'Serious concern' black and ethnic minority women treated differently at Wales' biggest hospital

Inspectors say they were "seriously concerned" to find evidence that some Black, Asian and Minority Ethnic women felt they were being treated differently.

There is 'serious concern' that Black, Asian and ethnic minority women are being treated differently at Wales' largest hospital.

A report released on Wednesday by Health Inspectorate Wales said the maternity department at the University Hospital of Wales in Cardiff needs "urgent improvement".

Inspectors said they found "several patient safety concerns", including the feeling from some black, Asian, and ethnic minority women that they were being treated differently.

  • Evelyn James, Campaign Manager at Women's Equality Network described this finding as "appalling".

"For someone to be treated otherwise, other than a human at that point, it's appalling, it's something that shouldn't even be thought of, it's inhuman." She said.

"It breaks my heart that we're still talking about this issue till today, it's decades and decades now and we shouldn't be at this point anymore."

A spokesperson for The Birth Partner Project, an organisation which provides volunteer birth partners to support refugee and asylum seeker women, said they find the report 'deeply concerning'.

"It is yet another report highlighting racial disparities in maternal and neonatal outcomes." They said.  

"As an organisation that works with displaced women and birthing people from ethnic minorities, we are fully aware of the barriers and discrimination that families face accessing maternity care in Wales.

They added: "We want to work closely with the health board and Welsh Government to address these issues and improve outcomes for these families."

The health board have since implemented a number of initiatives to improve patients experiences.

The report was released following an expectation which was carried out in March this year, after an unannounced inspection took place in November 2022 which found  "several patient safety concerns".

What did inspectors find?

  • Patients were not consistently receiving an acceptable standard of timely, safe, and effective care

  • Low staffing levels in the maternity unit and low morale amongst some staff

  • Significant concerns around infection prevention

  • Medicine not being stored securely

  • Visibly dirty theatre and treatment areas

  • Insufficient plans in place to protect the safety and dignity of patients

  • Insufficient management and security of confidential patient information

Patients were not consistently receiving an acceptable standard of timely, safe, and effective care, inspectors said. Credit: PA Images

Inspectors said the maternity unit had experienced a sustained period of low staffing levels and subsequently low morale amongst some staff.

However, they praised many staff members saying they went above and beyond to ensure that their patients were well cared for.

Inspectors said overall they were concerned that the culture of governance was not supportive and did not adequately promote accountability and safe patient care.

Responding to the report, a spokesperson for The National Childbirth Trust said: "It is imperative to listen and learn from all women’s experiences in the maternity system. 

"We know that the role of racism is underestimated in how Black pregnant women are treated, and there are poorer health outcomes for Black, Asian and other ethnic minority women.  We fully support the recommendation in the report for further work to support these women.   

“Some women felt they were not listened to or provided with the same level of information or care. It is clear that staffing shortages are contributing to the quality of care all pregnant women receive. The Welsh government must take immediate action to invest in the maternity workforce, so that women have access to safe and equitable care.” 

The health board said it accepts the findings of the report in full and has taken action since.

Alun Jones, Chief Executive of Healthcare Inspectorate Wales said: "Our work has highlighted significant challenges within the maternity services at Cardiff and Vale University Health Board.

"Whilst there were some improvements identified during our return inspection in March, the scale of issues and pace of change was not sufficient and as a result further urgent action was required.

"I hope this report will accelerate the measures taken to drive forward timely improvements for not only expectant and new mothers but also staff within the maternity unit.

"We will be working with the health board to ensure robust improvements are made and evidenced.”

Abigail Holmes, Director of Midwifery said: “The Health Board accepts the findings of the Healthcare Inspectorate Wales report in full and we have taken necessary action to address all immediate concerns outlined.

"We would like to reassure the community that providing safe, effective and inclusive care to all women and birthing people is always our paramount priority. We remain fully committed to delivering the very best care possible and all findings will be used to make positive improvements.

"We have invested more than £2 million to improve recruitment and resources across maternity services within Cardiff and the Vale of Glamorgan.

“As a Health Board, we place the highest priority on cleanliness and hygiene and we are disappointed that on occasion, some areas have not met our high standards. Following the inspections, we took immediate action to resolve this and have developed a robust action plan to ensure these levels are maintained.

“Whilst we experience challenges with the aged infrastructure at the University Hospital of Wales, we would like to reassure our patients and the wider community that we are working hard to identify ways of mitigating these challenges and ensure we are equipped to deliver modern healthcare in a modern environment.”

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