Two babies have died at Milton Keynes Hospital, where care has been labelled as 'scandalous' by the coroner investigating the deaths.
Now the health watchdog, the Care Quality Commission, has found there are still too few midwives and beds at the unit and unless action is taken short-term measures will not be sufficient to ensure the safety of mothers and babies born there in future.
The trust must employ more permanent midwives and plan for emergency situation such as complicated births or staff sickness better, the CQC said in a report.
The CQC carried out an inspection in September to ensure the progress of action ordered after earlier investigations into the deaths of Romy Feast in 2007 and Ebony McCall in 2009.
Deputy Coroner Thomas Osborne found that delays contributed to the death of baby Romy and assured the family that 'lessons would be learned and there will be no similar deaths in the future'. The Healthcare Commission launched an investigation.
However, just a year later Mr Osborne heard a second case where delays in ordering a caesarean section led to the death of baby Ebony McCall.
He branded the situation a 'scandal' and wrote to Andy Burnham, Health Secretary.
Last month Mr Osborne opened and adjourned a third case into the death of a baby, Alexander Broughton, born at Milton Keynes Hospital.
The CQC found some improvements had been made such as improved leadership, supervision and round-the-clock access to an obstetrics operating theatre.
But with rising birth rates and many of its midwives due to retire this year, futher expansion of the workforce is necessary, it said.
Midwives must recognise complex cases early, involve consultants and supervisors at an early stage, the regulator warned.
The CQC said 17 midwifery posts were still vacant and estimates by the trust suggest another 50 full time midwives would be needed within three years to keep pace with rising birth rates in the area.
The trust deals with around 4,000 births a year.
Roxy Boyce, CQC’s regional director in the south east, said: “The fundamental concerns about numbers of beds and midwives remain. With one of the highest birth rates in the country, it is vital that the added pressure on maternity services is closely managed.
“While we believe the trust has now made suitable arrangements to effectively manage demand in the short-term, the trust has not sufficiently planned for the added demand on its services. More midwives are needed if the trust is to open more permanent beds and deal with demand in the future.
“But capacity is not just about numbers of beds and midwives. It about making sure that potential emergency situations are planned for and staff are equipped to deal with any circumstances that could arise. The trust has new policies in place and it must make sure that these are followed on the ground.
“We want to see a trust that is determined to get it right for every mother, with zero tolerance of poor safety standards whatever the pressures. We will be watching very closely and will act swiftly if we believe, at any stage, that mothers or babies are at risk.”
Dr Sandro Lanzon-Miller, Medical Director at Milton Keynes Hospital NHS Foundation Trust, said: “We took action immediately following the visit made by the Healthcare Commission, the previous healthcare regulator, in 2008, and instigated a series of actions in response to their feedback.
“We put temporary measures in place to ensure that we always have enough midwives to deliver safe and effective care to local mothers while we work to recruit more permanent midwives and open more beds permanently.
“Strenuous efforts continue to be made by the Trust to recruit additional midwives. To ensure the delivery of high quality care we have increased staffing levels on wards with bank and agency midwives.”
Cathy Warwick, General Secretary of the Royal College of Midwives, said: “The continuing increase in the number of births has made it difficult to ensure that midwife numbers keep pace, and this is the case for many Trusts across England.
"This has put pressure on maternity services, with midwives working harder and harder to continue delivering safe, quality care.
"I think that there are lessons to be learned here for all Trusts; that resources must match demand."
Categories: Birth injury