Shock report that reveals a maternity ward in crisis

A bitter divide has emerged at the heart of the maternity ward in East Surrey Hospital.

Conflicts between staff and management led the director of nursing and governance, Mary Sexton, to commission an independent review of the maternity and obstetrics ward last November.

Behavioural issues and clinical leadership were her main concerns, but she could not have expected the damning assessment that consultants Phi Learning revealed last Thursday.

Shock revelations in the report include:

Mothers and babies are at risk.

The hospital has too few midwives.

A bullying culture has driven out experts.

Midwives face shortages of vital equipment.

Worrying evidence of 'hostile environment'.

Official recommendation to sack key staff.

The investigation has rocked the foundations of a hospital that delivers almost 80 babies a week.

Phi Learning carried out an engagement survey, meetings with individuals and small groups, involving more than 150 people, in November and December last year.

The review pulled no punches and highlighted the numbers of staff available and the working conditions in the delivery suite as the two greatest concerns.

"Staff are under pressure, sometimes considerable and there is a widely-held belief that there are insufficient staff available to provide a 'safe' level of service," it said.

It is believed this has led to a damaging rift between staff and management.

According to the independent report, the relationship has deteriorated to such an extent that under-pressure midwives are taking extra sick leave and in some cases leaving the trust, due to unacceptable working conditions.

The head of midwifery, Sue Chapman, told the Mirror they have begun looking at ways to solve the problems in her department.

She said: "The review was commissioned as anecdotal evidence of unacceptable behaviours had become apparent.

"The review has highlighted concerns of bullying among other issues, all of which will be addressed as part of an ongoing action plan.

"All staff are fully engaged in progressing the action plan and are optimistic about the future of maternity services at the trust."

She has discounted the report's claims that "there is a concern that the risks to mothers and babies is increasing" due to stress, and frustration is evident across the directorate.

She added: "This report was based on staff perceptions. There is no evidence that risks to mothers and babies are increasing."

However, Mrs Chapman did confirm that they will be addressing Phi's recommendation for a "respect campaign" to rebuild battered relationships as part of an ongoing action plan.

Heads may roll as the Trust looks to recover from the current crisis.

The report recommends "removal of identified staff from positions of authority and influence… in the worst cases consider a strategy culminating in the removal of 'said staff' from the maternity unit."

But when the Mirror quizzed the trust on this issue, they would not reveal who the employees in questions were.

An indication into the problems was highlighted last November when the trust's deputy chair, Yvette Robins, asked "if the committee could be satisfied there will not be another 'adverse outcome' during the investigation."

A midwife has lambasted the maternity ward's management for the "hostile environment" that is crippling the department.

The midwife, who wishes to remain anonymous, has said staff in the ward suffer from a lack of trust with their superiors.

She said: "There is clique culture which is having such a bad effect on everyone.

"I have heard of instances where a member of staff has been told not to talk to another midwife, as she has had too much time off.

"That's the big problem. If you have a problem you can't go and talk to your boss, as not only do you not trust them not to tell anyone but you know nothing will get done.

"No wonder people are taking extra sick leave. The mismanagement there is the biggest frustration for everybody."

The under-pressure head of midwifery has pledged to radically improve her department.

Sue Chapman, head of midwifery, said: "We expect the highest standards of behaviour from our staff and if there is evidence that that is not the case then we will carry out a full investigation, as we have done here.

"The report highlights a number of issues which we are addressing.

"This review was purely about behaviours and not about the clinical effectiveness of our maternity unit.

"Our midwives and paediatricians spend many years training to obtain the expertise to deliver and care for babies and children.

"Each year we deliver over 4,000 babies at East Surrey Hospital. The vast majority of them are normal, uncomplicated births.

"We also have a large number of babies born pre-term or with complications, who receive excellent treatment, and we receive many letters of thanks.

"We are committed to delivering high quality maternity care for our patients and the purpose of this review was to identify blockages to creating a high performing midwifery team.

"Now that they have been identified we can move forward with delivering even better care for our patients."

Meanwhile, a grateful husband has asked for extra support for the midwives who saved his wife and child from death's door.

Rob Hambly, 30, of Station Road, Lingfield, has made a passionate plea for better working conditions for midwives after his wife Vicki and son Thomas suffered heart-stopping drama on East Surrey Hospital's maternity ward in October 2009.

The emergency button was pressed on October 10 after doctors discovered Thomas's heart had stopped beating as the umbilical cord was wrapped around his neck in a figure of eight.

A blur of medical professionals arrived on the scene within three minutes to help safely deliver Thomas.

However, just as Vicki was about to hold her baby in her arms, she lost consciousness and started haemorrhaging blood inside her womb.

A five-day spell in intensive care followed before the 33-year-old was allowed to return home for the first time with her baby, husband and daughter Jess, 11.

Mr Hambly said: "Two more contractions and my wife and child would be dead. The midwives and doctors made instant decisions that saved my family.

"You just take it for granted that these doctors will be there for you. It's not until you see an emergency unfold right in front of you that you realise how lucky we are to have them.

"It was such a rollercoaster ride. From hearing that Thomas' heart had stopped, to him being OK, then suddenly seeing Vicki's eyes roll into the back of her head and being rushed off to theatre.

"I just can't speak highly enough about how well they looked after us while we were there.

"When you have a scare like we had, the help we got from our families and the staff at the hospital is the only thing that keeps you going."

Mr Hambly, a director of a building company, has asked for more support for the maternity ward's staff after seeing midwives working long shifts in understaffed wards.

He added: "There was one midwife looking after Vicki who would usually work 16 hour days and sometimes only have a couple bags of crisps to keep her going.

"When we were in there, there were 24 expectant mothers and just two midwives. How are they expected to cope with that?

"They should be getting all the support they need as they do the most fantastic job."

One of the maternity staff spent her free time looking after Oxted School pupil Jess while her mother was in intensive care.

Mrs Hambly added: "What struck me most about the staff in the maternity ward is that they care so much.

"The only reason I survived was because East Surrey Hospital has its own blood bank. If I had gone to a private hospital I would be dead.

"When I finally came round one of the midwives came over and hugged me and said she had been pumping the blood into me when I was bleeding internally.

"She wasn't even working. She just wanted to come and find me and check I was OK.

"I didn't know what to say, I was so touched. I owe my life to the midwives and doctors at East Surrey."

Want to have your say about this damning report and the maternity unit at East Surrey Hospital? Contact the newsdesk on 01737 732 000 or e-mail editor@surreymirror.co.uk