Melton baby unit rated 'good' while city maternity services are downgraded

No date has yet been given for St Mary’s Birth Centre to be absorbed into a new city-based set-up where all women across Leicestershire will have their babies, aside from those who give birth at home.

A Care Quality Commission (CQC) inspection team has been reviewing all maternity services in the county.

It concluded that St Mary’s should retain its rating as ‘good’ but downgraded services at Leicester Royal Infirmary (LRI) and Leicester General to ‘requires improvement’.

One of the major differences found at the sites was that Melton’s unit was sufficiently staffed while the Leicester hospitals maternity departments were ‘regularly understaffed’.

The inspectors found St Mary’s was a safe service and was good in terms of cleanliness, infection control and hygiene.

They said staff at the birth centre ‘should be proud of the safe care they were providing’.

Records were said to be ‘clear, up-to-date, stored securely and easily available to all staff providing care’.

Staff knew what incidents to report and how to report them although the report stated there had been no serious incident investigations related to the birth centre since 2020.

Inspectors said St Mary’s midwifery staff and maternity care assistants received and kept up-to-date with their training.

The Melton unit, which deals with low risk pregnancies and gives valuable after-care, has two birthing rooms with pools and an eight-bed post-natal ward.

According to the report, 137 women and birthing people had been cared for in labour at St Mary’s during 2022 and there had been 95 births, with 42 transferred to main units in the city.

Inspectors highlighted the important work of the post-natal ward, commenting: “This was of particular benefit to women and birthing people with complex needs or those who needed additional support with breastfeeding.”

The review did highlight an issue with the quality of leadership at St Mary’s, which was downgraded from ‘well-led’ to ‘requires improvement’.

The leadership team had been restructured, the inspectors noted, and many posts were new and those leader were getting used to working practices.

‘Staff had not always felt respected, supported, and valued’, the report stated but the leadership team was working to establish a more open culture where concerns could be reported.

In contrast, the CQC assessors concluded there had been a ‘deterioration in the level of care’ at the Leicester maternity sites.

Staff at the General told inspectors the service ‘had been very short-staffed’, the inspection report stated.

This had been ‘really hard work’ to deal with, and staff were ‘pushed to the brink’, they added.

They told the CQC team there used to be between 13 and 15 midwives on the delivery suite, but now there could be as few as seven.

Inspectors found many multiple examples in the city’s maternity service where care was delayed in triage due to doctors not being available.

Some waits were up to six hours which resulted in some patients self-discharging before their health had been checked.

Staff at LRI told the inspection team that induced labour was sometimes paused because of staff shortages, and women were given the option of going home.

Managers at LRI also told the CQC team that staffing on ante-natal and post-natal wards was ‘challenging generally’, with actual staffing levels frequently lower than planned.

Triage staffing was also flagged as a concern by inspectors at both Leicester hospitals.

There could be as many as 30 women in the triage area with just two midwives to care for them and cover the phones, the report said.

Concerns were also raised about the state of the second theatre at the General which was described as ‘not fit for purpose’ and was not in use. Planned births were being delayed in some cases when an emergency case came into the hospital as a result.

Julie Hogg, chief nurse for the University Hospitals of Leicester NHS Trust, which is responsible for the running of the city’s hospitals and the Melton birth centre, said steps had already been taken to recruit more staff and to improving maternity services.

She commented: “Our new director of midwifery has overseen plans to strengthen staffing.

“Since January this year, 25 new midwives have joined us, and we will welcome 24 more in November.

“We have invested in new equipment and daily safety checking and made rapid improvements to cleanliness and infection prevention practices.”

She added: “While we know there is more to do, we are committed to providing safe, high-quality and compassionate care and are encouraged that the reports highlight our hardworking staff and the actions being taken to ensure a culture of safety and openness.”

Campaigners fought passionately to retain St Mary’s Birth Centre in the town but in June 2021 the health authority backed a move to consolidate all county maternity services in the city.

They said the relatively low number of births at the Melton unit meant it was not viable long-term and that putting all resources in the city would make it easier for women to get there from across the county.

Campaigners argue St Mary’s is not marketed enough to stimulate more women to use the unit and its range of resources.

The change is part of a £450million revamp of Leicestershire hospital services. Early indications were that the relocation of St Mary’s services to the city would not take place until 2025 or 2026.

There are hopes that some services may still be retained at Melton, such as post-natal care, but that has not been confirmed.

***Additional reporting by Hannah Richardson, from the Local Democracy Reporting service