CQC: Portsmouth Maternity Requires Improvement, Citing Breaches

• The Care Quality Commission downgraded maternity services at three Portsmouth Hospitals University NHS Trust facilities from 'good' to 'requires improvement' following March inspections.
• Five regulatory breaches were identified, including repeat issues concerning safe care, treatment, and management, alongside new concerns about staffing, safeguarding, and person-centred care.
• The 'safe,' 'responsive,' and 'well-led' ratings for Gosport War Memorial Hospital, Saint Mary's Community Health Campus, and Queen Alexandra Hospital were specifically lowered.
• Despite positive feedback from patients about staff kindness, systemic issues like staffing shortages led to compromised birth choices, patient diversions, and significant delays.
• Portsmouth Hospitals University NHS Trust has been ordered by the CQC to submit an action plan for immediate improvements to address these staffing and governance deficiencies.

While women's day-to-day experiences of kindness often remained strong, the systems underpinning those experiences were not adequately keeping pace with the demand.

The Care Quality Commission (CQC) has significantly reduced the rating for maternity services at three facilities operated by Portsmouth Hospitals University NHS Trust, moving them from 'good' to 'requires improvement'. This downgrade follows comprehensive inspections conducted in March at Gosport War Memorial Hospital, Saint Mary's Community Health Campus, and Queen Alexandra Hospital.

Inspectors observed a deterioration in care, leading to five identified regulatory breaches. Certain breaches, particularly concerning safe care, treatment, and service management, were identified as recurring issues from prior inspections. Additionally, new concerns surfaced regarding staffing levels, safeguarding protocols, and the provision of person-centred care.

The CQC specifically lowered the ratings for the safety, responsiveness, and leadership of maternity services at all three locations from 'good' to 'requires improvement'. However, the 'effective' and 'caring' aspects of the services maintained their 'good' ratings. Queen Alexandra Hospital provides obstetric maternity services alongside a midwife-led birthing unit, while the Blake Maternity Centre at Gosport War Memorial Hospital and the Portsmouth Maternity Centre at Saint Mary's Community Health Campus both offer midwife-led maternity care.

A persistent breach related to safeguarding training requirements remained unaddressed across all three facilities, despite being flagged in previous assessments. Furthermore, Queen Alexandra Hospital also faced an additional breach concerning effective service management. These findings underscore a broader pattern of systemic issues within the trust's maternity provision.

Significant staffing shortages and operational pressures were found to be detrimentally affecting both the quality of women's care and their available choices. At Queen Alexandra Hospital, choices regarding birth location were occasionally dictated by staff availability rather than clinical necessity, and some women experienced delays exceeding six hours for the commencement of labour induction. At Saint Mary's Community Health Campus, pregnant women in labour were frequently diverted to the main hospital, bypassing their chosen midwife-led unit, with the trust lacking data on the frequency of these diversions, indicating a failure in monitoring. Similarly, at Gosport War Memorial Hospital, over an eighteen-month period, twenty-five women seeking to give birth at the birth centre were turned away due to insufficient staff.

Despite the identified systemic failings, women consistently reported feeling secure, well-supported, and cared for by their midwifery and medical teams during the inspections. Patients noted that staff clearly communicated risks and actively involved them in care decisions. Specific examples highlighted positive interactions, such as a midwife at Queen Alexandra Hospital who was praised for exceptional dedication, women at Saint Mary's Community Health Campus who appreciated feeling heard during care planning, and patients at Gosport War Memorial Hospital who valued the consistent care provided by the same midwife throughout their pregnancy.

Catherine Campbell, the CQC's deputy director for hospitals, secondary, and specialist care in the South-West region, commented on this dichotomy, stating that while women's day-to-day experiences of kindness often remained strong, the systems underpinning those experiences were not adequately keeping pace with the demand. This highlights a critical gap between individual staff efforts and the overarching operational framework.

In response to these serious concerns, the CQC has directed Portsmouth Hospitals University NHS Trust to present a comprehensive action plan outlining steps for immediate improvements. The regulatory body emphasized the urgent need for the trust to address these critical staffing and governance deficiencies. The CQC's expectation is that the trust will implement changes to ensure every woman's experience is consistently safe, beyond merely being consistently kind.

This CQC downgrade and identified breaches signal heightened regulatory risk for Portsmouth Hospitals University NHS Trust, potentially leading to enforcement actions or increased scrutiny. Legal and compliance teams should prepare for advising on the required action plan, reviewing governance structures, and addressing potential clinical negligence liabilities arising from staffing and safeguarding failures.

Source: Based on CQC inspection findings.