Maternity unit: Review reveals 'a culture of bullying' (From Witney Gazette)

Chipping Norton Maternity Unit: Review reveals breakdown of staff relationships

9:00am Thursday 14th March 2013 in News By Tom Jennings and Freddie Whittaker

STAFF relationships inside a maternity hospital broke down so badly it had to be shut, it was revealed last night.

Births at the Cotswold Maternity Unit in Chipping Norton were suspended in October last year, but a damning report into exactly why has only now been made public.

It includes claims staff were bullied and describes a rift between the “old guard” – who worked “the Chipping Norton way” – and those trying to meet national guidelines.

It describes a failure of management to address the problems between staff at the West Oxfordshire unit.

The Oxford University Hospitals Trust board met yesterday and pledged to resume births at the unit on July 1.

A total of 31 recommendations were agreed in an attempt to prevent problems occuring again.

Prime Minister and Witney MP David Cameron

'I have always been very clear, as the local MP, that the unit must reopen as soon as is possible'

But despite claims in the report staff were “afraid” of management, no individual managers have been found at fault or stepped down.

The unit, part of the Chipping Norton War Memorial Community Hospital, was officially opened by David Cameron in 2011 and replaced the “old and tired” Chipping Norton Maternity Unit.

But the report, which covered 2008-12, said the number of births plunged after the opening to just 32 between April and September 2012.

The report said “a culture of bullying was suggested by a number of staff” that had built up prior to the opening, but was exacerbated following the move.

Chipping Norton's county councillor, Hilary Hibbert-Biles, added: “I’m pleased that they’re considering re-opening it, although I’m nervous that they also talked about the future of midwife-led units. It makes me nervous that they might want to close it in the future.”

The report added: “In the previous unit some staff were excluded and an ‘elitist’ culture developed.

“Staff felt that the move to the new unit could have been managed differently to ensure all the staff were involved and responsibility for tasks should not have been taken away.

“These actions led to problems and the development of complex relationships which in turn lead to a breakdown of the team.”

It went on: “It is apparent that the two units had very different cultures and previously staff practised in the ‘Chipping Norton way’; this included practice, working hours and workload which differed from the national norms.”

The report also said the Cotswold Maternity Unit was “isolated” and lacked cooperation with nearby GP surgeries and hospitals.

But the number of transfers to other hospitals – which increased from 7.4 per cent in 2010 to 23.9 per cent in 2012 – were found to be “appropriate”.

Paul Brennan, clinical services director at OUHT, said: “I think what’s key is the issues about leadership and culture, and compliance with trust policy and with National Institute for Health and Clinical Excellence guidelines, and we should not be stepping outside that.”

But the report said that in order to maintain the viability of the unit, it would need to grow to a birth rate of 150 to 200 births each year.

The report’s author, head of midwifery Jane Hervé, refused to be interviewed last night.

The trust also failed to explain how much the review had cost or whether the unit could close if the birth target wasn’t reached.

Last night, Prime Minister and Witney MP David Cameron said: “I am pleased that this issue can now move forward.

“I have always been very clear, as the local MP, that the unit must reopen as soon as is possible and I will now seek to ensure that this happens on July 1.”

Review rundown

• The review focused on the period between 2008 and 2012
• The trust approached 51 NHS staff and interviewed 41
• Previous and current CMU staff and local midwives were consulted
• Questionnaires were completed by 106 women who gave birth at the unit
• The report reviewed 198 randomly selected case notes. It also reviewed 46 transfers from the maternity unit to other hospitals
• Two out of four home births were reviewed
• Questionnaires were sent to 16 local GPs – four replied
• The trust held six public meetings, which were attended by 52 people.

What happened when

• October 18, 2012: Oxford University Hospitals Trust announces the suspension of births at the Cotswold Maternity Unit, but refused to say what prompted the closure.
• October 19: Head of midwifery Jane Hervé confirms the suspension was as a result of concerns about the number of patients being referred elsewhere, but says the unit will re-open.
• October 23: A petition started on the gopetition website claims two midwives were suspended from the unit after they raised concerns about working practices and safety.
• October 30: Prime Minister and Witney MP DAvid Cameron backs a review of services at the unit.
• February 2, 2013: Three months into the review health bosses refuse to confirm when it will reopen.
• February 21: Health officials are grilled by the county’s joint health overview and scrutiny committee and accused of showing a “lack of transparency”