My first son was born at St Mary’s in Manchester by crash C section after a very long induction and labour. It was not a great birth experience. But I got a perfect little boy at the end of it, so I soon forgot the worst part.
15 months on and I found out I was pregnant again. Having moved since our first son was born, our second child was to be born at the Royal Oldham Hospital. I was born in Oldham myself and know a lot of people who’ve given birth there in recent years.
But I couldn’t help but recall stories I’d read in the local papers recently and even in the national press. The deaths of 7 babies and 3 mothers in just 8 months at Pennine Acute Trust hospitals was being investigated.
So I went and did something I probably shouldn’t have done… I read the CQC report.
The most recent CQC report on the Royal Oldham was published just a few weeks after I found out I was expecting… it didn’t make for great news.
Oldham Royal Hospital CQC Report – August 2016
At the link above you can download the whole thing and read it for yourself. But in summary, it doesn’t make for particularly pleasant reading.
Even the summary page is grim:
For me, alarm bells rang when I spotted the big red “inadequate” rating on safety. That worried me.
The opening page showed me the same rating specifically for maternity services:
I headed straight for the section on maternity care and a few paragraphs and sentences from the document worried me in particular. Here they are:
- “An independent review into nine serious incidents in the maternity services at the trust had been completed in January 2015. Following this several recommendations were made about incident reporting. These included; clarifying the process for escalating concerns, a quality check for incident reports to ensure the root cause was clearly established, making recommendations clear and unambiguous and where individual failings had been identified, including leadership failings, reports must demonstrate education and training had been considered. These recommendations had not been put into practice in the management of incidents we reviewed.”
- “There was a shortage of midwifery staff which led to some delays in transfers during labour and inductions of labour.”
Having had a previous birth where the life of my baby was dependent upon quick thinking and quick acting staff, the latter there was an issue.
Nonetheless, we made the decision that we would start our care at Oldham and form our own opinions. Here’s how that all went.
This is a long review, so if you want the very short version, here it is in bullet points:
- Midwives across ante natal and post natal were absolutely amazing
- Consultants were fantastic
- Wait times are problematic
- Shortage of staff causes problems
- Facilities are largely all very modern and very clean
On the whole, I feel like you have to be on top of your own care (as you should) and be prepared to push to make sure you get the appointments and care you need. Sometimes things get missed.
The Royal Oldham Antenatal Care
From day 1, I knew I would be a higher risk patient and probably on consultant led care, following complications right throughout my first pregnancy.
On my booking appointment, as the hospital didn’t have my notes from St Mary’s, the midwife who booked me in asked a number of in depth questions and made some extra notes. In addition, the waiting time on the booking appointment was not particularly long. So I was reassured.
I was put on consultant led care from day 1 and was advised that I would need some extra appointments to keep an eye on things.
- At every appointment, once I actually saw a consultant or a midwife, I felt like I was in good hands and like the professionals knew exactly what they were doing
- By the end of my pregnancy, I was visiting the ante natal day unit a couple of times a week for blood pressure profiles. The staff in ANDU are incredible. Despite the fact this is an incredibly busy unit at times, they were so efficient. They’re clearly short staffed, but just get on with it.
- I was admitted to the ante natal ward during the pregnancy and again found the staff there to be incredibly competent and the facilities to be clean and modern
- There are clearly staffing issues. On two occasions, everyone in the waiting room was advised to expect longer waits because of a shortage of consultants
- Some administrative problems in the early days meant I nearly didn’t get seen for a scan I had to have in a certain period. After my 12 week scan, the sonographer told me she couldn’t get the measurements she needed for the early Downs risk assessment. She said I needed to come back by a certain gestation to redo it and that I would get a letter. I called the hospital 2 days before the time limit I had been given. When I told them I had not received a letter about a follow up scan, the initial comment was, “Well we are very busy. We’ll get to you.” I then explained I would have to have this scan within the next 48 hours and she apologised and got me in the next day. But I feel I wouldn’t have had that appointment without my pushing for it
- Getting people in to see the right medical professionals looks like a bit of a hit and miss game at times. At one of my extra growth scans just a couple of days before Christmas, I was told my the reception staff that after my scan I could leave. But it clearly said on my notes that I should see a consultant after every single appointment. I raised this but the reception staff simply advised me that she had a note saying I could leave. It was the Sonographer during my scan who mentioned I needed to see a consultant. She spoke to the receptionist and got me in to see the consultant. So no harm done, but it seemed a bit of a mess
- At my second additional growth scan, I was told the same thing again – “you can leave after your scan if everything is normal.” So once again I mentioned the note in my notes. After my scan, the receptionist had been to see the Senior Midwife and questioned my being allowed to go home. Sure enough, they said they should see me. It turns out that was a great decision as my blood pressure had shot up and I needed to be seen and treated in the ante natal day unit. The worrying thing is that it took me to argue it and the receptionist to question the instruction she had been given. That comes despite the fact that I had told them about the huge blood pressure surge at 28 weeks of pregnancy in my first pregnancy. Here I was at about the same gestation and was almost sent home with high blood pressure.
