Gloucestershire hospitals have been warned a second time about failings in their maternity services.

The Care Quality Commission (CQC) said improvements had been made at Gloucestershire Royal and Cheltenham General Hospitals since a previous inspection.

However, it re-issued a warning notice in relation to safeguarding training and processes in maternity services.

The same warning was issued in April 2022 when the service was rated as 'inadequate'.

It found staff were still not all receiving the full remit of safety training and incidents were not always investigated in a timely way, which delayed the outcome and opportunity for learning to be shared.

Lisa Stephens, interim director of midwifery, said: "On occasions we've had to prioritise patient care over these."

She said the trust would continue to "invest heavily" in the service and work closely with regulators and advisory teams to provide care they could be proud of.

She added: "The challenges across midwifery nationally are well documented and there is no doubt that these are difficult times across the profession."

Inspectors said staff had worked hard to make sure the majority of women experienced 1 to 1 care in labour which is crucial to their safety.

They said risks to women were identified and acted on and waiting times in maternity triage had improved.

The CQC report was published today (Nov 10) following a focused inspection of surgical and maternity services in April 2023.

It identifies a number of positive changes since its last inspection in April 2022.

It found outstanding practice in relation to patient safety and quality of care, alongside an acknowledgement of the pride and hard work shown by the teams.

It said the surgical department had met the requirements of its warning notice issued last year.

Margaret Coyle, chief of service for the surgical division and consultant oral and maxillofacial surgeon, said: "We have always been confident about the level of care we've provided and it's encouraging to see this reflected by the inspection team who've described some of our practice as outstanding.

"That's testament to the hard work of the team."

Deborah Lee, CEO of Gloucestershire Hospitals NHS Foundation Trust, said: "Currently, our outcomes across surgery and maternity remain in line with other centres nationally and are better in some areas.

"We are determined that this report will provide further momentum and impetus to address the issues identified and are working harder than ever to engage and involve our frontline colleagues in finding solutions to our challenges."

She announced in April she would be stepping down from her role in March 2024 after seven years at the helm. Her replacement has not yet been announced.

The CQC did not issue new ratings so surgery remains as 'requires improvement, maternity remains as 'inadequate' and overall the Trust remains as 'requires improvement.'

Ms Lee said: "Overall this is a positive outcome which indicates some of the progress we have made over the last year or so.

"It also demonstrates the journey we are on and the trajectory that the team have put us on.

"That's particularly important given the context of health and care provision over the last few years."

The Trust expects the CQC to re-inspect services again in the near future and will be working with its colleagues and partners to obtain an improved overall rating.

The full reports are available on the Trust's website.