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Maternity Services: East Kent

Part of the debate – in the House of Commons at 11:06 am on 13th February 2020.

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Photo of Nadine Dorries Nadine Dorries The Parliamentary Under-Secretary for Health and Social Care 11:06 am, 13th February 2020

I will set out the situation concerning East Kent Hospitals University NHS Foundation Trust in line with the written statement laid in Parliament this morning. In fact, I took steps to inform Parliament of this matter before the UQ was requested, and I hope that reflects the importance I place on this issue. Before I begin, I would like to express my deepest and most heartfelt sympathies for the patients and families who have been affected.

I made a statement on 28 January on concerns about maternity services in East Kent Hospitals University NHS Foundation Trust, and I would now like to update the House based on the reports from the independent Healthcare Safety Investigation Branch and the Care Quality Commission. I requested that both HSIB and the CQC report back to me within 14 days when I instructed them to go into East Kent trust two weeks ago, and they reported to me on Monday.

HSIB has already conducted a number of maternity investigations at the trust as part of its national maternity investigation programme. These identified a number of safety concerns, including the availability of skilled staff—particularly out of hours—access to neonatal resuscitation equipment and the speed with which patients’ concerns are escalated up to senior clinicians and obstetricians, along with failings in leadership and governance.

As requested, the CQC carried out an unannounced inspection of the trust’s maternity services between 22 January and 5 February. It has written to the trust with an oversight of its findings, and the full inspection report will be published in due course. The CQC received additional information from the trust this week, following its request for further assurances on triage, day care and medical staffing. The CQC is considering this information. It is important that everyone is aware that the CQC is in regular contact with the trust and will continue to be so for the foreseeable future.

From the findings provided to me by HSIB and the CQC, it is clear that the challenges at East Kent point to a range of issues, including having the right staff with the right skills in the right place, effective multidisciplinary working, clear collaborative working between midwives and doctors, good communication and effective leadership support, but it would be wrong to speculate that there is indeed one single cause.

NHS England and NHS Improvement are working closely with the trust and have taken some immediate actions. First, the regional director and regional chief nurse are providing support to the trust, and the medical director will address concerns surrounding appropriate senior medical oversight. Secondly, the regional chief nurse is providing support to the director of nursing and head of midwifery, to prioritise and focus their local maternity improvement plans and address identified safety concerns. They will also review the effectiveness of clinical governance and executive leadership support. That will include ensuring that the trust learns from all historical cases, and disseminates that learning throughout the trust.

The Chief Midwifery Officer, Jacqueline Dunkley-Bent, has sent an independent clinical support team to the trust to provide assurances that all possible measures are being taken. That expert team includes a director of midwifery services from an outstanding trust, two consultant obstetricians, and a consultant paediatrician and neonatologist. She has placed the very best at the heart of the trust, on the wards, and at the bedsides of patients, with fresh eyes to oversee the care currently being delivered. The independent team is working with trust staff to deliver immediate improvements to care, and to put in place robust and comprehensive processes to support improvements in standards over the long term. Jacqueline Dunkley-Bent has personally visited the trust to assess the changes being put in place, and to ensure that improvements are moving at pace.

Jenny Hughes, chief midwife for the south-east region, is working with the trust directly, and regional and national teams from NHS England and NHS Improvement will continue to work with the trust. The trust is taking the issue seriously and is working closely with NHS England and NHS Improvement. It has created and filled several specialist midwife posts. Safety huddles, where safety issues are regularly and frequently discussed, have been embedded on both sites to anticipate problems before they occur, and multidisciplinary teams are working collaboratively.