Healthcare Inspectorate Wales has issued a report into our Maternity Services.

Please see our response below, along with additional background briefing:

Go to the HIW website to read the summary and full reports into maternity services at Singleton Hospital.

“We welcome the report and are already focused on making the improvements we have agreed with HIW as part of this process.  Indeed, many improvements have already been made. We are committed to learning from the feedback.

“We note HIW’s covering letter to us which states that it has evaluated our response and concluded that it provides them with sufficient assurance.  It goes on to explain that it has sufficient assurance because the improvements they identified have either already been addressed and / or progress is being made to ensure that patient safety is being protected.

“It is reassuring to note that the report has pointed out the kind and respectful care provided by staff and the way that good care planning has both evidenced, and promoted, patient safety. We are also pleased that the good multidisciplinary team working was recognised, and that the feedback provided by service users was generally positive, and they felt well cared for.

“However the report also sets out a number of areas where improvements are needed. Many of the issues raised were directly or indirectly linked to staffing pressures.  We are acutely aware of how difficult these pressures have made the jobs of our committed maternity and neonatal staff.

“Since the HIW unannounced visit on 5-7 September, we have successfully recruited 23 midwives and 14 Maternity Care Assistants, all of whom are already making a valuable contribution to the work of the service and who have already relieved much of the pressure the service has faced over the last couple of years.”

Ends

Background briefing

The following are taken from the ‘overall summary’ sections of both the summary and full HIW reports.  They are included in their entirety. We entirely agree with the findings and have already addressed them or are working on them.

Quality of Patient Experience

Overall Summary

We found that staff worked hard to provide women and birthing people, and their families, with a positive experience despite the sustained pressures on the department. Staff were observed providing kind and respectful care, and people we spoke to were generally positive of the care they received from staff. However, some raised concerns about staff availability, delays and sufficient support.

Delivery of Safe and Effective Care

Overall Summary

Patient records we reviewed confirmed good daily care planning, which promoted patient safety and evidenced the care provided. However, we raised significant concerns around staffing, security, and infection prevention and control.

We observed good multidisciplinary team working across services such as neonatal, pharmacy, theatres and anaesthetics.

We noted the efficiency improvements made in relation to the recruitment of a transformation midwife, digital midwife and changes to the maternity care assistant role. Some of these that had increased the time available for staff to care for patients.

Quality of Management and Leadership

Overall Summary

During the inspection we met with leaders across the maternity service that worked well together. We saw that multidisciplinary working appeared effective throughout the unit.

Staff feedback showed the team had experienced sustained periods of pressure. Many staff members we spoke to told us they were exhausted, and concerned about the impact of low numbers of midwifery staff on patient safety. The majority of midwifery staff we spoke to told us they were struggling to cope with their workloads and poor working environments, and were concerned about their own health and wellbeing. We did note however, staff teams worked hard to support each other in the circumstances. Several staff members mentioned the support, kindness and compassion that the medical team have provided to midwives in recent months.

We noted that many leadership roles in the department are interim and that there have been some challenges related to a stable leadership team over the last two years. We were told of additional measures in place to support the interim leadership team including peer mentoring and coaching.

Senior leaders shared plans to improve staffing levels and develop roles to meet future demands on the service.