St Georges Hospital, SW London - CQC Inadequate Maternity

[Sunnyshoeshine]

Much as the title says really. We live around 12mins drive from St Georges Hospital (taxi as we don't have a car). DD1 was born there in 2021. Our experience then was very good in terms of midwife care, although we noted at the time how run down all the wards were. With the exception of one night midwife, i felt very well looked after during the birth. DD had some health issues after birth and spent time in the St Georges NICU (level 3). I think potentially the staff could have been more proactive in picking up her issues sooner, but DH feels happy about her care and treatment.

Two years on and I'm pregnant with #2. I booked in at St Georges again last week, but today I've seen a pretty damning CQC report released last week based on an inspection in March. https://www.cqc.org.uk/press-release/cqc-tells-st-georges-hospital-make-immediate-improvements-maternity-care

Our alternatives would be Kingston (Outstanding - 40mins drive) and St Helier (Good - 25mins drive). Both of these only have level 2 NICUs and given our experience with DD1, this does make us nervous. They are further away from a travel perspective. DD1 was a quick birth but I had already been admitted due to my high BP. Also aware that St Helier is basically falling down and the building predates the NHS itself. I believe there are also plans to close the maternity services at St Helier but this is not before i would be giving birth i think.

I suppose my current thinking is to go to my booking appt next week and ask the midwife about the report and what changes are being planned to address the issues. DH's view is that maybe because its such a famous hospital and has had such a poor report, there will be a lot of effort to put it right. But I'm not sure if that's naive thinking based on the current issues within the NHS more generally?

Has anyone been in a similar situation? What did you decide to do?

As the OP, i thought i would come back and update this thread in case anyone is searching for it in the future. DD2 was born around 4 weeks ago.

After my last update at around 16w, things did go slightly downhill for me. I was originally assigned to the team for women classed as out of area. I had a named midwife (the same one as for my first pregnancy) and things were great - always seen on time, brilliant midwives, held in the Nelson Centre so really convenient. However this team was disbanded and my care was moved to the antenatal clinic at St G. itself at around 24w? The antenatal clinic was absolute chaos at every appointment - i was never seen less than 45mins late and i saw a different midwife every time. Although each of them was perfectly nice, i never really felt like anyone had a grip on the overall picture, unlike in my first pregnancy. If i had been low risk, i don't think this would have bothered me, but as i got towards 36w, my BP was starting to creep up and was worried about a repeat of the pregnancy hypertension i had in my first pregnancy. I actually went on to develop pre-eclampsia and whilst the care from the obstetricians and the DAU midwives was great, i do wonder if it might have been escalated sooner if one person had been monitoring my overall care. I think if you live within Wandsworth itself, this wont be an issue as you will be seen in the community clinics, but it is a big issue for anyone in Merton.

As for the birth itself, i had a vaginal delivery which was very fast. I gave birth in the delivery suite (rather than the birth centre) as i had requested an epidural. In the end, DD came so fast that i needed to push whilst the anesthetist was still setting up her equipment, so just had gas and air in the end, but not being in the birth centre didn't bother me. If i had opted for Kingston as i thought when i started this thread, my DH would have missed the birth as he would never have got to Kingston during rush hour in time after waiting for our childcare to arrive for DD1. The midwives in triage and at the birth were all amazing.

The postnatal ward was not that busy, so the postnatal midwives had lots of time to support with breastfeeding and answering questions about my ongoing care for PE etc. It also helped that as it was my second, i had a better idea of what to expect and what was going on. It was miles away from my experience first time around in 2021 when the postnatal ward was completely full and it was clear everyone was totally overstretched. Several of the midwives from my first pregnancy actually popped in to say hello when they heard i was back with DD2, which was so lovely.

We are glad that we stuck with St G - although there are improvements that need to be made (in terms of facilities and certain aspects of the process), overall, our experience was positive despite the report.

Hi everyone,

Has anyone given birth at St George’s Hospital between 2024 and 2025? The 2023 report is quite concerning. I had my first appointment last week at 9 weeks pregnant. The first thing I mentioned was that I have vein insufficiency in my leg, but I’m unsure whether a vaginal birth or a C-section would be more suitable for me. Do you think they have staff who can provide the right guidance on this?

Hi @Sdfplt - congratulations! My birth was in April 24. I think you should ask to talk to the consultant midwife - i can pm you her name if you are interested. They can do something called a birth options meeting. Mine was very long - over an hour! But we went through every different birth option in relation to my medical history and what the pros and cons would be. It was really useful and the consultant midwife was very kind. It isn't usually until quite later on (mine was around 30w). You could always enquire if you could have it earlier. Are you going to be midwife or consultant led? If you will have a consultant appointment (often around 16w) then you could ask there as well?

