The maternity unit at the main hospital used by Theresa May’s local constituents is so severely understaffed that wards are running with only a quarter of the nurses they need, potentially putting mothers’ and babies’ lives at risk.
The Royal Berkshire hospital’s staffing data shows that on some days in March its delivery suite lacked two-thirds of the nurses it needed to provide safe care, while the midwife-led unit had as few as a third of the preferred number nurses on duty, despite evidence that staff shortages increase the risks of childbirth.
Even the high-risk antenatal ward, where the most vulnerable unborn children receive intensive monitoring, was 50% to 75% short of nurses during some shifts.
The Reading hospital, which is used by many of the prime minister’s Maidenhead constituents, is struggling with one of the NHS’s biggest recruitment problems. It is so short of midwives that its maternity unit sometimes has to close its doors, forcing women in labour to go elsewhere to give birth. In addition, some women are being denied a home birth because midwives who are usually based in the community are being told to work in the RBH’s maternity unit instead.
An internal briefing compiled by the Reading trust reveals that nurse vacancy rates are as high as 47% on one of its elderly care wards, 32% on wards treating children and patients with kidney disease and 31% on a surgical ward.
The Guardian uncovered the severe staff shortages during an investigation into the performance of the three hospital trusts used by constituents of May and the health secretary, Jeremy Hunt, who is standing for election again in South West Surrey. They are the Royal Berkshire, the Royal Surrey County hospital in Guildford, Surrey and Frimley Health.
Frimley Health runs Frimley Park hospital in Surrey and two Berkshire hospitals that also treat many of May’s constituents: Wexham Park in Slough and Heatherwood in Ascot.
The investigation was based on responses to freedom of information requests, official NHS performance data, research by the House of Commons library and analysis of the trusts’ board papers. It also found huge understaffing issues at both the other trusts.
Among the findings are:
One in six (16%) of all posts at the Royal Surrey are vacant.
Frimley Health, which admits staffing is “a concern”, paid locum or agency nurses, doctors and midwives to cover 41,055 shifts during 2016, and the Royal Berkshire used them 33,013 times.
Frimley Health has recently had to raise its pay rates for some staff to help minimise rota gaps, and the Royal Berks has had to extend “golden hellos” in an attempt to attract extra nurses.
Royal Surrey has not met targets on giving patients X-rays, scans and other diagnostic tests within six weeks since January 2016. In March 7.4% of all patients who needed such tests waited longer than six weeks – far more than the 1% target. In 2016-17 it failed to test 6% of patients on time, one of the worst records in the NHS.
The acute staff shortages at the RBH contribute to the hospital’s inability to fully provide many of its key services. It admits it is short of 454 staff overall, has 10% fewer senior doctors than it needs and 13% too few therapists, and that one in six nursing and midwifery posts are vacant.
The Royal College of Nursing, the parenting charity NCT and the Royal College of Midwives have said the RBH’s routine understaffing is compromising the safety of babies and mothers.
“The Royal Berkshire hospital trust’s figures show that their staffing levels are worryingly inadequate,” said Elizabeth Duff, the NCT’s senior policy adviser. “At the Royal Berkshire hospital and elsewhere, action is needed on staffing so that women giving birth are not put at risk and every family receives an acceptable level of care.
Suzanne Tyler, the RCM’s director for services to members, said: “Any trust with this level of shortages, if correct, should compel the senior managers and the board to immediately look at their staffing levels and take action as a matter of urgency.”
All three trusts investigated by the Guardian also face acute financial challenges. For example, Royal Surrey last year considered abandoning an overhaul of its cancer centre because of a lack of cash. In addition, in the year to April 2017 the three trusts committed some of the biggest breaches of key NHS waiting time targets covering A&E care, cancer treatment and planned operations.
May and Hunt have repeatedly insisted the NHS is receiving more money than it asked for, has enjoyed large staffing increases under the Conservatives and is generally performing well.
Doctors’ leaders claim the revelations contradict May and Hunt, and the hospitals themselves say that they are victims of national shortages of many different types of health professionals.
Dr Mark Porter, the chair of council at the British Medical Association, said: “These findings reveal the truth behind the assurances about care in hospitals and GP surgeries across the country. A dangerous combination of staff shortages and chronic underfunding is harming patient care.”
Dr Mark Holland, president of the Society for Acute Medicine, said the findings “do worry me and are a great concern”. He added: “Nurse shortages are a huge worry. Patients will not benefit from a healthcare system under so much strain.”
The Royal Berkshire said its understaffing and 8.8% vacancy rate were due to “national shortages of clinical and nursing staff in specific specialities”, and it admitted it was struggling to get enough midwives. But it denied that operating its maternity unit with so few nurses so often was endangering patient safety.
It said in a statement: “We do not accept that our staffing levels pose a risk in maternity. The safety of women and babies in our care is paramount and our maternity staffing resource is used flexibly across the service to ensure that women in labour receive 1:1 care as a priority.”
It apologised for the underperformance of its cancer service in 2016 but said an action plan agreed with local GPs had led to improvements.
A Royal Surrey spokesman said the NHS nationally was facing “unprecedented demand and pressure”, and it had increased the number of nurses it employed by 13%. It declined to set out what the impact of so many delays in providing timely care would be on patients’ mental or physical health. A spokesman said improvements in its A&E performance meant it treated 97% of patients within four hours in March.
Frimley Health said: “In relation to staff levels, we do have a high vacancy rate, especially at Wexham Park. This hospital is just outside the M25 so has to compete with London hospitals where staff get paid more via London weighting. We have made big inroads into vacancies … We know that we still have more work to do.”
A Conservative party spokesman said of the investigation: “This is totally refuted by the facts. Since 2010 the Royal Surrey has 126 more doctors and 261 more nurses, and the Royal Berkshire has 150 more doctors and 195 more nurses. Together they do over 16,000 more operations annually than seven years ago, which is possible because the NHS has record funding.”