Health chief vows to act following damning healthcare inspectorate report
A health chief has vowed to implement any findings of an independent review into maternity services, following a report published by Healthcare Inspectorate Wales (HIW) which highlighted several issues.
Emma Woollett was speaking at the first Swansea Bay University Health Board meeting since the report, which raised significant patient concerns within maternity services.
The inspection at Swansea’s Singleton Hospital took place last September, with the report published three months later. A considerable number of midwives and maternity care assistants have been recruited of late.
Health board chairwoman Ms Wollett said: “I want to be clear that as things stand the information provided to this board does not suggest this service (maternity) is fundamentally unsafe.”
She said there had been staff shortages, and serious concerns had been raised in the media.
This, she said, meant the King’s Counsel-led (KC) review announced by the board in December was important, and that its independence was paramount.
“Regardless of what we think of the service today, I know the board will embrace whatever findings the review comes up with,” said Ms Woollett.
“I reiterate that whatever this review finds, we will implement.”
The review, which will be overseen by Margaret Bowron KC, will consider three key areas: clinical outcomes, patient and staff experience, and leadership and governance.
The health board is also completing a number of improvements required by HIW.
Its report said inspectors weren’t assured that processes in place were sufficient to ensure patients were consistently receiving an acceptable standard of care.
They found issues with safe staffing levels not always being met, low levels of mandatory training compliance, and inadequate security measures to ensure babies were kept safe and secure.
Staff told inspectors they were struggling to cope with their workloads and were concerned about their own health and well-being. The report said they were working hard to provide women and their families with a positive experience despite sustained pressures.
The findings led HIW to issue the health board an “immediate assurance” letter requiring urgent attention.
An internal report before the health board said 31 out of 41 actions identified in the assurance letter had been completed – including staff recruitment and security changes to address the risk of baby abduction – and that nine of the remaining 10 actions were in progress.
Many more actions which HIW set out in a general improvement plan have been addressed or were in hand.
Gareth Howells, executive director of nursing and patient experience, told the board that 14 to 16 midwives were now consistently on shift – up to two above what there should be.
Mr Howells said there was a national shortage of midwives and the health board had been trying to recruit long before the HIW report.
A director of midwifery is currently being sought, while applicant numbers for assistant roles within the service were said to be very positive. Staff absence within maternity services is down from 12% to 9%.
Mr Howells, in response to a question about the long-term sustainability of the workforce by independent board member Reena Owen, said the focus also needed to be on staff retention.
“We need to be over this like a rash, Reena,” he said.
Board members who have visited maternity services at Singleton Hospital said they were struck by the dedication of staff.
Independent board member Anne-Louise Ferguson said she had spoken to a young consultant at the antenatal unit whose passion and enthusiasm had “shone out”.
She added: “We also spoke to a really young mum in the ward, and she was so enthusiastic and grateful to the staff.”
Joint acting medical director Dr Raj Krishnan said: “The passion of the clinical team is actually extremely powerful.”
The meeting went on to hear that the birth centre at Neath Port Talbot Hospital, which closed more than two years ago due to staffing shortages, was due to reopen at the end of March.
But Mr Howells said while choice for mums-to-be was “imperative”, the end of March target could be put back if assurances about things like ambulance transport couldn’t be given.
Ms Woollett said people wanted clarity after such a long period of closure but said that any reopening of the birth centre had to be successful. Mr Howells added: “We don’t want to open it and close it.”
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