Three trusts whose struggling maternity departments were supported and supposedly improved by a national safety programme have since fallen back into the scheme
A freedom of information request by HSJ has for the first time revealed a complete list of participants in NHS England’s maternity safety support programme, with 28 trusts involved since its inception in 2018.
London North West University Healthcare Trust, Northern Lincolnshire and Goole Foundation Trust, and Worcestershire Acute Hospitals Trust all entered the scheme at the start, due to pre-existing quality and safety concerns. The trusts were all subsequently removed, having been deemed to have made improvements, but have since been placed back in it following inspections by the Care Quality Commission (see table below).
HSJ asked the trusts to explain why they had re-entered the scheme, and why it had failed to deliver sustainable improvements the first time, but they declined to comment.
NHSE said in a statement: “Trusts are placed on the maternity safety support programme according to complex criteria, including local insight and external performance measures, including CQC ratings. “Following the success of the programme since its creation in 2018, its criteria was widened to strengthen its role in proactively improving safety and enabling earlier intervention where there are concerns — this has allowed support to be offered to more trusts than in previous years.” However, it would not provide further details on the new entry criteria.
Three further trusts — Barts Health, North Devon Healthcare, and the Queen Elizabeth Hospital King’s Lynn — have previously exited the programme and not so far re-entered. Trusts such as Shrewsbury and Telford and East Kent — which have been at the centre of major maternity scandals — have been on the improvement scheme for all four years.
Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, said: “The number of NHS maternity services being found to be needing improvement is worrying. We welcome the fact that NHS England is devoting resources to support trusts to improve their maternity services, but there should be much more transparency about this.
“The criteria for needing this support should be published, and indeed should have been subject to consultation.”
Helen Hughes, chief executive of patient safety charity Patient Safety Learning, said there should be transparency about resource allocation and the criteria used to make decisions, adding: “It doesn’t appear that this information is easily accessible and in the public domain and rather begs the question, why not?”
NHSE said trusts receiving support from the programme detail this in their board papers, although HSJ found this is not always the case. It added trusts are made aware of the rationale for inclusion on an individual basis.
NHSE and the Department of Health and Social Care last year described the maternity safety support programme as the “highest level of maternity-specific response”. They have said the programme “involves senior clinical leaders providing hands on support to provider trusts, through visits, mentoring, and leadership development”.
Full article here (paywalled)
Original source: Health Service Journal