Deserted wards and firefighting staff: Jessops in crisis

Sheffield’s Jessop Wing maternity ward is in crisis. The unit, which until 2021 had been rated as outstanding by the Care Quality Commission, has failed two inspections in the space of six months. The two CQC reports make for worrying reading. Inspectors raised concerns about a lack of qualified staff and poor monitoring of mothers’ and babies’ health. They also said they were not satisfied that serious incidents were being recorded properly.

I've spent weeks trying to speak to people who have experience of the ward either as patients or as members of staff. It hasn’t been easy. We found patients relatively easily, but when we approached staff via social media, the trust’s press office tried to warn us off. In my four years of reporting on Sheffield Teaching Hospitals, it’s always been my experience that the trust struggles to accept criticism and wants to gloss over mistakes. This story has been no different.

The people we have spoken to all praise the “incredible” Jessops staff, who they say go out of their way to provide the best service they possibly can in very difficult circumstances. But they also paint a picture of a broken system. One patient told us Jessops was so chronically understaffed, it seemed at times to be deserted. Another said midwives and doctors were constantly rushed off their feet and spent so much time firefighting that less urgent tasks were frequently forgotten.

Some of these problems are common to all maternity units. Indeed, problems caused by underfunding, staff shortages, burnout and Covid are currently endemic across the NHS. But some issues at Jessops, including ones mentioned in the CQC reports, perhaps reveal more unique problems. A Sheffield GP we spoke to said a toxic culture around the reporting of mistakes is a recurring theme in maternity units that have had the most serious problems. Parts of the CQC report say Jessops staff were “fearful of reprisal” or being unfairly blamed if they raised concerns.

One of the mothers The Tribune spoke to was Chloe (not her real name) who had her baby at Jessops in September 2021. Towards the end of her “difficult” pregnancy, a consultant decided to induce her at 37 weeks because her baby was getting too big. However, an hour before she was due at Jessops, hospital staff called to cancel her induction. “They said they were really busy and that a doctor had checked and decided I could wait until 40 weeks,” she tells me. “I just started screaming. I threw a tantrum.” Her husband took the phone from her and tried to reason with the caller and get them to change their mind. “But they just said unless your wife is in labour, she can’t come,” says Chloe.

In the end, the hospital relented and let her onto the unit. But when they got there Chloe says she was astonished by the lack of both staff and patients there. “When I got there most of the wards were empty,” she says. “There were hardly any women there or many midwives. I remember thinking ‘where is everybody?’” Chloe now thinks that when they said they were full, they actually meant they didn't have enough staff. In the end, after two failed inductions and a Caesarean section, her baby ended up being born at 38 weeks and was placed straight into intensive care. “God knows what would have happened if they had waited until 40 weeks,” she tells me.

When her baby was in NICU, she says the staff were “absolutely faultless”. But when she was put back on the ward, she describes being left alone for long periods with no help, an experience that was made worse by Covid visiting restrictions which meant her husband was only allowed to stay for a few hours at a time. After she had been in the unit for ten days she’d had enough. She told hospital staff she was leaving but even then had to wait hours for the discharge paperwork to be done. In the end, she walked out of Jessops without the paperwork or her medications. Her husband went back to the unit hours later to collect them.

Chloe’s baby is doing well now, but she says her experience has left her confused and disappointed with the care she received. “The nurses and midwives are rushed off their feet, but management just isn't there and it’s frightening, especially for a first-time mother,” she tells me. “I feel jaded every time I get a health visitor now. I just felt failed by the NHS.”

Just two months after Chloe had her baby, The Star reported that 21 women who had arrived at Jessops in labour were sent to Chesterfield and Doncaster to give birth. At the time, chief nurse Professor Chris Morley blamed a higher level of staff sickness than normal and an “exceptionally high” number of women who needed interventions. He insisted that at no stage had Jessops closed.

Jessops’ first failed inspection in June 2021 found that the unit was not providing "the standard of care women should be able to expect". But a second unannounced inspection just a few months later (which was published earlier this year) found that the quality of care hadn’t got any better — and in some areas had actually got worse.

