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Camden New Journal - by ROISIN GADELRAB
Published: 21 June 2007
Staffing ‘below standard’ on night baby died

Outside inquiry at odds with hospital probe

ROYAL Free Hospital labour ward staffing levels fell below the national guidelines on the tragic night a baby died following a series of errors by midwives, it has emerged.
A hospital internal investigation claimed staffing was not an issue when baby Riley Croft died on Good Friday in March 2005 after blunders by hospital staff, but the New Journal can reveal that an external investigation has contradicted those findings.
Confidential documents shown to this newspaper reveal only five midwives were available to help eight patients on the labour ward on the night BBC journalist Heather Paterson gave birth to baby Riley. He died 35 minutes later. A coroner’s inquest revealed last week how baby Riley died following errors by hospital staff.
The Department of Health and the Royal College of Midwives recommend one-to-one care for women in active labour. But an investigation carried out by the Local Supervising Authority (LSA), which oversees midwives in London, found: “The staffing ratio was not conducive to the provision of care in labour to the expected one-to-one standard.”
The report also revealed how Ms Paterson was given birth induction drug Prostin “without a systematic evaluation being made of clinical activity, labour ward bed occupancy and midwife availability”.
It said patients in the ward where some expectant mothers are held “are listed on the labour ward board so information was easily available to medical and midwifery staff to inform planning for the night and to seek management/supervision advice if deemed necessary and this was not done”.
The Royal Free’s own inquiry disagreed with the midwives’ report.
It said Ms Paterson was offered the aid of a student midwife but she declined, adding: “The panel accepted there were sufficient numbers of appropriately-skilled staff available on that shift, therefore that shortage of staff had no role to play in this case.”
During the investigation, it emerged that one midwife at the centre of the inquiry was aged 65 and, now aged 67, is continuing to work at another hospital.
A Royal Free spokeswoman said the hospital has 67 staff aged over 65 in its employment, one of whom is a midwife.
She added: “The unit was fully staffed in line with establishment (on March 25). For that weekend, as for all weekend shifts, the doctors available (for the ward) were two registrars, one senior house officer and a consultant on call. There were eight patients at the time and three were delivered. Five midwives were working as well as a student midwife and a healthcare assistant.”
Royal College of Midwives policy supervisor Sean O’Sullivan said staff numbers are worked out using a formula known as Birthrate Plus, which recommends one-to-one care for low-risk women in labour but calculates extra staff for more complex cases.
He said: “We know in London there’s significant understaffing. We want to see one midwife to look after one woman in labour. Clearly, this isn’t happening.”
Camden Council has ordered a borough-wide review of maternity services. Lib Dem councillor David Abrahams, chairman of the health scrutiny panel, is writing to Royal Free chief executive Andrew Way about baby Riley’s death. He said: “When there is a terrible incident like this, people need to be assured that a thorough investigation has been carried out.”

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