- Staff shortages on the ante natal ward result in people staying in longer than needed, I believe, thus making the bed shortage situation even more problematic. I was admitted at a point for severely high blood pressure. On this day, ante natal were having massive bed shortage issues and sending people away. Nonetheless, I was admitted. I was given some revised medication and advised that if my blood pressure dropped to a certain level, I could go home. It dropped to the right level, but understandably I had to wait for a consultant to sign off on the discharge. It took a couple of hours for a consultant to come down and by that point the consultant felt it had been too long since the initial profile to sign off the discharge and asked for another profile. By the time the 30 minute profile had been taken, the consultant had left the ward. As a result, I was told I would need to stay until the following morning despite the fact my blood pressure was within the limits I’d been told it needed to get to. I appreciate that it is essential for me to see the consultant before discharge, but in this case, the staff shortages meant I was occupying a bed in a ward full to capacity needlessly. The consultants have to prioritise urgent wards (like labour!) of course, so I get it. And it’s purely a funding issue I’m sure. But a bit of a worry for the people being turned away because the ward is full.
Post Natal (and the C Section Itself)
So, there’s a reason I am jumping over to post natal without a section on the labour ward. Having had an emergency section the first time, I was opting for an elective this time. And then with consistently rising blood pressure, I was told I would need to deliver earlier than the 39 weeks I would have liked to get to.
So, I was given a date for an elective C section and for electives, you go right up to post natal.
Staff shortages played a bit of a part here too. The Royal Oldham, as of the time I was in, have election section tracks on 3 days of the week (Tuesday, Wednesday and Friday). I was in on a Friday afternoon. After waiting around all day and not even seeing a midwife during that time, the consultants finally came to see me around 5pm. A previous procedure had ended up being very complicated so no more sections would take place that day.
Initially they suggested I stay on the post natal ward, eat something then go nil by mouth again that night. I asked if I could go home that night and was told I could but would need to be back in on Saturday.
Now, coming back on a Saturday meant 2 things:
- No elective section track, so I was waiting to be able to fitted in as an emergency essentially
- Lower staffing
To cut a long story short, I waited around all day Saturday to be told late in the evening that it would be the next day. I stayed overnight again and the next morning was advised by a midwife and consultant that I would be unlikely to be seen that day.
In the meantime, my Nan had passed away on the Friday night and my state of mind wasn’t great. The staff were incredibly understanding and suggested that I could go home for a few hours and get back that evening.
Eventually, I was taken to theatre early Monday evening. The staff in the theatre were amazing – absolutely incredible. All of them. The procedure was smooth, calm and efficient.
After the section, I was discharged within 28 hours or so having been seen by a great number of medical professionals.
A few good and bad points:
- The staff are just wonderful. The midwives are under so much pressure here, but the staff I saw every single day were just amazing. Midwives were compassionate, understanding, patient and professional constantly. The consultants and theatre staff were the same.
- The facilities are amazing. I was in a very large private room and was able to stay there both before and after my section. The facilities are incredible (particularly compared to St Mary’s)
- They’re so short of staff. The staff that are there are pushed so hard because there simply are not enough midwives. At one point, a midwife told me there were just 2 midwives available that day for 29 mothers and 28 babies on postnatal. This puts a huge reliance on healthcare assistants and students
- The staff shortage also resulted in my section being delayed to a point that was beyond the last date I had told the baby had to be delivered. It was worrying, to say the least, though I was monitored throughout.
At the end of it all, I got another perfect little boy out of it:
I think the CQC report is incredibly unfair on the staff on the front line dealing with mothers and babies. Yes, there are problems at the Royal Oldham Hospital. But throughout my C section and immediately before and after it (despite a recent death in the family) I felt incredibly well cared for. Yes, there was a long wait but there’s nothing the staff can do about that. The front line medical professionals are essentially there just trying to do the best by the patients and working seriously hard!