An alarming investigation has highlighted troubling issues surrounding maternal care at the Edinburgh Royal Infirmary’s maternity unit, particularly in the obstetrics triage and assessment unit. According to findings shared with BBC News, mothers and their newborns have faced serious harm largely due to severe staffing shortages and a problematic working culture. The investigation was commissioned by NHS Lothian following a whistleblower’s concerns raised in February of this year, which prompted an in-depth scrutiny of safety practices within the facility.
The report identified 17 significant safety concerns that were either upheld or partially upheld. Following the evidence revealed in this whistleblowing investigation, NHS Lothian announced that an “improvement plan” is already in progress. This plan aims to bolster patient safety and enhance the working environment for healthcare staff. However, concerns persist as reports of a mother’s death in the maternity unit emerged despite the completion of the whistleblowing inquiry. Officials are currently conducting a thorough review of her case in hopes of providing the family with much-needed answers.
Healthcare professionals within the unit have voiced their worries regarding patient safety, sharing their fears about the risks that patients continue to face. One anonymous staff member expressed a grim assessment of the situation, stating, “We are afraid we can’t provide safe patient care and that women and babies are being harmed.” The staff echoed a sentiment that the crisis has been escalating over the past five years and is at a particularly dire state now.
The obstetrics triage and assessment unit, which caters to approximately 1,200 women needing urgent care each month, has come under scrutiny for its practices. The investigation pointed to a myriad of issues compromising patient safety, particularly citing the substantial staff shortages which have resulted in significant delays for women seeking treatment. Alarmingly, some patients were seen by personnel who lacked appropriate qualifications, creating a “toxic relationship” between managers and midwives that exacerbates operational challenges.
According to the report, it was conclusively stated that “there is no dispute that there have been safety concerns, near misses, and actual adverse outcomes for women and babies.” The investigation painted a troubling picture of a work environment where midwives felt “professionally compromised” due to inadequate support stemming from staffing deficiencies. Specific harrowing accounts illustrate the gravity of the situation; one woman in labor had to independently contact a neighboring maternity unit to check if space was available after waiting hours for treatment.
Moreover, the investigation revealed discrepancies between reported staffing levels and the actual situation on the ground. Managers allegedly misrepresented staffing adequacy, while many midwives reported considerable shortages across shifts, with inexperienced staff often responsible for caring for multiple women simultaneously. The resultant analysis showed that staff absence rates had surged—a staggering 200% increase noted between April 2023 and April 2024, reaching an alarming 15.2%.
Staff accounts depict a culture of disrespect and excessive pressure, with some describing the relationship dynamics as abusive following the tragic suicide of a colleague. Concerns voiced by staff often met with dismissal or downplaying by management have contributed to a pervasive culture of fear regarding reprisals for raising issues, impacting their willingness to speak out.
The comprehensive report included testimonies from 30 individuals, including current and former workers in the obstetrics triage department. Norton Crombie, NHS Lothian’s deputy chief executive, confirmed ongoing investigations into the death of the mother and emphasized the importance of implementing effective safety measures in response to the whistleblowing report. He indicated that maternity units across Scotland would face regular unannounced inspections from the NHS safety watchdog, Healthcare Improvement Scotland, in light of the increase of serious incidents, including spikes in newborn mortality rates in recent years.
The way forward remains precarious; while efforts to remedy the shortcomings are in progress, ongoing vigilance and robust managerial oversight are crucial to restoring trust and ensuring the safety of mothers and their babies within the care system.
