Campaigners call for 'best' neonatal services in wake of Countess of Chester baby deaths probe
Around 10% of North Wales babies are born at the Countess of Chester Hospital where police are investigating an unusually high number of infant deaths on the neonatal unit.
Insufficient senior cover and inadequate staffing numbers were found to be an issue, according to a report.
The Countess of Chester Hospital Foundation Trust asked police to look into deaths on the unit between June 2015 and June 2016.
Of the 7,000 births in the Besti Cadwaladr University Health Board area a year around 600 North Wales babies are delivered in Chester.
The North Wales Health Alliance say the news is a “concern” after critically ill babies from the region were transferred to England during the downgrading of neonatal services.
Marc Jones, spokesman, said: “Concerns over the loss of neonatal services here in North Wales was a key issue that prompted the formation of the NWHA in 2013.
“We opposed the decision by Betsi Cadwaladr to downgrade neonatal intensive care services in Glan Clwyd and Wrexham Maelor hospitals and transfer critically ill babies to England because of the perceived risks involved.
“The investigation into baby deaths in Chester is a tragedy for those directly involved but it’s also a concern for everyone else.
“It’s clear that, as a result, we must look to provide the best possible neonatal services here in the north as there’s no guarantee that those services will be available elsewhere.
“I’d like to see the Sub-Regional Neonatal Intensive Care Centre (SuRNICC), due to open in Ysbyty Glan Clwyd in 2018, opened as soon as possible to we get the best-possible care locally.”
Cheshire police will focus on the deaths of eight babies, review seven further deaths and six non-fatal collapses.
In July 2016, when the unit changed admission arrangements and stopped providing intensive care, the trust asked the Royal College of Paediatrics and Child Health (RCPCH) to review the increased mortality rate.
The report found significant gaps in medical and nursing rotas and insufficient staffing for the provision of longer term high dependency and some intensive care.
It said: “The investigation reports from the infant deaths showed a pattern of insufficient senior cover and a reluctance to seek advice.
“Consultants reported visiting every day and being available on site 9am-5pm, perhaps by supervising work on the postnatal ward and teaching.
“Given the acuity of the ward (pre July 7) there should have been a greater level of consultant presence on the ward.”
Staffing numbers and competencies were not appropriate for the seriousness of the babies being cared for.
The report said: “The paediatric service (including neonates) struggles to fill its Tier 2 (middle grade) posts and medical staffing numbers are inadequate for a Tier 2 LNU (local neonatal unit), although sufficient for a Level 1 SCU (special care baby unit).”
Paediatric consultants were concerned since June 2015 about a higher than usual number of deaths on the ward, several of which were “unexplained” or “unexpected”.
Two babies died on the unit in 2013 and there were three deaths in 2014.
But eight deaths were recorded in 2015. And in 2016, up until June, five babies died on the unit.
Two of the deaths being investigated or reviewed by police are of babies who died at other hospitals after collapsing.
The RCPCH review found no obvious factor linking the deaths.
It recommended the unit’s death and near miss reviews procedure was strengthened and the area’s Child Death Overview Panel (CDOP) consider whether it could have detected the cluster of deaths more swiftly.
Post-mortem examinations did not include systematic tests for toxicology, blood electrolytes or blood sugar.
Former North Wales AM, Antionette Sandbach said: “The news of the investigation relating to baby deaths at the Counctess of Chester will be devastating for the families involved.
“I welcome the investigation as clearly it is vital that the hospital and the police investigates the cause of those deaths as quickly as possible.
“This is clearly an extremely serious issue and I hope that the families involved will be offered additional support as this will be a distressing time for them.”
