- NHS hospital
New Cross Hospital
Report from 17 September 2024 assessment
Ratings - Maternity
Our view of the service
Date of the on-site assessment was 29 October and 30 October 2024. During the assessment we found 2 breaches of regulation. These were in relation to safe care and treatment as outcomes for women, birthing people and their babies were not always positive and good governance as compliance with caesarean section decision to delivery targets were not routinely monitored. However, during our assessment staff were positive about the culture of the service and processes were in place for shared learning. The environment was visibly clean and tidy and medicines storage areas were secure. There were comprehensive guidelines in place for induction of labour. Staff worked well together and completed National Perinatal Mortality Review tools when required. Audits took place, and the service benchmarked against other hospitals. Leaders completed leadership courses, and Freedom to Speak Up arrangements were in place. There was a governance structure, and various quality improvement projects. There were high numbers of red flags in relation to delayed or time critical activity. Midwives staffing was up to funded establishment, but short staffing sometimes occurred at short notice. On both days of the assessment, we observed delivery suite staffing was below the recommended numbers. Staff were concerned about sonography staffing levels. The perinatal death rate was over 5% higher than the Mothers and Babies: Reducing Risk through Audit and Confidential enquiries; (MBBRACE-UK) group average. Reviews on mortality found themes such as failure to provide aspirin and a partogram as well as a failure in risk assessment, although these did not impact on the outcome. The service was not fully complaint with guidance to provide Uterine Artery Doppler Scans for women at high risk of foetal growth restriction. We have asked for an action plan.
People's experience of this service
Women and birthing people spoke positively about the departments systems and pathways. Most women and birthing people told us they received their ultrasounds on time; they felt communication was good and that the pathway had been smooth. Women and birthing people felt safe and felt they could tell staff anything; however, some women and birthing people were not sure how they would raise concerns about staff if they had any. They felt staff explained about procedures and risk factors in pregnancy. They felt there were enough staff, and they were friendly and helpful. They told us call bells were always answered promptly and they provided us with positive feedback about the environment and equipment. They told us the environment was visibly clean, and they saw domestic staff cleaning wards daily. However, one woman told us how they had their baby put in bed with them for several hours after a caesarean section and that this was due to lack of cots. However, we saw that 5 additional cots were ordered. Women and birthing people told us how staff followed good infection prevention control techniques such as washing their hands, using alcohol gel, and wearing personal protective equipment. Women and birthing people gave examples of how staff adapted and assessed their needs. Feedback from the local Maternity and neonatal Voices Partnership showed women and birthing people would have liked their partner to be able to stay with them longer after giving birth. Women and birthing people felt staff worked well together and gave examples of how they had been supported provided with advice around their health.