Clare Panniker presented the report that updated Members on the Care Quality Commission (CQC) inspection of the maternity services at Basildon University Hospital on Friday 12 June 2020. Following this inspection and a review of Trust incident reports, the CQC published its report on Wednesday 19 August 2020 which had rated the service as Inadequate. The Trust had been disappointed but had accepted the findings of the report and had taken urgent and significant action to improve the service. Residents were assured that Basildon Maternity Unit remained safe but had not kept pace with the increasingly complex demands being put upon the service. Claire Panniker stated that a number of changes had already taken place such as changes to the leadership team, investing in the recruitment of 29 midwives and two additional consultations, improving security, restructuring of ward facilities and had increased the bed capacity on the delivery suite and cedar ward. That time would be required to embed these changes to put in place an enhanced robust process so that the maternity unit could deliver to the highest standards.
Councillor Muldowney had concerns that some of the issues identified in this recent inspection had been the same issues that had been identified and signed off by the Trust in February 2019 and questioned what was being undertaken this time to ensure those changes made were for the better and stayed for the better. Clare Panniker stated that the Trust Board and Executive Team had asked the same questions and going forward a lookback exercise would be undertaken to see what could be learnt from their governance and assurance processes to ensure the same scenario would not happen again. That time was required for the changes to be embedded and for these to be implemented and evidenced as working. That the leadership team had received additional help with a director of midwifery to sit above the maternity services at all three sites and an Improvement Director to support and deliver the changes being made.
Councillor Muldowney thanked Clare Panniker for the response and understood that time was needed to embed these changes and recommended that this item be added to the work programme for the 4 March 2021 committee for a further update.
Members agreed that this report should return for a further update.
Councillor Ralph stated that this was a very damning report that had evidenced that basic errors were being made and this was unacceptable when dealing with people’s lives. Councillor Ralph stated he would like to see the second CQC report when this was available.
Councillor Redsell agreed that the report was very damning and the seriousness of some of contents of that report especially around the deaths of babies and also questioned why there was nothing in the report about home births. Clare Panniker referred to the report where it had stated that six babies had been classed as serious incidents and that following difficult births one of those babies had unfortunately some ongoing concerns with the other five babies being discharged home and stated that women were at no greater risk having their babies at Basildon Hospital and if CQC had thought that they would have shut the maternity unit down. That Basildon Hospital had a home birth service and supported this but this report had focused on the labour ward where the highest risk ladies were giving birth. Councillor Redsell stated this could have been an opportunity to demonstrate that something good was happening. Clare Panniker suggested that reports on other services from the leadership team could be brought to committee.
Councillor Ralph stated this report had a start and end date as to when cases were being looked into and unfortunately there had been other incidents that had fallen outside of those dates. Clare Panniker stated that these cases had been reported to the CQC. Councillor Ralph asked was this after the whistle-blower to which Clare Panniker had stated the incidents being reported to the CQC and the whistle-blower had incidentally happened at the same time.
Clare Panniker stated that everything was reported to the CQC within 48 hours so as to remain transparent.
Councillor Ralph acknowledged that Members had been invited to attend the hospital but due to COVID this had not been possible.
Councillor Holloway thanked Claire Panniker for her time this evening and stated that it was a very hard report to read and questioned whether all staff where now in post. Clare Panniker stated that by January 2021, if no further changes there would be six vacancies for midwives so would be fully established. There were no consultancy vacancies, 38 student midwives had qualified and opted to stay with the NEC Group and those that had trained at Basildon had opted to stay at Basildon which was a reassuring message.
Councillor Holloway emphasised that those concerns raised needed to be sorted as soon as possible and would be reviewed again very soon by the committee. Clare Panniker stated she really did care and would undertake this role personally and had spent time with the leadership team to get this unit to the right place.
Councillor Massey stated he was saddened there had been some shortcomings and this needed action as soon as possible and recommended again that this be brought back to committee with perhaps with some members of the leadership team.
Councillor Ralph questioned the opening hours of the scanning facilities. Clare Panniker stated there was currently no routine seven day scanning facilities. Currently as a priority, there were plans to establish this scanning facility, seven days a week, at one location over the three sites. Councillor Ralph stated that it was very important to get a 24 hour scanning facility.
Councillor Rigby questioned the low completion training rates and although due to COVID, with staff not completing this mandatory training would this not affect their professional practice ability and questioned whether more training had been completed since the report had been published. Clare Panniker stated yes the rates of compliancy mandatory training was now significantly higher up in the 90s%. That across the trust mandatory training had to stop due to COVID. That 97% of clinical staff had now undertaken a weekend training programme with external trainers. That the levels of incidents in the unit had fallen with a number of quality indicators going in the right direction. Councillor Rigby questioned whether these weekend training sessions would be refreshed to which Clare Panniker stated there would not be the need for a further two day session as these would be refreshed over a six month period.
Councillor Redsell referred to the report where it had stated “not assured that the service made sure staff were component in their roles” and added her concerns. Clare Panniker stated that this would be covered by the mandatory training and the two day weekend training programme which had now been put in place. That training was important and this had now been caught up.
Councillor Muldowney questioned whether anything else had been moved on since the investigation. Clare Panniker stated that the government structure had been revamped with national support. That the hospital was up to date with investigations and that learnings needed to be learnt. That the hospital was now in a good position on the number of incidents for the CQC to sign off on. There were now champions undertaking walkabouts, talking with patients and staff, there had been further CQC visits. For some external reassurances, the lead nurse for the CQC had spent time on the maternity unit and had reported back as having had a good experience. The maternity leadership team reported to the board more frequently and had involved the help of HealthWatch to ensure the voice of women were heard.
Councillor Ralph asked what was being undertaken to reassure those who attended the maternity unit. Clare Panniker stated that lots of open listening events had taken place, hearing and talking with staff on an informal and formal basis and staff had been given the opportunity to talk.
Councillor Ralph thanked Clare Panniker for attending this evening and that the committee’s concerns had been noted. Clare Panniker would be happy to return to the committee to provide further updates and suggested the right time for this would be when the CQC had identified that the maternity unit had improved.
That the Members of the Health and Wellbeing Overview and Scrutiny Committee noted and commented on the report.