‘Effective oversight’ of maternity unit urged after triage and induction delays

A health board has been told to ensure “effective oversight” on a maternity ward after delays to triage and induction were highlighted by inspectors.

Healthcare Improvement Scotland (HIS) has published a report following a Maternity Services Safe Delivery of Care inspection at Forth Valley Royal Hospital in Larbert.

The unannounced inspection took place on August 25 and 26.

The report highlighted nine areas of good practice, but made two recommendations and issued 11 requirements.

It said that while at the time of inspection there were no delays to the induction of labour process, discussion with staff and evidence provided by NHS Forth Valley showed such delays “occurred frequently”.

The report said there were delays of up to 72 hours due to patient acuity and staff availability within the labour ward.

Senior managers on the ward informed inspectors that the current induction of labour rate within NHS Forth Valley sits above the current Scottish national average, which impacts on the delays to the process.

Donna Maclean, chief inspector at HIS, said: “During our inspection of the maternity services we saw staff providing compassionate and responsive care to women and their families. Women we spoke with were complimentary of the care they received and the staff providing it.

“We saw good multidisciplinary teamwork and visible senor midwifery leadership and student midwives described a friendly and supportive learning environment. There were a variety of initiatives for staff well-being and we received feedback from staff of supportive senior leadership.”

However, Ms Maclean noted there are areas for improvement, including on delays within maternity triage.

She continued: “Areas for improvement included improved oversight of activity within the maternity unit to support the safe delivery of care, including delays to care within maternity triage.

“We also observed the need for improved governance and oversight of adverse events to ensure these are reliably reported and identified improvement actions implemented in good time.”

Feedback provided by the inspectorate said NHS Forth Valley must ensure effective oversight of activity within the maternity unit to support safe delivery of care for women.

This includes, but is not limited to, maternity triage and delays to care, including inductions.

Other areas for improvement identified include systems and processes to ensure consistent and accurate assessment of real-time staffing risks.

Professor Karen Goudie, executive nurse director at NHS Forth Valley, said: “The inspectors highlighted the compassionate and responsive care provided to women and their families by local staff. They observed good teamwork, visible and supportive leadership and a well organised response to both planned and emergency maternity care.

“However, they also highlighted a number of areas for improvement and work is already under way to address the recommendations and requirements outlined in the report.

“We welcome the feedback from the inspection team and will continue to work with Health Improvement Scotland, local staff, women and their families to further strengthen and improve local systems and support.”