equipment. This is an ongoing programme of work which includes regular review to ensure we maintain high standards of cleanliness in all areas.

If during your stay, you are concerned that our facilities do not meet our cleanliness standards, please report to a staff member, who will be able to help.

We work closely with the infection control team in the Trust to manage any infection risks in our service. Our staff receive infection control training, such as thorough hand hygiene, as this is a key element in reducing the risk of infection in healthcare.

Our equipment is cleaned between use, and we monitor this closely through an ongoing audit programme.

As soon as it is identified that a patient poses an infection risk, we would take steps to isolate and care for them in a separate, private room and all appropriate precautions would also be in place to manage that ongoing situation.

Guidance on infection control measures including hand washing is available in your green maternity notes and we are working to produce a leaflet and video to support this.

Staff and visitors are currently asked to wear a face mask in all clinical areas to reduce the risk of the transmission of Covid-19.

You can of course speak to other parents; however, we would encourage you to speak with your community midwife about any concerns you may have. Additionally, you can follow the Lister Maternity Voices Partnership (MVP) on Facebook, where key messages and information is shared, in collaboration with the Lister Diamond Jubilee Maternity Unit.

The Lister Maternity Voices Partnership (MVP) is a team of people who have had recent engagement with the maternity unit and who are interested in working with us to make our services better. They work with us when we develop any new systems, processes or leaflets to ensure their voices are heard, experiences are learned from, and suggestions considered to improve and develop our services to truly reflect the requirements of pregnant women and their families locally.

The MVP have a Facebook page which can be accessed by anyone to see what is happening within the unit, and there is the ability to post on the page and some mothers like to leave feedback this way.

The MVP are always interested in hearing from women and birthing people who would like to be involved in helping shape and develop maternity services at the Lister hospital. You do not need to have any experience in order to be involved and you would always be very welcome at any of the meetings held between the MVP and hospital.