Maternity services 'robust' despite report warning of risk to mothers and babies

The health secretary said he believes mothers can still have confidence in Edinburgh’s maternity unit despite a report outlining concerns from whistleblowers.

An NHS Lothian investigation into the obstetrics triage and assessment unit at the Royal Infirmary of Edinburgh highlighted staff shortages and a “toxic culture” between management and midwives.

It follows concerns raised by whistleblowers over the unit, which deals with around 1,200 pregnant women a month who require urgent care.

One midwife told STV News there have been high levels of burnout, absences and people leaving.

They said, “Management didn’t listen to our concerns. We’d say we were short-staffed, and they’d say it’s fine.

“If your staffing is down, you have more patients to care for, and you can’t give the same care to a larger number of patients.”

Health Secretary Neil Gray said he is to meet the health board to ensure improvements are put in place. STV News

NHS Lothian said an improvement plan has been implemented to enhance patient safety and the working environment for staff.

A separate review is being carried out into the death of a mother at the unit in September, with the family to be informed of the findings.

Health secretary Neil Gray, speaking during a visit to the NHS24 call centre on Thursday, said he would meet the health board to ensure improvements are made.

He told STV News: “It is concerning on the whistleblowing report. I want to provide reassurance that maternity services across Scotland are safe.

“This is an issue we want to address in Lothian. We will seek to ensure all necessary support and additional intervention will be taken forward as appropriate.

“The service available across NHS Lothian for mothers delivering or expecting babies is robust.”

Leah Hazard, an NHS midwife who has been campaigning for change and has written extensively about the profession, spoke with STV News about the report, which she said “sent chills down the spines” of midwives across Scotland.

Ms Hazard, who does not work at the hospital, said: “It’s incredibly concerning and that sadly is a story that I’ve heard echoed from midwives not just in Edinburgh but actually in many units across the country.

Ms Hazard said staff have long raised concerns about patient safety, lack of resources, and toxic workplace cultures.

“It has taken quite a while for those concerns to really come to light in a productive way,” she told STV News.

“It actually is sadly apparently endemic across Scotland’s maternity services.

“It has a massive impact on patients, and that’s why staff in this instance have been brave and persistent enough to raise concerns and to whistleblow.

“Midwives go to work every day wanting to do their best, and we’re really lucky in this country that we are trained to give absolutely world-class, gold-standard care.

“But when we get to work, and our hands are tied, and we’re not able to give that care, we see safety suffering and it’s absolutely not what we want.”

The Scottish Government has commissioned Healthcare Improvement Scotland (HIS) to develop clear standards for maternity care in Scotland due to be published in summer 2025.

Meanwhile, HIS announced earlier this year that it will start carrying out “safe care” inspections of maternity services across the country in January.

Jim Crombie, deputy chief executive of NHS Lothian, said the death of a mother at the unit in September will provide “much-needed answers” to the family.

He said, “I extend our sincere condolences to the family involved in this tragic incident, and I would reassure them that a detailed review is underway to give them much-needed answers and establish what happened.

“A significant adverse event (SAE) panel, made up of a number of experts including three external clinicians, will carry out the careful review using the normal processes, and the report will be shared directly with the family and the service to ensure that all necessary steps are taken.

“We need to wait on the outcome of the SAE and address any recommendations from that, as well as continuing to implement actions in relation to the whistleblowing concerns.

“We would reassure women that their health and the health of their baby is our paramount priority and we have taken a number of concrete actions to ensure we are providing safe care.

“Since concerns were raised, an improvement plan designed with staff to enhance patient safety, quality of care and improve the working environment and experience for our teams of dedicated staff is already under way.

“All aspects of patient care and workforce have been reviewed as well as staff working patterns, training and environment, as part of an open and transparent plan to work with teams.”