BOSSES at Warrington Hospital have been ordered to make improvements after an inspection of maternity services found 'overnight' changes went against guidelines.

Health watchdog the Care Quality Commission (CQC) visited the Lovely Lane hospital in the summer after bosses switched to continuous fetal monitoring all women on the labour ward earlier this year following nine stillbirths and one neonatal death, as previously reported in the Warrington Guardian.

The report said while feedback from mothers on the labour ward was positive, the maternity service was meeting only three out of five standards after introducing extra monitoring.

The inspection judgement read: "Care and treatment was not always planned and delivered in a way that ensured people's safety and welfare because care and treatment to low risk women during labour did not reflect relevant research and guidance."

Continuous monitoring was not advised for 'low risk' pregnancies as a 'significant number of false positive readings' can occur which can lead to 'invasive high risk interventions' including c-sections being carried out unnecessarily. 

During the inspection, each member of the clinical staff stated morale among midwives had been affected because they now 'lacked confidence in their skills to determine whether labour was proceeding without complications'.

The report added midwives were given 'confusing' instructions about the policies and comments from staff included: 
“Midwives are fearful. Fear has changed the unit and it is now a unit of blame culture and not a listening culture.
"Midwives were given no warning about continuous fetal monitoring which was implemented overnight."

Inspectors have now asked the hospital to produce an action plan to show how they are meeting standards.

The report also looked at operating theatres at the hospital after receiving concerns from an anonymous whistle-blower but found no issues.

Karen Dawber, director of nursing and organisational development governance at Warrington Hospital, said: “We’re pleased that the concerns raised around our theatre services were unfounded and that all standards are being met, but we are disappointed with the findings of the inspection around the fetal monitoring.

"We introduced this following robust discussion with clinical staff and the trust board.

"We fully understood that we moved away from national guidance when we made the decision but mum and baby were at the heart of our decisions."

A spokesman added the move was viewed as an 'extra safety step that could be offered to women at the time' but the CQC said that this was 'moderate non-compliance' with their standards.