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Materni
The new rating is ‘requires improvement’, up from the previous rating of ‘inadequate’ in May 2023.
The CQC highlighted that improvements had been made since they last inspected the service, including more equipment in the department, a new handover tool to improve communication between midwives and doctors and a dedicated breastfeeding midwife.
The CQC recognised that the culture within the department was found to have improved but also recommended that more needed to be done to address bullying, discrimination and harassment.
These improvements are thanks to a huge effort by everybody at North Mid, with a real focus on providing a better experience for women and people using the service.
North Mid’s maternity service has also been rated requires improvement for ‘safety’ and being ‘well led’. Being ‘caring responsible and effective’ were not looked at during this inspection and remain rated as good from their previous inspection.
Dr Nnenna Osuji, chief executive of North Mid, said: “I’m pleased that the rating of our maternity services has improved following this inspection in January. Thank you to the staff who have worked hard to improve the service since our last inspection two years ago. I was particularly pleased to hear the positive feedback from those who use our services.
“We know we have more to do, and we will be working to address all the points raised in the inspection report to ensure we can continue to provide the very best care.”
Jane Ray, CQC deputy director of operations in London, said: “It was positive to see progress at North Middlesex University Hospital’s maternity service following our previous inspection.
“Women and people using the service described staff as kind, compassionate and responsive to their individual needs. Many told us they felt listened to, involved in decisions about their care and gave examples of adjustments made by staff to accommodate their needs.
“At our last inspection, the triage process, the order in which people were seen by a clinician, was ineffective meaning people weren’t always prioritised safely. This time, we saw a dedicated telephone triage midwife in place and improved use of a recognised triage tool, to help to ensure quicker and safer assessments.
“Previously, not all staff had completed mandatory training to keep women, people and their babies safe, including in areas like safeguarding and life support. Midwifery staff have made significant progress, now meeting or exceeding trust targets in all areas of mandatory training, including obstetric emergencies and neonatal life support. However, medical staff still need to improve their training completion rates in several key areas to ensure consistently safe care.
“The trust has made some improvements, but they have much more work to do to make sure people are safer and leadership continues to improve as we know that better leaders mean better care. They should continue to build on these foundations, ensure their improvements are embedded and sustained, and we’ll continue to monitor them to make sure this happens.”
Peter Landstrom, RFL group chief executive, said: “I am really pleased to see this big step in the right direction for maternity services at North Mid. It’s a testament to all of the hard work which has taken place over the past two years, and the determination of staff to provide the very best service. This is a great start, and I can promise that following our merger, we will collectively strive to make improvements in the areas where the CQC have indicated that more work needs to be done.”
Inspectors also found:
• Staff made reasonable adjustments to support individual needs, including for mothers and people with mental health conditions.
• The service provided leaflets produced in multiple languages, to ensure they catered to the diverse population of people they provide care to.
• The service had enough suitable equipment to help them to safely care for people. Staff also told inspectors there was an improvement in the amount of equipment available.
• Staff introduced a dedicated breastfeeding midwife twice a week to offer one-to-one and group support, after people raised concerns about babies being readmitted due to weight loss.
• Leaders had introduced a new handover tool to improve communication between midwives and neonatal doctors, helping ensure the right staff respond quickly in emergencies.
• Leaders were found to be more stable since the hospital merged with the Royal Free London NHS Foundation Trust, and staff told them that senior leaders were more visible and supportive.
However:
• Risk assessments were not always carried out or recorded in a timely way, meaning staff could not be assured that safety concerns were identified early.
• Most managers and staff reported an improvement in the culture within the service, however, some staff continued to experience bullying and inequality. The inspectors emphasised the need for leaders to take immediate action to prevent and address bullying, discrimination and harassment at all levels.
• The bereavement room required people to walk through the labour ward, which did not align with national best practice as it was insensitive to people who had experienced fetal loss.
Image: The maternity team at North Mid
