'Exhausted and broken' midwives at West Suffolk Hospital in Bury St Edmunds speak out about 'substandard care' in whistleblowing letter
In another blow to beleaguered West Suffolk Hospital, midwives have spoken out about the ‘demoralising and heartbreaking’ problems in their department.
In a letter to Suffolk News' sister title, the Bury Free Press, also sent to the hospital’s management and the Care Quality Commission (CQC), the midwives, who declined to name themselves for ‘fear of retribution’, said low staff numbers had left them ‘overwhelmed by the unmanageable and relentless workload’.
As a result, the ‘exhausted and broken’ midwives said they were providing ‘substandard care’ and the situation was ‘now so critical’ they had no choice but to whistleblow.
The CQC has acknowledged receipt of the letter and said it would use the information as part of its ongoing monitoring of West Suffolk NHS Foundation Trust, which holds a ‘requires improvement’ rating.
The Bury St Edmunds hospital said it was working ‘exceptionally hard’ to employ extra midwives and, following recent recruitment, there would be at least two senior midwives on every shift.
Bosses were ‘grateful for the flexibility and dedication’ of staff in working to provide a safe service and noted that a CQC inspection in April found the trust ‘managed safety well’ after a warning notice was issued in 2019 due to significant concerns.
Inspectors ruled the trust had improved all issues which led to the warning notice, but further improvements were needed across the service which was ‘frequently short staffed’.
In the letter, the midwives said the CQC’s assessment ‘doesn’t even scratch the surface of how bad the situation really is’ and they were ‘regularly tearful and angry about the unsafe working conditions’.
Shifts were ‘consistently short staffed, as in every single shift every single day’ and a fully staffed shift seemed completely unachievable.
Staff were ‘under extreme pressures all the time, which has left them fed up, exhausted and burnt out’ with colleagues feeling anxious about going to work.
They said: “We frequently work long hours without meaningful breaks. Efforts are made on weekdays to cover us for a 30 minute lunch break but this is difficult to achieve on weekends and nights when non-clinical staff are not present.”
It should not be accepted or tolerated for us to be forced into giving unsafe care entirely due to unsafe staffing - the midwives
They said it was not acceptable or safe for staff working in such a ‘high pressured environment’ to work 12.5 hour shifts with a maximum of 30 minutes break, and frequently with no break at all.
Shifts run not only short staffed but with a ‘very poor skill mix’ and there was often no support for juniors, preceptors or those new to the trust.
According to the midwives, there was a heavy reliance on offering bank to cover shifts but ‘staff are broken and nobody wants to work bank anymore to help out as they are too tired’, with managers constantly ‘beg, borrow and stealing’ from other shifts to even the numbers out.
“The reality is they are just trying to deplete shifts that are already short staffed to cover the shifts that are very, very short staffed,” they noted.
“The unit essentially runs on the goodwill of staff. However, due to the atmosphere at work being so unpleasant and morale being so low, our goodwill is rapidly running out.”
The Midwife Led Birthing Unit was also ‘failing’ due to a lack of staff, with midwives pulled to cover the labour suite.
Community midwives are called into the unit as a backup plan and, the letter said, while their presence was appreciated, they were unfamiliar and unskilled with working in the hospital environment and struggled to carry out simple tasks which ‘leaves the unit feeling even more unsafe’.
Citing a culture of blame and fear, the midwives claimed they were regularly told and emailed about what they were doing wrong with little gratitude of their hard work.
“As a result staff do not feel valued or appreciated,” they said.
Arguing that the priorities seemed to be wrong, they said it was ‘unacceptable’ to have a full complement of non-clinical midwives working in offices when day-in day-out the clinical shifts were unfilled and the clinical midwives were being worked harder and harder.
When they have attempted to raise the issues with managers, they were told short staffing is a nationwide problem.
“Their expectations of what is considered ‘acceptable’ staffing levels have been lowered so much that it is consistently unsafe and unacceptable,” said the midwives.
If staffing was a nationwide problem, they felt it should be urgently raised and addressed at the highest levels as ‘maternity services seem to be in a crisis’.
With staff looking for other jobs, the situation ‘continues to get worse’ and the trust’s response that new midwives were joining was ‘misleading’ as it did not take into account all the midwives who have left.
They added: “We entered midwifery to be able to give women centred, holistic care.
"Instead it feels like we are being overwhelmed by the unmanageable and relentless workload, and as a result are giving substandard care which is demoralising and heartbreaking.
“We are all feeling like we are now desperate for change.
"This change is beyond what we can achieve ourselves so we urge you to please help us to generate it.
"It should not be accepted or tolerated for us to be forced into giving unsafe care entirely due to unsafe staffing.”
In response, Karen Newbury, head of midwifery at the trust, said: “We are working exceptionally hard to recruit additional midwives and we are very grateful for the flexibility and dedication of our staff in ensuring that we provide a safe and caring service – this was recognised by our Care Quality Commission inspection in April which found we managed safety well.
“We have recently completed recruitment so there will be at least two senior midwives on every shift to provide flexible and experienced support to our maternity teams, and we are working with colleagues regionally to recruit staff both locally and internationally as well as running a full student training programme.”
The concerns raised by staff have been referred to the trust’s Freedom to Speak Up guardians and the trust will share its response with the CQC.
The trust said all women in labour continued to receive one-to-one care and all midwives who worked in the hospital or community setting were trained to care for women in labour no matter what the location.
In a June survey, 100 per cent of 62 respondents would recommend the maternity service.
The trust was previously at the centre of controversy after staff were asked for handwriting and fingerprint samples to identify who wrote a letter in 2018 to the husband of a patient following her death which detailed errors in her treatment.
An independent review into how the trust handled the issue is due to publish its findings this summer.