Enforcement action taken against Bedford Hospital after maternity services deemed ‘inadequate’

The regulator has “found a decline in the quality of maternity services at both hospitals run by Bedfordshire Hospitals NHS Foundation Trust” following visits to both of its hospitals in November.

The ratings for maternity services at Luton and Dunstable Hospital (L&D) and Bedford Hospital have both now declined from ‘requires improvement’ to ‘inadequate’, according to the report, published today (July 5).

Concerns over safety, culture and management of the maternity wards reported by whistle-blowers prompted the CQC inspection.

David Carter, Chief Executive at Bedfordshire Hospitals NHS Foundation Trust, said: “As a Trust committed to delivering excellent care, the CQC feedback was disappointing for us to hear but we are focussing our effort on ensuring that our maternity services consistently meets the standards of care we aspire to give.

"It was reassuring that the CQC confirmed that on both sites staff treated women with compassion and kindness, provided a service which was inclusive and took account of women’s individual needs and preferences and achieved good outcomes.

"On behalf of the board, I want to thank our staff for their hard work and commitment during what has been a period of significant challenges.”

While the trust’s overall rating remains good, CQC issued a warning notice in December to make immediate improvements to safe staffing. The trust has submitted an action plan to address these issues.

Stuart Dunn, CQC deputy director of operations in the East of England, said that “racism against staff” and “a lack of support from leaders” had undermined the trust’s steps to address staffing issues.

He explained: “At our inspection, we were concerned to find low staffing for midwives was still a significant risk to the safety of women, people using these services, and their babies despite us telling the trust they needed to address this previously.

“The trust had taken steps to address the issue by recruiting midwives internationally, but at this inspection we found this programme was being undermined by racism against staff, by their own colleagues, and a lack of support from leaders.”

Mr Carter said that vacancy rate for registered midwives is now 6.6 per cent on the L&D site, while Bedford’s department is “fully staffed”.

He said: “We were disappointed to hear that our international midwives reported issues of discrimination. Any act of discrimination or racism is unacceptable and the Trust is committed to ensuring any issues are addressed.

A staff survey from the trust in 2022 found that a third of all midwives reported experiencing at least one incident of bullying or harassment from colleagues. Leaders hadn’t always taken meaningful action to address these issues, but have started to put actions in place since we raised this with them.

Mr Dunn explained: “Midwives in the community service told us day to day staffing was often difficult as they were pulled in to cover the labour wards. This meant they weren’t available for their planned work in the community the following day, impacting on people’s care.”

Staff were praised for making sure that women living with mental health problems, learning disabilities, and dementia received the necessary care to meet all their needs.

Even where there were limited resources, staff worked hard to meet people’s needs in a compassionate way. But the report stated: “The service did not always have enough staff to care for women and keep them safe.

“Staff did not always feel respected, supported and valued. The service did not manage cultural issues raised by staff effectively.”

Mr Carter added: “We are taking immediate action in the areas identified by the CQC, many of which have already been addressed since the inspection visit in November 2023.

“The Trust has a tailored induction programme for international midwives to help them adjust to a new country and healthcare system and we were pleased to hear in the report that internationally trained staff were complimentary of the support they received from the Trust.

“We have also developed a fully tailored culture and development programme for our maternity staff to foster a more inclusive and respectful working environment.

“To support this programme, we are also currently running staff engagement events in July that will be attended by over 4,500 colleagues, focusing on increasing awareness and understanding of different cultural backgrounds and preventing discriminatory behaviours.”