Concerns have been raised by inspectors after exhausted maternity staff were found to be working 20-hour shifts at east Kent's scandal-hit hospitals.

A lack of workers at Margate's QEQM and Ashford's William Harvey means expectant mums have had to be transferred between hospitals mid-labour, and staff have often had to care for two patients in childbirth at once.

The issues - which also include a lack of staff training, and community midwifery teams not visiting new mothers at their homes - were uncovered by the Care Quality Commission (CQC) during an unannounced July inspection.

An eye-opening report has now been published on maternity and children's services at the East Kent Hospitals University Foundation Trust, which has been mired in a recent baby death scandal.

Amanda Williams, CQC’s head of hospital inspection, said: "We were concerned that there were not enough midwifery staff and maternity support workers to keep women and babies safe.

"We were also concerned that some staff were feeling exhausted, stressed and anxious, because mistakes can easily be made when people’s judgement is impaired by fatigue.

“Managers weren’t doing enough to effectively tackle this shortfall and were offering staff financial incentives to work above their contracted hours, and asking community midwives to take on additional work in the acute units, which meant they were sometimes working 20-hour days, with very little time for a break."

Improvements demanded by the CQC after the inspection have already resulted in the trust making changes to the way its maternity wards are managed.

A total of £1.6 million has been pumped into the struggling service, with an additional 38 midwives being brought on board.

Ms Williams says the trust "responded swiftly" to produce an action plan focused on tackling staff shortages, including suspending homebirth services to ensure more midwives can be deployed to hospital maternity units.

So far, 26 of the proposed 38 new midwives have been employed.

The Trust has been going through one of the most turbulent times in its history, with its board last year admitting there could have been as many as 15 potentially avoidable baby deaths in just seven years.

Amanda Williams is from the CQC

Susan Acott is to step down as chief executive in 2022, while an independent standard of care inquiry - said to have collected reports from more than 200 families who believe they received poor clinical care - will soon be published.

Following July's inspection, maternity services at the trust are still rated 'requires improvement', while the overall rating for children's services has been upgraded to the same level from 'inadequate'.

Leadership has boosted performance, and there are sufficient levels of staff on the children's wards where good, up-to-date records are kept.

Inspectors did, however, discover that training compliance for medical staff at the QEQM was worse than the trust target of 85%, and in Ashford, children’s waiting areas in radiology were also used by adults.

The trust's chief nursing officer, Sarah Shingler, says the improved rating for children's services is a good step forward.

“We are pleased that the CQC has recognised the hard work and commitment of staff and the significant improvements that they have made for children, young people and their families," she said.

“We know there is still more we can do to make sure we always provide the best possible care, and we will continue to build on the improvements we have made to date."

Reacting to the report, county councillor Karen Constantine (Lab) said: "The CQC review is seriously concerning. It’s clear to me that staffing issues across a broad range of services in the NHS are at a critical stage.

"Without proper government intervention these ‘clinician gaps’, will continue to materialise and inevitably people will fall through those gaps; Suffering, harm and anxiety are predictable.

"Without sufficient and safe staffing levels we are not going to see the scale of improvements needed."

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