The Care Quality Commission says it has taken urgent action to safeguard patients at Shrewsbury and Telford Hospital Trust, after inspectors raised serious concerns about the monitoring of unborn babies and care for people at risk of sepsis.
The regulator announced it had placed conditions on the trust’s registration following inspections of maternity and emergency departments at its Princess Royal and Royal Shrewsbury hospitals.
“We meet national guidelines in our maternity unit and conduct twice daily consultant led ward rounds”
The trust is currently the subject of an independent review of baby deaths, brain injuries and maternal deaths, which was expanded this summer to encompass more than 40 cases.
Unannounced visits in August and September highlighted concerns about foetal monitoring and the organisation’s approach to dealing with reduced foetal movement, said the CQC.
The trust – which is currently rated “requires improvement” overall – must now report weekly to the regulator setting out the action it has taken to ensure effective clinical management of those using its midwifery services.
In addition, inspectors raised concerns about the treatment and recognition of sepsis in urgent and emergency care, and the trust must submit weekly progress reports on the safe management of deteriorating patients and sepsis at both hospital sites.
“We have also introduced daily safety huddles and senior clinically-led two hourly sweeps”
Managers have also been told they must ensure the emergency department at the Princess Royal is safe with equipment stored safely, risk assessments carried out and reviewed, and all staff aware of and following safety protocols.
CQC chief inspector of hospitals Professor Ted Baker said the regulator remained “very concerned” about emergency and maternity services at the trust.
“We are monitoring the trust extremely closely and continue to work with NHS Improvement to ensure patient safety improves,” he said.
“We will return to check on whether sufficient improvements have been made and will take further action if needed,” said Professor Baker.
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Trust managers said immediate action had been taken to address all the concerns raised by the CQC.
“We take the safety of our patients and their care very seriously. We are addressing all the areas raised by the CQC,” said its medical director Dr Edwin Borman.
Meanwhile, director of nursing, midwifery and quality Deirdre Fowler said the trust was meeting national guidelines and had provided proof to the CCQ.
“We meet national guidelines in our maternity unit and conduct twice daily consultant led ward rounds,” she said. “We have now provided the CQC with the records that show this.”
In addition, Ms Fowler highlighted that the trust had changed its approach to foetal monitoring.
Previously midwives in Shropshire’s midwifery led units (MLUs) had used CTG (cardiotacography) to monitor fetal movements and where there was cause for concern mothers were referred to an obstetrician in the maternity unit at the Princess Royal, she noted.
“In regards to the reviewing of CTG foetal monitoring by midwives in the MLUs, the trust has now changed its approach and all women are now monitored in the Princess Royal Hospital obstetric unit,” she said.
Dr Borman also said the trust had implemented an action plan in the emergency department, focusing on the concerns raised by the CQC, including the monitoring of patients at risk of sepsis.
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“We have also introduced daily safety huddles and senior clinically-led two hourly sweeps of the department; as well as spot checks overnight and out of hours,” he said.
The trust had also taken steps to end the practice of “boarding” emergency patients in acute wards during periods of high demand.
“We are working really hard to ensure that this does not re-occur,” added Dr Borman.
The CQC said the full findings of its inspections at Shrewsbury and Telford Hospital Trust would be published soon.