While attention has been focused on the Amos Review in England, Health Improvement Scotland finds yet another maternity service in Scotland has come up short. 

While much of the attention for maternity services failings has focused on England and the investigation headed by Valerie Amos, Baroness Amos, health services in Scotland have been undergoing their own maternity review. Health Improvement Scotland, a public body, has said that all of Scotland’s maternity units are on track to be inspected by the end of March.

The latest investigation and the latest to come up short is Ayrshire Maternity Unit, University Hospital Crosshouse, NHS Ayrshire & Arran. 

As a result of concerns raised during an inspection at the end of October last year, it was investigated again at the start of the year. This inspection resulted in ten areas of good practice, two recommendations and 16 requirements.

“We raised concerns regarding potential delays to care for women accessing maternity triage and potential gaps in incident reporting, which may impact the learning from adverse events and reduce opportunities to improve safety,” said Donna Maclean, chief inspector, Healthcare Improvement Scotland. “We also raised concerns regarding fire safety,” she added. 

16 requirements

The report has recommended that NHS Ayrshire & Arran should consider current guidance around shared language for pregnancy, labour and birth, and should improve bereavement training compliance rates for all staff providing bereavement care to families. 

The 16 requirements are significant and range from ensuring that a process is in place to ensure women receive timely access to midwifery telephone assessment and ensuring effective governance and oversight of activity within the maternity service to support safe delivery of care for women, including, but not limited to, maternity triage, to a number of requirements around patient equipment and fire risk assessments. 

Following the investigation, a detailed improvement action plan has been developed by NHS Ayrshire & Arran in order to meet the requirements.

There were three Healthcare Improvement Scotland safe delivery of care inspections of maternity units in Scotland last year. All were found lacking. The inspection, at Ninewells Hospital in NHS Tayside in June, found good teamwork and compassionate care, but concerns specifically about how patients were assessed and treated. The maternity services inspection at the Royal Infirmary of Edinburgh in November, damned the culture, oversight of patient safety and staff wellbeing. And at the beginning of December, the report into maternity services at Forth Valley Royal Hospital, NHS Forth Valley, raised significant safety issues.