A regulator has downgraded its rating of The Royal London Hospital's maternity service after an inspection.

The Care Quality Commission (CQC) visited the Whitechapel hospital, run by Barts Health NHS Trust, in August.

The regulator's findings were published in a report on November 15, where it rated the maternity service 'requires improvement'.

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CQC said: "The service did not have enough staff to care for women and keep them safe."

"Workload pressure" meant staff were not supported to develop their skills and some staff did not feel respected, supported and valued, inspectors found.

Medication was also not managed safely, according to the report.

More than 5,100 babies were born at the hospital between August 2021 and July 2022.

The regulator gave The Barkantine Centre, also run by Barts Health, its lowest rating - 'inadequate'.

CQC issued the trust with a warning notice requiring it to make "significant" improvements at Barkantine.

East London Advertiser: The Barkantine CentreThe Barkantine Centre (Image: Google)

The centre, which saw 233 deliveries in 2020, "did not have sufficient leadership capacity to manage, monitor and improve the service", inspectors wrote.

CQC said Barts proactively reduced its services at Barkantine, on the Isle of Dogs, to focus on addressing areas of concern following the inspection.

Among reasons given for the service's grading included "significant failures" in performance management and audit processes.

Leaders had "little understanding or management of risks and issues", according to CQC.

Inspectors wrote: "Staff did not always effectively assess, monitor and manage risks to people using services so there were missed opportunities to minimise harm.

"Leaders didn’t have a vision or strategy to provide safe and sustainable services at the birth centre."

Barkantine also did not have adult emergency resuscitation equipment or safe equipment to evacuate a woman from a birth pool in the event of a mother collapsing, CQC said.

CQC also published reports outlining its findings from inspection visits made to maternity services at Whipps Cross Hospital and the Barking Birth Centre in August.

These maternity services are also run by Barts Health.

Nicola Wise, CQC head of hospital inspection, said: “Maternity services across England face significant challenges, but there are steps Barts Health NHS Trust can and must take to ensure all risks to mothers and babies are well managed while they are in its care.

“The trust has our findings and it knows where it must improve. We will not hesitate to take further action if people are at risk of harm.”

Barking Birth Centre, based at Barking Community Hospital in Upney, was rated 'requires improvement'.

Challenges around staffing were mentioned by inspectors in its report on this centre, which they said "affected the sustainability" of the service.

They found that women could not always access the centre due to "intermittent" closures and that staff satisfaction was mixed.

There were 121 babies born at the centre between March 2021 and April 2022 but monitoring of outcomes for women and babies who used it was limited, according to inspectors.

The maternity service at Whipps Cross Hospital, in Leytonstone, was however rated 'good' by CQC.

According to inspectors, staff received training in key skills and "worked well together for the benefit of women".

They added: "Staff mostly felt respected, supported, and valued. They were focused on the needs of women receiving care.

"People could access the service when they needed it and did not have to wait too long for treatment. Staff were committed to continually improving services."

But inspectors did find that the Whipps Cross maternity service also did not have enough staff to "keep women safe".

They also wrote that staff "did not always assess risks to women and babies in line with guidance" and that records were not always up to date.

There were almost 4,000 babies born at the hospital between August 2021 and July 2022.

Ms Wise said the trust's leaders need to develop plans to meet patient needs despite the staffing shortages.

"This should include developing a comprehensive understanding of the issues it faces, so it can tailor its response accordingly.  

“The trust must also ensure all its maternity staff receive the right training to deliver safe care and treatment, and that it has the right policies in place to help staff fulfil their roles."

But she admitted inspectors found instances of good practice across the trust's maternity services.

These included "good engagement with women, the community and other healthcare partners to help shape care to meet people’s needs".

A spokesperson for Barts Health NHS Trust said: "We are actively recruiting, including from overseas, and more than 70 new midwives are set to join our hospitals in the coming weeks.

"Despite the national shortage of midwives we are working to improve our services for pregnant women in line with the CQC recommendations.”  

The visits took place as part of CQC’s national maternity inspection programme, the regulator said.

Maternity services at Newham Hospital were not visited as part of the August inspection.

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