Midwives at an NHS trust were told to work double shifts without sleep, leaving them awake for more than 24 hours, according to a new inspection report.The Care Quality Commission (CQC) found that Oxford University Hospitals NHS Foundation Trust, specifically the John Radcliffe Hospital, was failing to triage pregnant women promptly and inaccurately reporting delays to induction of labour as incidents.Inspectors highlighted that staff were being asked to work dangerously long shifts. Community midwives "raised concerns about the on-call system because there were times when they were called to work a 12-hour night shift after working a day shift." The CQC report revealed managers were redeploying community staff to cover hospital shifts overnight during busy periods, leading to "extended periods without rest" for some healthcare professionals.John Radcliffe Hospital in Oxford was failing to triage pregnant women promptly and inaccurately reporting delays to induction of labour as incidents (PA Archive)It added: “Staff told us this meant they were awake for more than 24 hours, which they felt impacted their wellbeing and patient safety.“This posed a risk as evidence shows that fatigue can cause mistakes that lead to harm.“Following our inspection feedback the trust provided assurance that community midwives called to cover the unit should only be called for a four-hour period and if the shift occurs after midnight the midwife is entitled to a compensatory rest period the following day.”Leaders at the hospital were also not reporting all delays in induction of labour as incidents, recording only 32 cases, even though 206 delays over 24 hours were identified as “red flags” according to watchdog rules.The hospital was not treating all “red flags” as meeting the threshold for incident reporting, inspectors said.They added: “Staff did not triage women within the nationally recommended 15-minute timeframe, with only 36 per cent assessed on time, leading to delays and an increased risk of undetected deterioration.”On the day of the inspection, the area was very busy and one woman left the unit before being seen.The inspectors further said leaders failed to ensure adequate staffing and capacity, resulting in bereaved women being cared for in environments that did not meet required standards for privacy or dignity.Despite this, the CQC rated the overall maternity unit, and another at Horton General Hospital run by the trust, as ‘good’, up from ‘requires improvement’ before.The CQC report revealed managers were redeploying community staff to cover hospital shifts overnight during busy periods (AFP/Getty)At the John Radcliffe, the safety of maternity services was rated as requires improvement.Amanda Williams, CQC deputy director of hospitals, secondary and specialist care for the South East, said: “When we inspected maternity services at both John Radcliffe and Horton General hospitals, it was encouraging to see that some improvements had been made.“We found services being delivered by caring and supportive staff who treated women as individuals, involving them in decisions about their care.”However, she added that “John Radcliffe was a busy unit operating under significant pressure, and systems to keep women and their babies safe didn’t always work consistently well under that pressure”.“As a result, women weren’t always triaged in a timely way and staff didn’t always have a line of sight to observe women at high risk,” she said.“While medical cover between 7pm and 8am was provided by the on-call team, there was no dedicated cover on the maternity assessment unit. We saw one woman leave without being seen as a result.“At Horton, we found some of the same issues we flagged at our previous inspection. However, leadership had full oversight of the issues we had identified previously and were on a journey of improvement.“Leaders acknowledged areas for improvement across both hospitals and knew they needed to tackle and embed them with more urgency.“Staff should be proud of the progress they’re making, and we will continue to monitor the trust to make sure women and their babies are safe while these improvements take place.”Simon Crowther, interim chief executive officer at the trust, said: “We take these findings very seriously and we have already begun work to address them.“It is important that we tackle these areas with urgency and embed the changes needed to build on the progress which has been made.“We remain committed to driving further improvement and will continue to work closely with women, families, staff and partner organisations to deliver the safe, high-quality care that our service users, families and communities deserve.“Thank you to all colleagues who have been, and will continue to be, part of this journey.”