Maternity services at a Romford hospital have been rated 'good' in a review by the healthcare watchdog - but safety still remains a concern.
Following an assessment in October 2024 that saw Queen's Hospital identified as requiring improvement, the Care Quality Commission (CQC) has improved its rating for maternity care.
The CQC made an unannounced revisit in August specifically to review the 'safe' and 'well led' assessment domains of Queen's maternity services, where there had been breaches of regulation.
Inspectors changed the rating of the maternity services from 'requires improvement' to 'good' in the 'well-led' domain, but safety has been left as 'requires improvement'.
The improved overall rating for maternity comes despite Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) - which runs Queen's - previously telling this paper he did not expect it.
Inspectors observed how the service had made improvements that meant it is "no longer in breach of the regulation for good governance".
This included having enough midwifery and medical staff to ensure the safety of mothers and babies, and understanding and managing risks with an effective governance process.
CQC said it obtained feedback from three users of the maternity services, who reported that Queen's "provided high quality and responsive care".
In terms of safeguarding linked to the maternity services, inspectors were satisfied that "evidence shows a good standard of care".
Particularly, the report highlights the competency of the staff to recognise, raise and address safeguarding concerns.
Staff received training on this, inspectors found, though a fall in compliance by medical staff below the trust's target was identified.
CQC was advised that this was the result of "industrial action", and the trust were "actively managing non-compliance".
Midwifery staff exceeded the training target of 90 per cent.
Patient information was available to access by appropriate staff, but CQC found in some cases the confidentiality of women's information was "not always maintained".
Information displayed on whiteboards was highlighted as a confidentiality concern, with the report stating "immediate" action was taken to address this risk.
A good standard of care was reported in the service's work with women to understand and manage risks.
This included supporting mothers with mental health and learning disabilities, as well as providing maternity information leaflets in a number of languages.
Inspectors noted the "overwhelmingly positive" feedback from women to do with support and professional counselling for women and families who had experienced late miscarriages, stillbirths or terminations.
CQC observed evidence of a good standard of care linked to the service's safe and effective staffing.
A daily safety huddle covered topics such as staffing, the severity of patient conditions, safeguarding and recent incidents, with maternity 'red flag' staffing incidents monitored every four hours.
These 'red flags' indicate concern surrounding midwifery staffing levels.
After data between September 2024 and March 2025 revealed 79 red flag events were recorded by the maternity service, new flow coordinators were onboarded, along with an increased midwifery and medical staff.
The most common red flag events included delayed or cancelled time critical activity, delays between admission for induction and the start of the process, and delays in initial midwife checks in triage.
According to inspectors, there was a good standard of care observed in the trust's infection prevention and control, and leaders were observed to be capable and compassionate.
Governance and management within maternity services were reported to be good.
However, shortfalls were found in a number of inspection categories and, at the time of the assessment, a breach of safe care and treatment was identified relating to incidents and medicine management.
Inspectors reported that women could not always access services in a "timely manner", with Queen's maternity services "consistently" failing to meet a local target relating to midwife appointments.
The report states that women did not always have their initial midwife appointment by ten weeks gestation, in line with NICE guidelines.
The service's aim was to have pregnant women booked in for this by nine weeks, six days gestation, but this did not meet the local target of 70pc.
Inspectors warned: "Late access to antenatal care contributes to higher mortality and morbidity rates, especially among ethnic minority women in deprived areas.
"The service did not identify actions to improve these figures."
Improvement to access and flow throughout the maternity services since the last assessment was observed, thanks to the introduction of a flow matron, flow coordinators and discharge coordinator.
Staff continued to report episodes of delays in transferring women, though these had "greatly reduced".
Queen's maternity services also reported to the CQC a "risk that the current theatre capacity might not be sufficient for future demand".
Whilst inspectors found there was adequate levels of equipment to provide safe care for women and babies, they saw out of date consumables in clinical areas including blood bottles and resuscitation face masks.
This was flagged to the midwife in charge and the items were removed.
A dirty drawer and mould in the shower of the bereavement room were also flagged as not improving from the previous assessment.
CQC believes these to be "isolated cases".
Another concern raised by inspectors related to the accurate and timely keeping of medicine records.
Maternity services staff were seen using a paper-based prescribing system with a single prescription chart for multiple inpatient admissions.
Outdated medications that were no longer appropriate were kept on the chart without being crossed out, CQC said, "increasing the potential for medication errors".
This matter had been raised in the previous assessment, with the service reporting that it plans to introduce an electronic prescription and medication admin system by June 2026.
Queen's maternity services assured the CQC it would remind staff to cross through old prescription charts and remove these at the point of discharge.
Since the inspection was conducted, it was announced that Queen's maternity services, run by BHRUT, would be one of 14 NHS trusts to be investigated as part of a national probe to "urgently improve care".
The news comes amidst a backdrop of a major increase in maternity 'red flag' alerts at the hospital.
BHRUT described the improvement in the maternity services as meaning Queen's has now "put their troubled past behind them".
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Mr Trainer said: "I am glad the hard work our team has done to improve maternity care at Queen's Hospital has been recognised by the CQC.
"We have made changes to the way we run services and have invested heavily in more midwives, and more medical cover to improve care. This extra investment has had results.
"We still have plenty of work to do to make sure every mother and baby gets the care they deserve. However, this is an important moment for our Trust and I hope it will give local women more confidence about the care we provide at Queen's."
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