It comes ‘despite previous warnings’ and three years of attempts to turn things aroundThe intervention comes ‘despite previous warnings’ at the North Manchester General Hospital department(Image: ABNM Photography)

The doctors’ regulator has taken major action over ‘serious concerns’ for women’s safety at a Greater Manchester hospital’s obstetrics and gynaecology department.

The intervention comes ‘despite previous warnings’ and ‘three years’ of attempts to turn things around at the North Manchester General Hospital department, the General Medical Council (GMC) said.

The health watchdog said the standards of doctors’ training and patient safety ‘are not being met’ – ‘including failing to demonstrate a culture that investigates and learns from mistakes – despite previous warnings’.

On Thursday (June 12) the GMC hit the department with a series of conditions to order it to improve. The conditions include stopping short-staffing as doctors suffer the impacts of fatigue, high workload and missing out on vital training.

If the conditions are not met, working doctors training at the hospital could be removed, which would have a huge impact on the ability of the department to treat patients.

Professor Colin Melville, medical director and director foreducation and standards at the GMC said: “We have placed conditions on Obstetrics and Gynaecology at North Manchester General Hospital which is part of Manchester University NHS Foundation Trust to ensure long-standing concerns are addressed.

“Despite ongoing work with the trust for nearly three years, it is still not meeting the standards required, which need to be addressed as a priority. There are also concerns about the trust’s ability to meet our standards in relation to educational governance and the handover of patient care within the department.

There have been multiple legal warnings over problems at the region’s major maternity units, including North Manchester General Hospital’s(Image: Manchester Evening News)

“Our standards require training pathways to be fair for everyone to ensure effective training, trainee wellbeing and patient safety are maintained – but they are not currently being met.”

The action comes after years of safety fears about women’s healthcare in Greater Manchester. There have been multiple legal warnings over problems at the region’s major maternity units, including North Manchester General Hospital’s, because of lack of senior staff, serious shortstaffing, delays in care and slammed telephone services.

Health watchdog reports in recent years have revealed that mothers and babies have been left at risk and harmed because of demand far outstripping capacity.

The GMC, which is responsible for ensuring the quality of medical training, says it already subjected the department to a process called ‘enhanced monitoring’ back in November 2022. That enhanced monitoring is the way the GMC ensures organisations address serious concerns about training.

But ‘satisfactory progress’ has not been made, instructed the regulator. The regulator has now put conditions on its approval of the hospital’s training programme.

‘The conditions are designed to ensure standards can be met on a sustainable basis, and that patient safety and trainee wellbeing is maintained,’ says the GMC. ‘Ultimately, if conditions are not met, trainees can be removed from the site.’

The conditions include that every weekly doctor-in-training rota must be reviewed, agreed and signed-off by a senior leader before it is distributed.

That is to ensure it ‘accurately reflects’ day-to-day demand versus workforce capacity in the department, and to minimise gaps in rotas so doctors do not suffer as much fatigue, high workload, and do not miss out on crucial training.

“Where gaps exist, they need to be recorded and monitored and any missed sessions should be re-rostered as soon as practicably possible,” added the GMC.

Another condition is that ‘protected time must be incorporated into rota planning’ to ensure doctors in training are regularly getting experience in general and specialist clinics in obstetrics and gynaecology to meet the requirements of their curriculum and training programme.

The final condition on the hospital is that doctors-in-training must be given fair access to gynaecology sessions and operations to meet the requirements of their curriculum and training programme.

When doctors cannot get those opportunities, it must be recorded and monitored. Any missed sessions should be rescheduled as soon as possible, says the GMC.

The GMC said that NHS England will ‘work closely with the trust to provide evidence to the GMC that conditions are being met’. The regulator says it will be speaking directly to doctors in training in obstetrics and gynaecology to ensure progress is made.

Manchester University NHS Foundation Trust, which runs North Manchester General Hospital, has said: “We are committed to providing excellent training programmes across our hospitals to help develop the next generation of healthcare professionals.

“An important part of this is listening and responding to what our resident doctors tell us about their experiences. Whilst we have made some improvements to the programme at North Manchester General Hospital, we absolutely recognise that there is more to do.

“We acknowledge the conditions now attached to our obstetrics and gynaecology postgraduate programme at North Manchester General Hospital and will continue to work closely with our resident doctors, as well as the GMC and NHS England, to make the necessary improvements in a timely manner.”