I gave birth at St George’s in May 2024. I also have vein insufficiency as I have Factor V Leiden and had a blood clot when I was very young.

I was happy with my birth and the care I got at St George’s. The inadequate report scared me quite a bit, and I even posted about it in this thread back in 2023. The antenatal team at St George’s took my vein sufficiency seriously and referred me to Heamatology and a vascular surgeon. I saw multiple doctors from the Heamatology department during my pregnancy, and the vascular surgeon after giving birth (this should have taken place earlier but didn’t because of queues) . I do feel like I was in the right place considering my medical history. I used blood thinners from week 6 of my pregnancy to 12 weeks after giving birth.

I was hoping to give birth in the birth centre, but due to complications at the end (unrelated to my veins) I had to be induced and give birth in delivery suite. Again, I was happy with the care I got and felt safe throughout the whole process. Even more importantly, I felt that my baby was in safe hands as the neonatal care at St George’s is exceptionally good. My baby had to be taken to intensive care for a few days after being born, and I was so happy we were at St George’s.

If we get a second baby in the future I will choose St George’s again.

With regards to guidance on birth options, this takes place quite late like the previous poster mentioned. I met with a consultant around week 35 to discuss my birth plan, considering the vein situation and blood thinners. But we had initial discussions about birth options with my midwife already early on, so I knew roughly what to expect.

Wow, I had the same choice (and concerns) over twenty years ago. I had a look at St George's and it was awful back then, so I went to Kingston which wasn't quite so grubby looking, and the care was excellent (with the exception of one sadistic cow of a nurse). I was working in St Helier and at the time and it was falling apart even then so didn't consider it. All of which is now doubt totally out of date advice now!

Hi! I had my baby in January ‘24 at St George’s and I had a good experience overall. It was a bit of a long ordeal as I was induced and ended up getting an infection and needing an emergency c section, and then was in post natal for a week after giving birth… But, despite this I was so happy with the care I received pre, during and post birth. I felt like I was in safe hands the whole time. The consultants, midwives and surgeons were great. And I was then seeing the Infant Feeding team who were also great and helped me to exclusively breastfeed, which was one of my wishes. Honestly I would choose St George’s again in a heartbeat. Don’t be discouraged by the report!

Forgot to mention, regarding your worry about vein insufficiency, I also had the birth options meeting at around 34 weeks. I also had another one with a consultant prior to that, as I had a single artery umbilical cord and also during my pregnancy there were additional checks being done on babies heart and brain (although these ended up being fine by the time I was at term). I was having so many scans and checks and all my concerns were taken seriously, so my advice would be to raise it early on.

Hi, I work in a delivery suite as a midwife (not that trust though). A few points that may be helpful:

• When are you due? I.e if you are due September, October or mid to late December these tend to be the busiest, and therefore most dangerous periods. Also, January tends to be a lot quieter, and therefore safer. Biggest danger is understaffing/more patients than staff can safely look after.

• You have the right to choose where you deliver, you can ask your CMW to refer you.

• If you presented somewhere in labour (established), it's very hard for them to justify turning you away, even if you are not booked there. So say you booked somewhere else, then there were concerns raised there, you could literally rock up at another hospitals triage.

• A lot of hospitals have some sort shit like this going on, it just hasn't been officially reported/documented. It may actually be safer than average there if you're due in a few months for 2 reasons:

1. A lot of other women moving their care - so there are fewer patients, and therefore better care.
2. Typically, a dept will get extra stringent/strict after a bad report, compared to other places, where it is bad but it just hasn't been put in an official report. Sometimes the report saying 'staffing is dangerously low' is the justification they need to the higher ups to take on more staff or issue more bank shifts. Plus, management may change, and management will typically need to show certain measures they have taken to tackle things in the report.

Plus, I also think a lot of the ways the inspections are done are pretty daft - the trust is usually told a timeframe the inspection will take place. Some things can't be fixed for an inspection, like staffing over several months, acuity scores, statistics ect - but a lot can. All inspections should be unannounced in my view, how else can they be an accurate picture?

This is so interesting and your point 2 is what my MW said had happened at Georges. The report confirmed everything the MWs had been saying to management for ages but it took the report for them to get the funding to bring in extra staff.

@alwayscrashinginthesamecar1 all three trusts still have the same reputations 🫠 and the funding for the St Helier rebuild has been pushed back to 2033 now.

