NHS maternity deaths: patients still at risk, Care Quality Commission warns

A hospital trust where two women died in childbirth this year is still putting patients at risk, has failed to learn from its mistakes and employs staff who verbally abuse patients and colleagues, according to the NHS inspectorate.

Emergency measures have been put in place at Barking, Havering and Redbridge University Hospitals NHS Trust, but patients "remain at risk of poor care, particularly in maternity services", says the Care Quality Commission report.

It is the latest in a long series of reprimands, warnings and criticisms of care at two Essex hospitals, Queen's in Romford and King George in Goodmayes, Ilford.

Sareena Ali died at Queen's, one of the largest maternity units in the country, in January, when she had a heart attack after her womb ruptured in labour. She had been left unattended by midwives for two hours despite pleas from her husband.

In April, Violet Stephens died without the knowledge of CQC inspectors who were visiting the hospital. She was known to be at risk from high blood pressure, but there were delays in giving her a caesarean and blood transfusions.

The hospital admitted that neither woman received the standard of care they had needed. The deaths helped to trigger a full CQC investigation into the trust in July, which focused on maternity care, emergencies and governance. In all areas the trust was found wanting.

The CQC report highlighted verbally abusive staff in the maternity unit. One of the midwives was heard to say to a woman in labour: "Hurry up, or I'll cut you."

There is evidence, says the report "that some women were not treated with dignity or respect at Queen's hospital. Both staff and patients raised concerns over the attitude of some midwives."

Long-standing concerns have "progressively worsened", says the report. As well as abusive midwives, these included "poor clinical care, a service operating in isolation … a lack of learning from maternal deaths and incidents and a lack of leadership from senior management".

Women were sent home while in labour; one was fetched back in a wheelchair by nurses from the car park, where she was bleeding.

Accident and emergency services were also a concern. Last winter "a tipping point was reached … when the quality of services began to collapse", says the report.

Ambulances were queuing outside, unable to deliver sick people needing care because earlier arrivals were not being moved promptly on to the wards.

The trust is one of the most complained-about in the country, said Cynthia Bower, chief executive of the CQC. "Some patients said the experience of getting a poor response was nearly as bad as the poor care they had got in the first place."

Emergency measures had been taken to ensure patient safety, said Bowers, but "real improvements have to be made in order to ensure that patients attending the hospitals receive safe care".

Averil Dongworth, who was appointed as the trust's chief executive in February, apologised for the failings while insisting other services provided good care. Substantial numbers of midwives had been appointed ,and she hoped to rebuild confidence in maternity services at Queen's.

Seven abusive staff had been disciplined and some sacked, she said, while others would face action.

"It is beyond the pale and people will not be working in my organisation if that continues," she said. "That is not to say it will not happen tomorrow. We have to change the whole attitude and culture."

She was "determined" to turn around the trust, in which excellent services were being let down by those that were failing.

Andrew Lansley, the health secretary, has formally agreed to close maternity and A&E services at King George and relocate them mostly at Queen's.

The independent reconfiguration panel which made the recommendation, in the face of local opposition, said concerns over care at Queen's must be addressed to allow the change to take place.