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Singleton Hospital's maternity ward, sourced from Google Maps

A recent report conducted by the Health Inspection Wales (HIW) into Singleton Hospital’s maternity services in Swansea stated that during their unannounced inspection, significant concerns were found around staffing, security, equipment, training and infection prevention and control.  


What is an Unannounced Inspection?

Unannounced inspections are a common practice throughout several services, including healthcare.

The HIW, for example, will carry out unannounced inspections in hospitals around Wales. This is because it allows them to see how the hospital usually operates day-to-day, without knowingly putting on their best behaviour for an inspection.

What is an Inspection Report?

An inspection report is a report produced by the inspection company following their inspection of a property, business, or establishment. In this report, they outline the failures of the establishment and what needs to be changed to operate properly and safely.


Singleton Hospital Maternity Service

So, first and foremost, what is the hospital doing wrong? The following issues were identified by the HIW upon their inspection of Singleton Hospital:

  • Insufficient ultrasound capacity within the health board to offer all women serial ultrasound scan screening in the third trimester.
  • HIW was not assured regular checks are being conducted on all equipment under the health board’s policy to ensure the required equipment, such as defibrillators, are available and suitable to use in the event of a patient emergency.
  • Communication and handover related to antenatal and intrapartum care were insufficient to enable the planning of safe care for all women and babies.
  • Ineffective infection prevention and control processes in place in some areas of the unit.
  • Medical equipment and fluid storage in some areas of the unit was not sufficiently secured.
  • One emergency theatre space was described as ‘unfit for purpose’.
  • Pain relief was not always given in a timely manner.
  • Poor compliance with mandatory training from all specialities (Doctors and Midwives).
  • The HIW was not assured the unit was sufficiently protected to minimise the risk of baby abduction.
  • Inconsistencies and illegibility were found in some of the records that were reviewed.


What Does a Maternity Service Need?

Following the inspection, an immediate assurance letter was issued to Swansea Bay University health board. Some of the improvements recommended by HIW included:

  • Increase the frequency of antenatal scanning for foetal growth in line with national guidelines.
  • Ensure that comprehensive and effective staffing escalation procedures are followed and communicated to all clinical staff. This must include clear guidance of the process to follow when staff identify low staffing levels.
  • Review the activity, staffing, location and processes related to the Antenatal Assessment Unit to ensure safe and effective care for all women who contact the service.
  • Review and improve the infection prevention and control measures and layout of the second obstetric theatre.
  • Review the processes and provisions for women and birthing people and their babies, should an ITU transfer for an obstetric patient be necessary.

At the time of inspection, there were around 300 open incidents reported. Sadly, the HIW found a significant backlog in management and resolving the incidents. This meant that there were missed opportunities for lessons to be learned, and staff had not been given formal feedback to reduce the risk of reoccurrence.

The Welsh government has placed the maternity unit at Singleton Hospital under enhanced monitoring. However, it remains to be seen what, if any, impact this will have on the standard of care provided to women and babies.


How Howells Can Help

Howells Solicitors specialises in medical negligence cases and understands the devastating implications poor maternity care can have on families.

We’ve represented many clients who have sadly experienced substandard care which has led to them suffering from significant perineal tears, fissures, organ damage, infections such as sepsis which get passed on to their baby, and even stillbirths.

If you or someone you know has been involved in a medical negligence case, get in touch with Howells Solicitors today.

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