The CQC said from April to October 2021, 35 patient safety incidents had been raised due to lack of suitably trained or skilled staff. The inspection also found that “staff did not always treat women with compassion and kindness, respect their privacy and dignity, or take account of their individual needs”.

Perhaps most damningly, the CQC said they were not assured that leaders had the skills and abilities required to run the service. They added they were concerned that leaders within the service were not effective in implementing meaningful changes that improved safety. Trust chief executive Kirsten Major promised to make improvements.

Another person with recent experience of the unit is Chris (again, not his real name) whose wife gave birth there in September last year. He told The Tribune that although the staff were “absolutely incredible” and put their all into providing the best service possible, the serious problems at Jessops were clear to see.

“The system was certainly broken,” he told us. Chris said when his and his wife’s baby showed reduced foetal movements, they experienced significant delays in getting seen by an experienced clinician. “The staff were essentially firefighting and only dealing with the most urgent and essential of tasks,” he says.

The Tribune also spoke to two NHS clinicians who work with colleagues at Jessops on a regular basis. The two doctors — one a Sheffield Children's Hospital consultant and the other a city GP — agreed that staffing was probably the main issue at the unit. However, they differed on the extent to which the problems were NHS-wide or particular to Jessops. 

The consultant at Sheffield Children’s Hospital told us he thought Jessops had just been unfortunate to be inspected in the middle of the pandemic. “Most units have been run on ‘just enough’ staff with people filling in here and there out of goodness for a long time now,” he told us. “Once you severely stress the system, it fails.”

The consultant told us that due to the current financial pressures the NHS is under, services can’t be delivered and staff are not being replaced. The impact of Brexit was also reducing the pool of staff the ward was able to recruit from and those that are employed are more inexperienced and the mentors they need have largely disappeared.

“Complaints go up, morale goes down and then staff go off ill and retire even more,” he tells me. “It becomes a vicious cycle.” But he rejected the idea that hospital staff could be covering up a bigger and more worrying story. “I don’t think that there is a conspiracy of silence,” he says. “If I thought there was, I’d say for the sake of patient safety.”

However, another Sheffield clinician who currently works as a GP in the city but has previously specialised in obstetrics, told us he was more worried about Jessops. He says consultants there had recently told him that the unit simply didn’t have enough staff to do the job safely, but that being open about that is almost impossible in the NHS at the moment. 

“To say that a hospital has unsafe levels of staffing is politically explosive,” he tells me. “It also happens to be true of many hospitals in the UK right now. Every doctor knows this. But many are worried that if they speak out, they will be blamed and hung out to dry.”

The GP agreed that many of the issues affecting Jessops were probably common to most, if not all maternity units in the UK at the moment. But he added that not every unit had failed two inspections in the space of six months and that there were parts of the CQC report that made for more worrying reading, particularly around the culture on the ward.

He told us that poor working relationships in maternity units was a recurring theme on those wards that have had the most serious problems. He added this can sometimes lead to a lack of transparency around errors and ultimately adverse outcomes for mothers and babies, as had happened at hospitals in Shrewsbury and Telford and Morecambe Bay in recent years.

“The question that I hope people are asking within the trust is how can they can go from being outstanding to inadequate in the space of two years,” he tells me. “Undoubtedly Covid is a big factor but you’ve got to think about were there some fundamentals that were not quite right that have been exposed by this. Good obstetrics is an art. It requires teamwork.”

The Tribune asked Sheffield Teaching Hospitals to respond to our story on Friday. A statement from chief nurse Professor Chris Morley said: “We have taken the findings of the CQC report extremely seriously and I can assure women that we have already taken several actions to make the improvements needed, including recruiting more midwives, nurses and support staff.

“In addition we are delighted that 24 of our student midwives have chosen to join us, when they qualify, in September and we have 15 international midwives joining us over the coming months. Our teams work exceptionally hard to provide good care but we know there is more we can do and we are always happy to have a conversation with patients and staff who want to raise any concerns with us.

“We have developed a Maternity Improvement Programme to make further improvements and we use all the feedback we receive along with the CQC findings to inform this work.”

Do you have any experience of the Jessop Wing, either as a patient or as a member of staff? If so, and you would like to share your story with us, please hit reply to this newsletter or email editor@sheffieldtribune.co.uk. Thank you.