An “urgent need for actions” to improve maternity care at a scandal-hit NHS trust remains, despite some improvements being made, a midwives union has said.

Care for mothers and newborn babies at East Kent Hospitals University NHS Foundation Trust has been heavily criticised following a series of baby deaths.

Among those treated at the trust was Harry Richford who died in a “wholly avoidable” tragedy, seven days after his emergency delivery in November 2017, an inquest found.

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Sarah and Tom Richford with their son Harry who died seven days after he was born in November 2017 at the Queen Elizabeth the Queen Mother (QEQM) Hospital in Margate (Derek Richford/PA)

A CQC report published today rated maternity services at the trust as Requires Improvement following an inspection.

Inspectors found a number of improvements had been made at William Harvey Hospital in Ashford and Queen Elizabeth the Queen Mother Hospital in Margate.

However concerns remain, including instances where midwives were left to assess women, who may be high risk, rather than a doctor.

Dr Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals, said: “Our inspectors found a team committed to learning and continually improving the department.

“The service had a vision for what it wanted to achieve and a strategy to turn it into action.

“Despite these green shoots of improvement there was still work to be done especially in antenatal services.

“At William Harvey Hospital, the antenatal clinic in outpatients was poorly maintained.

“Staff in day care did not always report incidents, which meant managers could be unaware of avoidable events on the unit.

“We found that because the risk to women was not effectively managed in antenatal services, midwives sometimes had to review and assess women, who may be at high risk, rather than a doctor.

“Midwives told us that a senior doctor was sometimes available in clinic.

“However, it was usually a junior doctor with limited experience in obstetrics that would review and discharge.”

Parking at hospitals
A view of the William Harvey Hospital in Ashford, Kent, which is part of the East Kent Hospitals University NHS Foundation Trust (Gareth Fuller/PA)

Responding to the report, Gill Walton, CEO of the Royal College of Midwives (RCM) said: “The RCM is disappointed to read this report and see the same issues that were flagged in the Royal College of Obstetricians and Gynaecologists invited review in 2015 remain.

“There is an urgent need for actions to be completed so safety is not compromised and this needs to happen at board level within the Trust.

“Safety must be the absolute priority and the basis on which all care is delivered and on which all decisions are made.

“Good leadership at every level of maternity services is key to delivering safe, high-quality care for women and their babies.”

Responding to the CQC report, trust chief executive Susan Acott said: “The improvements and positive work cited in the CQC’s report is a testament to the hard work put in by the maternity and obstetric teams to improve the quality of services for women and babies in east Kent.

“We know we have much more to do.

“We are already acting on the CQC’s recommendations, and have improved staffing levels in the antenatal triage and day care service, implemented a nationally-recognised safety system in that service, and appointed a maternity governance lead to co-ordinate the review and improvement of the service’s internal governance processes.

“We are determined to provide an excellent standard of care to every mother and child who uses our maternity service and we will continue to make improvements and make sure positive changes are thoroughly embedded, so local families can have absolute confidence in their care.”

In April, a report by the Healthcare Safety Investigation Branch (HSIB) was published which identified “recurrent safety risks around several key themes of clinical care” in the trust’s maternity services.

Dr Bill Kirkup, who led the investigation into serious maternity failings at University Hospitals of Morecambe Bay NHS Foundation Trust, is conducting an independent review into East Kent hospitals maternity services.

Dr Jo Mountfield, consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists, said: “It is encouraging to see improvements taking place in the maternity services at East Kent Hospital University NHS Foundation Trust.

“But, as this latest CQC inspection shows, further urgent action is required to ensure women, their babies and families receive the safest possible care.

“The Rcog undertook an independent review of the maternity services in November 2015 which found a number of serious concerns.

“It is very disappointing that some of the same improvements are still required, such as the appropriate escalation of serious incidents, and improved staffing and governance as well as adequate consultant accessibility and responsiveness.

“We remain absolutely committed to providing the necessary support to NHS England and Improvement to ensure the maternity services are of the highest standard for every woman and her family.”