Maternity care downgraded amid staff shortages

Staff shortages at a busy maternity unit left some women facing long delays and unable to give birth where they chose, inspectors found.

The Care Quality Commission (CQC) downgraded maternity care at Queen Alexandra (QA) Hospital in Portsmouth from "good" to "requires improvement".

Inspectors said the QA unit was under high pressure on 267 days in a year, with some women waiting more than six hours to start induction and others sent elsewhere.

Portsmouth Hospitals University NHS Trust chief executive Penny Emerit said it is "determined to address the issues raised".

Also included in the inspection were birth centres at St Mary's Community Health Campus, also in Portsmouth, and Gosport War Memorial Hospital.

Catherine Campbell, a deputy director at the CQC, said while "women's day-to-day experiences of kindness often remained strong, the systems underpinning those experiences weren't keeping pace".

She said staffing shortages and operational pressures were having a "significant impact" on women's care and the choices available to them.

Inspectors, who visited in March, found five breaches of regulations across the three sites, including a repeat failure to make sure staff were trained in safeguarding.

Across the trust's maternity services, only 29% of doctors were up to date with their safeguarding training.

The QA unit reached "extreme pressure" four times in the year, including during the inspection itself, when it diverted new admissions to other hospitals.

In March alone, 17 women waited more than six hours for their induction to start, while 17 were sent to neighbouring trusts for inductions over six months.

Midwife numbers were often below planned levels, and staff sickness was at times more than three times the expected rate, the CQC said.

Inspectors also found long-running poor behaviour from some senior staff on the labour ward, with some newer midwives saying they felt unable to raise concerns or ask these colleagues for help.

Efforts to address it had not led to any improvement, the report said.

The trust's two birth centres rely on midwives being released from QA to deliver babies, which inspectors found was often not possible.

Just 22 babies were born across the two centres in the 18 months before the inspection, and neither had recorded a birth since June 2025.

At Gosport, 25 women who asked to give birth at the centre were turned away over an 18-month period, while at St Mary's one woman in active labour was taken to QA by ambulance.

However, inspectors praised staff for treating women with kindness and compassion.

After holding a listening event with Muslim women, the trust also began offering female obstetricians on request.

Following the inspection, the trust said it had reviewed its safety checklists and would begin monitoring how many women were unable to give birth at their chosen location.

The CQC has told the trust to submit a plan showing how it will make improvements.

Emerit, who is also the chief executive of the Isle of Wight NHS Trust, said: "We already have improvement plans in place, and we will continue to work with women, birthing people, families and our staff to ensure these are implemented and fully reflect the improvements we need to make.

"I would like to thank our staff for their commitment and for the care they continue to provide.

"Our focus continues to be on ensuring our women and families have a positive experience and receive the best possible care."