The Care Quality Commission (CQC) will today publish a report following an inspection of Maternity and Gynaecology services at Liverpool Women’s NHS Foundation Trust in January and February 2023.
An unannounced inspection of Gynaecology was carried out, as well as a focused inspection of Maternity services as part of the CQC’s national maternity inspection programme.
The programme aims to provide an up-to-date view of the quality of hospital maternity care across the country, and a better understanding of what is working well to support learning and improvement at a local and national level.
Following the inspection, the overall rating for Gynaecology services at Liverpool Women’s Hospital has gone up from Requires Improvement to Good. However, Maternity services has gone down from Good to Requires Improvement.
The overall rating for the Trust has gone down from Good to Requires Improvement.
The full CQC inspection report can be accessed from 10am on Friday 23rd June 2023 via the following link: https://www.cqc.org.uk/provider/REP/inspection-summary
Trust response
Despite receiving a Requires Improvement overall rating, there were many examples of positive feedback within the report, including within Gynaecology services which received a Good rating overall, and a number of examples of outstanding practice Trust wide.
The report also highlighted how staff are focussed on the needs of people and that they strive to deliver the best possible care.
The Trust’s Chief Executive, Kathryn Thomson, has issued the following statement:
“We accept the CQC inspection report and commit to making the necessary improvements. Naturally, we are disappointed to receive a Requires Improvement rating for the Trust overall and in particular, we are disappointed with our Maternity service ratings. We have taken immediate action to address the issues raised within the report; many of these actions have already been completed or are underway as we were made aware of them immediately following our CQC inspection, prior to publication of the final report.
“I am pleased to say that we have already seen positive results which we have shared with the CQC, and we will continue to respond to the wider inspection report findings to make further and sustained improvements.
“As well as acknowledging the areas where we need to improve, I also want to highlight the positive feedback we received within the report across many areas of the Trust from the team of inspectors who visited us, in particular our Gynaecology service which has seen its overall rating increase to Good.
“I would like to reassure women, families and other people who we care for, that I have full confidence in the quality and safety of our services, the care that our staff provide, and our ability to make the improvements identified in the inspection report.
“We look forward to being able to demonstrate these improvements in due course as part of any planned follow up inspections that may take place.”
Following the CQC inspection early this year, and in response to initial feedback, the Trust took action prior to the publication of the final report to make improvements in a number of areas. A summary of the main actions being taken is as follows:
- The Trust has ensured significant improvement in the time women wait for triage in MAU - 99.9% of women are now triaged within 30 minutes of which 87.3% are triaged within 15 minutes of arrival.
- Significant recruitment efforts have taken place, which has led to demonstrable improvement in staffing levels with a reduction in the midwifery vacancy rate to 4.9% in May 2023.
- The MAU triage phone line is staffed at all times on a 24/7 basis. On the rare occasions when delays occur in answering due to service pressures (e.g an influx of women attending MAU or short notice staff sickness absence) a range of staff on the unit are utilised to maintain the phone line to as optimal a standard as possible.
- We acknowledge that sometimes challenges can occur in answering call bells as quickly as we would like to. Any delays are usually limited to minutes and it is extremely rare that any woman would be waiting for a significant amount of time for a call bell to be answered. However, to address this issue and to ensure a continuous and timely response to call bells, the Trust has employed eight additional Maternity Support Workers within its Maternity Ward, to ensure that there are five support workers allocated to each shift on a 24/7 basis.
- We acknowledge that sometimes challenges can occur in answering call bells as quickly as we would like to. Any delays are usually limited to minutes and it is extremely rare that any woman would be waiting for a significant amount of time for a call bell to be answered. However, to address this issue and to ensure a continuous and timely response to call bells, the Trust has employed eight additional Maternity Support Workers within its Maternity Ward, to ensure that there are five support workers allocated to each shift on a 24/7 basis.
- Weekly clinically led staff meetings have been introduced to ensure that all staff are involved in future service improvements and to provide a safe space for staff to raise concerns, and feel listened to, supported, and valued. These groups are in place within all areas of the Maternity service.
- There is ongoing Estates improvement work, to maximise use of, and improve, the clinical estate and patient flow as well as enhancing the patient experience.
- Weekly meetings with the Governance Team are in place to review and action all clinical incidents and to assess emerging themes and trends.
- Separation of emergency attendances and planned appointments within MAU is underway with an alternative location identified for planned care to relocate to the main Outpatient’s department.
The current Family Health Leadership Team – which oversees Maternity services – was in place for 5 months prior to the CQC inspection. The newly formed team was appointed as a result of the Trust Executive Team’s investment in Maternity services. During 2022, significant workforce investment was made in the operational management, clinical and midwifery leadership structures. The leadership team is now well established, and it is pleasing to note that many sustained improvements have already been made, with clear plans and priorities in place to address the remaining issues within the CQC inspection report.
If any patients have any concerns or questions about the above or would like any further assurance about the actions that the Trust is taking in response, please contact a member of staff looking after you and they will make arrangements for a member of the team to speak with you.
You can also contact our Patient Experience Team by emailing pals@lwh.nhs.uk or by calling 0151 702 4353.