Health: Maternity Care Provisions in East Kent - Statement

Part of the debate – in the House of Lords at 11:44 am on 13th February 2020.

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Photo of Baroness Blackwood of North Oxford Baroness Blackwood of North Oxford The Parliamentary Under-Secretary for Health and Social Care 11:44 am, 13th February 2020

My Lords, with permission, I will now repeat in the form of a Statement the Answer given to an Urgent Question by my honourable friend the Minister for Mental Health earlier today. The Statement is as follows:

“Mr Speaker, I will be setting out the situation concerning East Kent Hospitals University NHS Foundation Trust in line with the Written Ministerial Statement that was laid in Parliament this morning. The fact that I took steps to inform Parliament of this matter reflects the importance I have placed 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 about concerns regarding maternity services in East Kent Hospitals University NHS Foundation Trust. I would now like to update the House based on the reports from the independent Healthcare Safety Investigation Branch, which I refer to as HSIB from now on, 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 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; the speed with which patient 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 service between 22 January and 5 February 2020. It has written to the trust with an overview of its findings and a full inspection report will be published in due course. The CQC received additional information from the trust this week, following its request for further assurance on triage, day care and medical staffing, and 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 one single cause. NHS England and NHS Improvement are working very closely with the trust and have taken some immediate actions.

First, the regional medical director and regional chief nurse are providing support to the trust. 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 the head of midwifery to prioritise and focus their local maternity improvement plans to address identified safety concerns. They will also review the effectiveness of clinical governance and executive leadership support, and this will include ensuring that the trust is taking the learning from all historical cases and disseminating that learning through the trust.

The chief midwifery officer, Jacqueline Dunkley-Bent, has sent an independent clinical support team to the trust to provide assurance that all measures possible are being taken. This expert team includes a director of midwifery services from an outstanding trust, two consultant obstetricians, a consultant paediatrician and a neonatologist. She has placed the very best at the heart of the trust—on the wards, at the bedside of patients—with fresh eyes to oversee the care presently 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 improvement in standards over the long term. I can offer reassurance that Jacqueline Dunkley-Bent personally visited the trust two weeks ago to assess changes being put in place and that improvements are moving at pace.

Jenny Hughes, chief midwife for the south-east region, is also working with the trust directly. NHS England and NHS Improvement regional and national teams will continue to work with the trust. The trust is taking the issues seriously, is working closely with NHS England and NHS Improvement, and 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.

I would like to reiterate my condolences, particularly to Harry Richford’s family and all those affected. I also thank the honourable Member for North Thanet for raising this important issue. The Government are fully committed to reducing patient harm and improving the safety of maternity services.”