Mayday Hospital has been put on a warning by national regulator the Care Quality Commission following a critical report by inspectors who were called in to the maternity unit following the death of five mothers after giving birth last year.

According to CQC, Croydon University Hospital “is not meeting six essential standards”, and it has been ordered to increase the number of midwives in its maternity unit.

Three deaths occurred in May and June last year, one happening to a mother following an elective caesarean section.

Mayday’s management reported the incidents and instigated an independent investigation, which reported last October. Its findings included that at least one of the deaths was “avoidable and that there was a lack of optimum care in all three”. There were two further two maternal deaths at Mayday  in 2010.

The CQC report says that the deaths indicate a trend, but that management at Mayday did not appear to have learned from their mistakes.

Patient comments published in the CQC report (click here to access the report) were widely positive of their experiences in the maternity unit, but they did include remarks suggesting that standards had fallen over time, with some saying:

• “Attitude of the staff is horrible”
• “Only midwife has been nice.”
• “Customer care zero. Patient care zero.”
• “Hospital has changed name, but needs to change its service.”

Colin Hough, the regional director of CQC in London said, “The Maternity Unit at Croydon University Hospital is not meeting all of the essential standards people should be able to expect. We have told the trust where it needs to do more to comply.

“We will continue to monitor the trust’s progress, to make more unannounced visits if necessary, and to take any further action that we deem necessary to make sure the trust gets it right.”

The report was published on Tuesday, though hospital managers will have received the report before the Easter break. “We have asked the trust to reply within 28 days of receiving CQC’s report, setting out the action they will take to improve. We will follow up to make sure that the improvements have been made,” Hough said.

CQC also said that, “While the majority of births at the maternity unit are safe, we were concerned at recent occurrences of maternal deaths and the trust’s ability to ensure optimum care when an emergency high risk situation occurs.

“We found evidence that the maternity unit may not always be able to provide 1:1 care on the labour ward, that the trust has not devised a process to ensure timely and effective provision of epidurals in all cases, and that an anaesthetist may not be available at all times. These scenarios are likely to impact on patient welfare and care.”

The inspectors said, “We asked other staff if women are ever left alone during labour and were told that this does not happen a lot but there had been instances when one member of staff had to look after two women at the same time.

The main entrance to Mayday Hospital

“This person felt able to manage these situations but did say that other midwives have struggled. Similarly, another member of staff said that the person would not be left alone for more than 10-15 minutes at most as they have to document in the notes every 15 minutes, and the patient will be left with a buzzer. In the circumstance of caring for two women and one had any complications or was
nearing birth, then the midwife would find someone else to cover the other patient.”

They also observed that, “Equipment in the maternity unit was not always available when needed, especially during busy periods, and was not always repaired in a timely manner.”

Above all, there was concern that “there were insufficient numbers of midwives giving direct clinical care to ensure people who use the services were safe and their health and welfare needs were met”.

Mayday Hospital is not new to controversy over poor standards of care: in 2008 a survey of patients found the Thornton Heath hospital the worst in London.

Following the latest report, under the Health and Social Care Act 2008, CQC has a number of enforcement powers when a hospital’s services are failing people. These include issuing warning notices – such as this report this week to the Mayday – and in the most serious cases, suspending or cancelling a service.

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• CQC Tells Croydon University Hospital Improvements Are Needed, UK (medicalnewstoday.com)