Shrewsbury and Telford Hospital NHS Trust has again been rated inadequate despite inspectors identifying improvements to care, including outstanding practice among midwifery staff.

The Care Quality Commission (CQC) said it had found “some progress” at the trust, which was heavily criticised last year in an independent report by former senior midwife Donna Ockenden.

The report, published last December, said “one of the most disappointing and deeply worrying themes” was the “reported lack of kindness and compassion from some members of the maternity team at the trust”.

The CQC conducted unannounced inspections of services at the Royal Shrewsbury Hospital and Telford’s Princess Royal Hospital, including urgent and emergency care, medical care, as well as end-of-life and maternity services.

Following the inspection, the trust has been rated inadequate overall, meaning it has had the same rating following each CQC inspection since 2018.

The trust was rated inadequate again for being safe and responsive to people’s needs and requires improvement for being caring.

It has been rated requires improvement for being effective and well-led, which represents progress on its previous inadequate ratings for these performance measures.

The report also stated: “We found the following outstanding practice: Midwifery staff showed immense levels of resilience as they were able to continue to provide high levels of care to women and babies and maintained a positive and caring attitude during extremely challenging circumstances.

“The maternity department was under considerable scrutiny following the publication of the first Ockenden review (independent review of maternity services) and during the Covid-19 pandemic. This was in addition to the maternity service’s ongoing challenges with the stability of the senior maternity leadership team which further impacted on staff.”

The inspectors’ assessment of maternity care at the Princess Royal Hospital found a shortage of midwives worsened the pressure the service faced, but “recognised the exceptionally dedicated and caring approach of its staff, despite being under considerable scrutiny, which benefited both new mothers and babies”.

Improvement was seen in urgent and emergency care, the report said, particularly at the Princess Royal Hospital, where improved staffing arrangements and collaborative working between teams supported people to have better outcomes compared to findings from previous inspections.

Commenting on the latest report, Ted Baker, CQC chief inspector of hospitals, said: “I recognise the enormous pressure NHS services are under across the country and that usual expectations cannot always be maintained, but it is important they do all they can to mitigate risks to patient safety while facing these pressures.

“Despite these pressures, the trust has made progress. It has benefited from more effective leadership that has helped drive improvements, and it has a much better understanding of the challenges it faces.

“While the trust continues to have significant work to do to provide care that meets standards people have a right to expect, it is providing more effective care overall.

“However, its risk management remains inconsistent and we are not assured it is doing all it can to ensure people’s safety.

“This is particularly concerning in urgent and emergency care at the Royal Shrewsbury Hospital, where people did not always receive timely assessment to identify their needs, meaning staff were not aware whether people needed urgent treatment or not.

“The trust understands what it must do to improve, and we will continue to monitor its progress.”

In a response to the report, trust chief executive Louise Barnett said: “In incredibly difficult circumstances, progress has been made in key areas and much has been done to improve the way we work and deliver care.

“The whole team here have shown enormous dedication and commitment and I want to thank them for their exceptionally hard work to bring about these positive changes.

“However, the report also reinforces the amount there is still to do on the trust’s improvement journey. We are determined to build on this progress and use this, and the report, as a stepping stone to provide excellent care across all our services for patients and families in our communities.”