King’s Mill Hospital’s maternity services rated ‘good’ despite safety concerns raised

King's Mill Hospital in Sutton-in-Ashfield.
By Anna Whittaker, Local Democracy Reporter

The maternity services at King’s Mill Hospital in Nottinghamshire have been rated ‘good’ by the healthcare watchdog.

The Care Quality Commission (CQC) visited the hospital, run by Sherwood Forest Hospitals (SFH) in November.

However, improvements must be made after the rating for safety dropped from ‘good’ to ‘requires improvement’.

Concerns were raised by inspectors over maternity triage – an area where advice and assessments are given to pregnant women – and staff training.

The hospital as a whole remains rated as ‘outstanding’ by the CQC – it is the only hospital with this rating in the East Midlands.

The inspection was carried out as part of CQC’s national maternity services inspection programme.

Inspectors found the service had enough staff to keep women and babies safe.

However, the report stated that “more women and birthing people were choosing to birth at King’s Mill hospital which was affecting the capacity of the service”.

The maternity unit temporarily closed to new mums 11 times during November 2022 and staff told inspectors they did not feel there was always enough staff to meet demand in service.

Staff told inspectors they felt listened to by the leadership team and felt actions were taken when concerns were raised.

However, not all staff had completed mandatory training. For midwifery
staff, compliance with training ranged from 39 per cent to 100 per cent.

Chief Nurse Phil Bolton said training levels have “increased significantly” since the inspection.

Chief Nurse Phil Bolton (far left) and Director of Midwifery and Head of Nursing Paula Shore with members of the Maternity team.

The triage system was found to be “ineffective” as there were multiple options that people could choose when calling the unit. This posed a risk to those needing urgent care.

SFH said staff are currently receiving training ahead of the launch of a new maternity triage system.

Inspectors wrote in the report: “Leaders had plans in place to improve the triage area of the maternity ward.

“Currently, there was not a suitable waiting area causing the clinical triage area to become full. This posed a risk that women would not be seen in a timely way.

“This meant they may be put through to the emergency phone on the Labour ward instead of triage. The midwife on the triage line said they were answering calls from post-natal women as well as women who could be in labour. Staff
told us they would escalate clinical concerns as they knew how to prioritise women, but this was not always clearly documented.

“The trust was already aware that there were improvements needed to the triage system, they were working on ways to move their improvement plans forward.”

The trust reported two maternity serious incidents in the last six months, both in relation to babies being stillborn, and both occurred in May 2022.

Inspectors said the trust was “open and transparent and gave women
and families a full explanation if and when things went wrong”.

Phil Bolton, Chief Nurse at Sherwood Forest Hospitals, said the trust was “incredibly proud” of the positive findings in the report.

He said: “The ‘good’ rating rightly recognises the fantastic work our maternity colleagues do, day in and day out, despite the ongoing challenges placed on maternity services.

“Continuous improvement is one of our top priorities and work is well underway to address the points raised, as well as others we have identified.

“We pride ourselves on setting incredibly high targets for training, and I’m pleased that our training levels have increased significantly since the inspection.”

Greg Rielly, CQC’s deputy director of operations in the Midlands, said there was a “positive culture” within the service.

He said: “Both women and staff felt they could raise concerns without fear, and we were pleased to find that leaders were visible and approachable, for them to do so.

“However, we did find concerns around safety which leaders must work to address. We found that the triage system was ineffective, with a multi-option phone line meaning calls could end up being put through to the labour ward.

“Additionally, while staff told us they knew how to prioritise calls of clinical concern, this wasn’t always clearly documented, meaning leaders couldn’t be assured appropriate triaging had taken place.

“We will continue to monitor the service, including through future inspections, to make sure that the trust improves the safety of this service.”

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