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A recent review discovered that staffing shortages and a prevailing “culture of mistrust” at a prominent maternity unit in the UK led to delays and harm to patients. According to the inspection at the Royal Infirmary of Edinburgh, some women experienced labor induction delays exceeding 24 hours. The report also highlighted the staff’s reluctance to file safety reports, expressing concerns about feeling overwhelmed and unsupported. This assessment aligns with the findings of NHS Lothian’s previous review of the troubled maternity unit, despite the health board’s claims of making strides in enhancing and investing in women’s services.
Following a BBC Disclosure investigation, calls for urgent improvements in maternity safety were sparked nationwide. Testimonies from numerous families underscored instances of subpar and occasionally fatal care. The concerns surrounding Edinburgh’s maternity unit first arose in 2024 when whistleblowers prompted NHS Lothian to conduct an internal safety review. The review concluded that staffing shortages and a “toxic” workplace environment had resulted in harm to mothers and newborns. Health Secretary Neil Gray described the Healthcare Improvement Scotland (HIS) report as “deeply, deeply concerning” and directed NHS Lothian to promptly implement the recommendations.
In a recent unannounced inspection by HIS, which took place in June, staff were acknowledged for their efforts to provide compassionate care despite challenging circumstances. The report outlined 26 necessary improvements and raised “serious concerns” about the maternity unit to NHS Lothian and the Scottish government. Significant issues identified included delays in care escalation leading to adverse outcomes, errors due to communication lapses, and a negative work culture characterized by a lack of senior management visibility. Despite some positive interactions observed during the inspection, most multi-disciplinary team members expressed frustration over staffing levels and safety risks, which they had flagged to management multiple times.
HIS chief inspector Donna Maclean emphasized gaps in incident reporting and a prevailing sense of mistrust among staff, which hampers the learning process from adverse events. Women’s experiences at the hospital varied, with mixed feedback ranging from complimentary care to instances of poor communication that left them feeling uninformed and lacking a voice in their treatment. Several midwives from Edinburgh’s maternity unit, speaking on the condition of anonymity, shed light on the challenges they encountered, such as inadequate staffing and workload pressures. Notably, NHS Lothian’s 2024 review validated or partially validated 17 safety concerns, acknowledging instances of adverse outcomes for women and babies
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