The report comes almost 10 years after an investigation into baby deaths at the hospital, with the Scottish Government ordering a review.
A Scots maternity ward has fallen short of standards in 16 different areas in a recent inspection, including potential gaps in incident reporting.
Healthcare Improvement Scotland (HIS) carried out an unannounced inspection of Ayrshire Maternity Unit at NHS Ayrshire & Arran’s University Hospital Crosshouse on October 8-9 last year, and later carried out another on October 27 the same year.
The report comes almost 10 years after an investigation into baby deaths at the hospital, with the Scottish Government ordering a review. Between 2008 and March 31 2016, there were four significant adverse event reviews concerning stillbirth deaths at the unit at Crosshouse Hospital, Kilmarnock, East Ayrshire.
A BBC investigation at that time found there had been six so-called “unnecessary” deaths of babies at the hospital since 2008. In a report released on Wednesday, HIS said it had found 16 requirements, two recommendations, and 10 areas of good practice.
Requirements included better fire safety, incident reporting, ensuring women can receive timely access to midwifery telephone assessments, better governance and oversight of the maternity ward, and the right care at the right time. It also called for ongoing engagement among staff to ensure a transparent workplace, and to ensure timescales of significant adverse events reviews are achieved to support and improve the quality and safety of care.
It also found the hospital must take more steps to ensure patient equipment is clean and ready for use. The inspection also noted a number of areas where the ward is excelling – including support for families with newborns, a dedicated area for bereaved families, and that families were given the opportunity to stay in the hospital during births.
Speaking of the report, Donna Maclean, chief inspector, HIS, said: “During this inspection we observed cohesive team working in all areas inspected. Maternity staff we spoke with described positive working relations between midwifery, obstetric, anaesthetic and the health care support team. Staff described feeling supported to escalate staffing issues and concerns to their senior charge midwife.
“Women within the unit told us they felt listened to and supported in making decisions about their care – women described positive experiences of communication and compassionate interactions with staff. Women and their families also told us they would be happy to recommend NHS Ayrshire & Arran maternity services to their family and friends.”
She added: “However, we raised concerns regarding potential delays to care for women accessing maternity triage and potential gaps in incident reporting, which may impact on the learning from adverse events and reducing opportunities to improve safety. We also raised concerns regarding fire safety. Other areas for improvement identified include flushing of infrequently used water outlets and some improvements required in the cleanliness of patient equipment.”
This inspection resulted in 10 areas of good practice, two recommendations and 16 requirements. Jennifer Wilson, nurse director of Ayrshire Maternity Unit, said she acknowledges the findings in the report, and says NHS Ayrshire & Arran is committed to making the necessary improvements.
She said: “NHS Ayrshire & Arran is committed to the provision of high standards to ensure our patients receive safe and dignified care at all times. Our teams have a strong focus on ensuring that improvements are made to deliver the best possible care across health and social care services.
“As a learning organisation, NHS Ayrshire & Arran values scrutiny and inspection of our services. We acknowledge the recent Healthcare Improvement Scotland’s (HIS) report following their visit to Ayrshire Maternity Unit. The report highlighted cohesive multidisciplinary team working and positive working relationships and demonstrated that our teams provide a good standard of care for families, supporting patients to make decisions about their care.”
She added: “We acknowledge that there are areas where we need to make further improvements, and these have been addressed within our action plan. I would like to take this opportunity to thank our teams for their hard work in caring for the women, babies and families who use our services.”
Health Secretary Neil Gray was asked about the report in an interview on BBC Radio Scotland’s Breakfast programme. He was asked why issues around the reporting of adverse events have been raised almost a decade after a review ordered by the Scottish Government.
Mr Gray said: “I welcome Healthcare Improvement Scotland’s report, it demonstrates that our inspection regime is working to ensure that localised issues are being addressed, and I expect Ayrshire and Arran to respond timeously, to ensure that all of the recommendations, all 16 recommendations, are delivered as fast as possible.
“This is the fifth inspection that Healthcare Improvement Scotland has carried out at our acute maternity services across Scotland, when we consider that NHS Tayside has now implemented all of the recommendations in its report into the maternity services at Ninewells.
“I expect a similarly timeous response from Ayrshire and Arran in Crosshouse to ensure that the safety of patients is absolutely paramount, and that we can ensure that our maternity services are safe for women and their families.”
Asked whether they are safe today he said: “Yes I believe they are.”
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