. Edited to delete as just realised it was an old thread sorry OP!
!

I know this is quite an old thread but just wanted to add my experience in here of St Helier…. I totally get the building is quite ugly from the outside and not the newest!

But I had both my children here (2020 and 2023) and they were fantastic. Really impressed with the medical treatment I received - two emergency c sections, the second was a crash section and baby’s life was seriously at risk. I wrote to their PALs afterwards to thank all the staff for quick actions to save our child’s life.

I did also consider St George’s (two friends had babies there when I had dc1, one had a not great time, one had a good birth experience). Interestingly lots of mums around here pick Kingston instead but my best friend had a terrible birth there and negligence caused her to have lifelong problems from birth injuries that were preventable.

i do think you can have a good birth or bad birth in any hospital tbh and you can’t guarantee anything just by reports

Hey @Sunnyshoeshine thank you for the advice! We are expecting our first (!) EDD 09/2025. Just had a quick question regarding something you said: "I think if you live within Wandsworth itself, this wont be an issue as you will be seen in the community clinics, but it is a big issue for anyone in Merton."

We live in Merton and hence are looking at the different options available for delivery hospital-wise. I'm wanting St George's due to their availability of NICU3 albeit seeing the dodgy CQC reports! Why would it be a big issue for us from Merton to choose St George's? Thank you and congrats on the Baby!!

Hi MohssiahsBaby, just chipping in as someone who lives in Merton and had my babies at St George's, I think it very much depends on where you live in Merton. I lucked out and got assigned to the continuity of care midwife team so I saw the same midwife for most of my appointments which was great. I think in some parts of Merton you would be assigned to the out of area team which I've heard can be a bit more chaotic in terms of seeing different midwives for each appointment etc. I can't fault St George's for the care I received but I had uncomplicated pregnancies and births so was very lucky.

Hi @MohssiahsBaby, thank you and congrats on your pregnancy! What i mean by an issue is that rather than having your standard appointments at the GP or community clinic, you have to go to the main antenatal clinic at the hospital itself, I never really saw the same midwife twice and it was always running at least 45mins late 🥴 I personally felt this had a negative impact on my care in comparison to my eldest DD - for her, StG still had the Merton team, so I saw the same midwife every time at the Nelson Clinic and it was always on time and very efficient and I really felt like my MW had got to know me as a person. Apparently, some of the midwives in the main antenatal clinic are happy for you to request them each time? I did this a couple of times but I was unlucky in that two of the MWs I had also went on their own maternity leaves whilst I was pregnant. Obviously as this was my second baby, appointments are more light touch anyway so maybe they prioritise first pregnancies as seeing the same MW? But if you go ahead at Georges (which on the whole i would still recommend based on my own two experiences), it's something you could ask about at your booking appointment. To add that all the delivery midwives were absolutely amazing and if you end up being consultant led, the MW appointments are less important as you'll have continuity via your consultant.

Thank you for all of your messages ladies. I had miscarriage yesterday.

Oh yes, just on the back of @TheEarlOfGrey 's post, we are CR4 and our out of area continuity of care team was disbanded in 2023. (My first pregnancy was 2020/2021 when CR4 did still have its own continuity of care team.) If you are SW19, you could always call them before booking and ask what their system is for SW19?

So sorry for your loss @Sdfplt💐

So sorry 😔

So sorry for your loss 😢 @Sdfplt

@Sunnyshoeshine Thank you for your in-depth reply...I really appreciate the time, esp with a new baby to also take care of!!!

I will definitely request that; as a first time Dad I'm not very well clued up on the in's and outs of appointments etc side of things so just trying to do my research via these forums-which are amazing as you get genuine advice! My wife and I were looking at the reviews and were getting scared at the prospects judging by how bad some people's experiences at StG's was...hopefully things are changing as a result of the CQC. I think we will go for it but will highlight your points in our meeting! Sorry for another Q (I'm sure I'll have a lot more going forward 😬), by midwife led vs consultant led; is this in terms of the whole antenatal and birthing period and is this our choice as parents?...if yes; are there pro's and con's of each? Sorry I'm sure we will find out more info in our first appointment and maybe I am jumping the gun!!

Under NHS, you.are midwife led as default if you are low risk eg no issues. Consultant led if you are a high risk pregnancy - someone with medical needs or previous birth complications

This is a good article that explains why you might be consultant led. https://toddleabout.co.uk/parenting/midwife-vs-consultant-led-care-understanding-the-uk-maternity-system/