The story behind the NHS’s largest maternity study

The maternity wards at Nottingham’s two main NHS hospitals are among the most troubled and controversial in the UK.

Hundreds of babies have died or been injured while in the care of Nottingham University Hospitals (NUH) NHS Trust, which runs departments at City Hospital and Queen’s Medical Centre.

The units, which have been deemed inadequate, are currently the subject of the largest investigation of their kind in the history of the NHS.

The NHS already has paid more than £100 million due to the failures of these centres between 2006 and 2023.

One of the first families to raise the alarm was that of Jack and Sarah Hawkins, whose daughter Harriet died in the womb at the city’s hospital in April 2016.

Dr and Mrs Hawkins, who both worked for the facility, did not accept a hospital report that found “no obvious wrongdoing” and said their child died of an infection.

The couple pushed for an external review, which began four months later.

Published in January 2018, it 13 failures were found and concluded that the death was “almost certainly preventable.”

That same year, midwives at the facility wrote a letter that would later form part of an inquest into the death of another baby, Wynter Andrews.

She died 23 minutes after being delivered by cesarean section in September 2019.

When surveyed the following year, the assistant Coroner Laurinda Bower said Wynter’s parents, Sarah and Gary, said his death was “a clear and obvious case of neglect”.

Ms Bower cited the 2018 letter from the unit’s midwives to NUH leaders, which highlighted concerns about staffing levels as “the cause of potential disaster”.

In December 2020, two months after the Wynter investigation, the facility’s maternity services were deemed inadequate by healthcare watchdog the Care Quality Commission (CQC).

The report found that some staff had not received training in key skills and “did not always understand how to keep women and babies safe”.

Inspectors added that there was “little evidence that managers monitored the effectiveness of care and treatment and encouraged improvement”.

This prompted the Andrews and Hawkins families to call for a public inquiry.

Calls increased in July 2021, when Channel 4 News and the Independent reported that 46 babies suffered brain injuries and 19 were stillborn at the facility between 2010 and 2020.

Plans for an evaluation, led by the local clinical commissioning group (CCG) and NHS England, were announced that month with the intention of reporting by November 2022.

By March 2022, he had been in contact with nearly 400 families, but had already been criticised by campaigners for what they saw as a lack of independence, experience and “movement with society”. viscosity of molasses“.

It was at this point that the families asked Donna Ockenden to take charge of a completely independent investigation.

Ms Ockenden had just completed an investigation into what was, at the time, the UK’s biggest maternity scandal, at the Shrewsbury and Telford NHS Trust.

His appointment was confirmed in July 2022, and the review of the care provided by the establishment was launched in September of the same year.

By July 2023, the review had become the largest in the UKwith the cases of 1,700 families to be examined.

In September of that year, Nottinghamshire Police launched its own investigation in chess.

A few days later, the CQC announcement that maternity units had been modernized from inadequate to needs improvement.

The following month, some families joined calls for a national maternity survey.

At the time, Dr Hawkins said: “We have had repeated requests and it’s the same issues that keep coming up.

“There is a fundamental problem with maternity services in this country.

“We have to understand that. Right now, it feels like you can do horrible damage to someone’s family and not really realize it, it doesn’t matter.”

The £101 million in compensation and legal fees paid out over maternity failures were revealed in February.

The payments covered 134 cases, including one family whose son had cerebral palsy who fought for 10 years to win an initial £6m award and annual payments thereafter.

The NHS has paid 22 cerebral palsy cases to NUH, totalling £53.1m in legal fees and damages over the past 17 years.

Stillbirth was the second highest figure at £4.6 million, followed by successful claims for bowel injuries (£3.4 million), bladder injuries (£2.2 million) and death (£1.9 million).

Dr and Mrs Hawkins were awarded £2.8 million – the largest compensation in a stillbirth clinical negligence claim in NHS history, five years after Harriet’s death.

NUH also received a £800,000 fine – the largest ever awarded to an NHS organisation for maternity care – by magistrates in January 2023 after admitting failings following the death of Wynter Andrews.

In May of this year, the the scope of the review has been expanded from the examination of stillbirths, neonatal deaths, injured babies and mothers and maternal deaths, to antenatal care – all of mothers’ contacts with maternity services up until the birth of their children.

The assessment team is currently reviewing the cases of approximately 2,000 families and a final report is not expected until September 2025.

Speaking after attending an all-party parliamentary group on birth trauma in May, Ms Ockenden said: “I listened to some of the testimony from across the country and it was extremely poignant.

“Frankly, we can’t keep coming out with report after report of glowing words saying that things are going to get better, that we have to do better.”

The institution’s leaders have repeatedly apologised for their failings, with chief executive Anthony May saying he was committed to “transparent and full engagement” and improvements in “staffing levels, training and compliance” within the department.

However, concerns remain.

Ms Ockenden told the BBC earlier this month that improvements had “stalled”, saying the trust needed to “get back on track” after an unannounced CQC inspection in June.

In response, Mr May said the trust would “address the issues identified by Donna and the CQC”.

“I am confident that our maternity services are adequately staffed and that we have effective monitoring systems in place,” he said. “At the same time, I am committed to ensuring that we have sufficient resources to provide safe and effective care.”

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