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Statement relating to the Care Quality Commission (CQC) maternity services rating

Posted: 22 December 2021

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Statement relating to the Care Quality Commission (CQC) maternity services rating

West Herts Hospitals NHS Trust says a recent boost in recruitment, advanced plans for a brand new building and some important maintenance work will help its maternity service reclaim its previous rating of ‘good’.

A national shortage of midwives and the age of the building where maternity services are based have contributed to a drop in ratings by the Care Quality Commission (CQC). The service has now been rated as ‘requires improvement’ following an inspection in October 2021.

Chief Nurse Tracey Carter said: “We are disappointed by the drop in the rating but we take heart from the CQC’s report which praises our safety culture and the passion that our team clearly has to provide great care. We were also pleased to see that the support our maternity staff give each other has been noted. The way that this busy team has pulled together during the pandemic and in the face of staffing challenges has been remarkable.”

CQC inspectors commented that “there is a wealth of specialist midwives and matrons” and their report also records comprehensive consultant cover. However, the total number of midwives has affected the choice of place of birth as Tracey Carter explained:

“The consequences of the pandemic have added to our staffing challenge as many maternity staff have had time off to isolate or because they have been unwell. Our maternity service is not one where we can manage the demand for our service – those babies follow their own timetable! So, for the sake of safety, we have had to withdraw our home birthing service at times and temporarily close our low-risk birthing unit so that we can concentrate our midwifery skills on our delivery suite. We review this every single day so that we can offer choice whenever and wherever possible. Safety is always our number one priority.”

The determination to learn from incidents and strong team-working was noted by inspectors despite the challenges staff faced with the “aged estate and vacancies”.

A recent report to the trust’s board mentioned that 17 new midwives joined the team between November and December 2021. This is an impressive result given that a) there is a national shortage and b) proximity to London can be a challenge because wages there are higher.

The CQC inspection took place following the retirement of the trust’s previous director of midwifery and having this post vacant contributed to the drop in rating. The trust expects to announce a new postholder early in the new year.

Inspectors were positive on the whole about the upkeep of the physical environment, saying that the “service generally performed well for cleanliness” but they did highlight the window frames in the delivery suite. The casements are ‘critall’ (metal) and, despite thorough cleaning, they can appear dirty. A new chemical cleaning regime is now in place.

Another area for improvement was the ability to monitor levels of Entonox (a pain relief gas). Whilst the levels being given to the patient are closely measured, there was no system for monitoring gas which may escape into the environment. An interim measure is being implemented and the new facilities will have an inbuilt monitoring system.

Summing up, Tracey Carter said: “I’d like to place on record my sincere thanks to our maternity team for keeping the quality of the service and safety of their women at the forefront at this challenging time.

“With recruitment going well and plans for a new women’s and children’s services building in better shape than ever before, I am confident that we can return to a rating of ‘good’ at the next possible opportunity.”


  1. Please click here to view the CQC report on the CQC website.
  2. For more information, please contact the communications team on: 01923 436280 or email: Out of hours, please call the Watford General Hospital switchboard on 01923 244366 and ask for the on call communications manager.
  3. West Hertfordshire Hospitals NHS Trust serves people from across Hertfordshire, north London and further afield. It operates from three hospitals; Watford General, St Albans City and Hemel Hempstead. The trust has a catchment area of over 500,000 people and is one of the largest employers locally, with around 5,000 staff and volunteers.
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