Insights into the Nottingham Maternity Scandal following the Trust’s Annual Public Meeting

Members of the Freeths Clinical Negligence team in Nottingham attended the Nottingham University Hospitals NHS Trust Annual Public Meeting, held on 18 September 2024. The focus of the meeting was to consider the significant changes made to the maternity services in Nottingham, the ongoing independent review, and what was still to be done.

It was aimed at showing what needed to be done to improve the quality of care for expectant mothers and their families. However, it was also an opportunity for the Trust to acknowledge past failures and the impact these have had on the local community.

The Trust admitted that they had failed the local community by not providing clear communication around the issues within maternity services previously, and that this lack of transparency has sadly worsened the situation for many families who were already dealing with significant distress.

Donna Ockenden, Chair of the Independent Review of Maternity Services at NUH, spoke at length about the review process and the ongoing efforts to improve maternity care. She highlighted the bravery of the families who called for the review over many years, particularly following the avoidable death of Harriet Hawkins in 2016.

In her speech, Ms Ockenden noted the key statistics with the ongoing review as follows:

• Review Team: The review team consists of over 100 experienced doctors and midwives.
• Timeline:
• The review was initially considered due to concerns first raised by families in 2016.
• Donna Ockenden was appointed as chair in May 2022.
• The review officially started on 1 September 2022.
• 1,200 letters were sent out to families in September 2023.
• The decision to switch to the “opt-out” process started in Autumn 2023 to ensure no families were missed.
• Collaboration: Ms Ockenden is working closely with Anthony May, NUH Chief Executive.
• Scope of Review: The review covers a five categories of concerns: stillbirths from 24 weeks’ gestation, neonatal deaths from 24 weeks old, babies who have sadly suffered HIE (hypoxic ischaemia / brain injuries due to lack of oxygen), severe maternal harm, and maternal death.
• Engagement: The review has had contact with 1,941 families as part of the review, as well as a further 442 families who are not included within the scope of the review itself. As well as this, 789 members of Nottingham University Hospitals Trust staff have engaged with the review, which is significantly more than was the case in the previous Shrewsbury review. This is a very positive step forward to ensuring real change.
• Psychological Support: The review is working with the Family Psychological Support Service to assist families with the psychological impact of their experience, having referred 333 families to date.

Donna Ockenden went on to discuss the key themes which she has noticed to be arising from the review. The key issues she noted were as follows:

• Culture: Issues surrounding the culture within maternity services were flagged, in particular noting - failures by staff to believe women, staff being afraid to speak out in relation to issues, a failure to obtain properly informed consent, and issues of bullying and cliques between staff members.
• Timely Response: Issues surrounding staff acting within a timely manner were noted, including - delays in providing medical records, poor complaint responses, and protracted investigations.
• Discriminatory Behaviours: Issues surrounding discrimination have sadly been noted, including - families feeling as though they have been treated differently based on race, staff experiencing microaggressions themselves, and a lack of clarity within the pre and post natal period and during complaints procedures for non-English speakers.

Improvements and Ongoing Efforts

Anthony May, NUH Chief Executive, spoke about the improvements which had already been made and the ongoing efforts which are continuing to enhance the maternity services. He noted the following key points:

• Maternity Improvement Programme: this has been put in place but the Trust and enhanced by Donna Ockenden’s feedback from the families. The Trust have used this to help create safer services, with the key improvement to date being better triaging processes, which the Trist have seen to result in fewer safety incidents.
• Inclusion: the Trust are working on ensuring that their services emphasise equal and inclusive access for everyone.
• CQC Rating: this has been improved from inadequate to requires improvement in September 2023, with ongoing efforts to further enhance this rating further.
• Commitments: Anthony May launched new commitments today, including continued psychological support to families even after the review has concluded, making a formal apology with the help of the campaigning families once the review has been published, taking accountability for what has happened to date, and improving the family liaison services to make a horrible process more bearable for those who have to use it.

The changes which have been made to the maternity services at Nottingham University Hospitals NHS Trust to date are a testament to both the families who have come forward and to Donna Ockenden’s review team in really pushing forward and highlighting the issues that have been ingrained in the service for so long. Now, the Trust’s acknowledgment of past failures and their ongoing efforts to engage with families and staff are positive steps towards rebuilding trust and ensuring a safer, more supportive environment for childbirth.

As clinical negligence lawyers we have been contacted and represent an increasing number of families and children who have suffered or have lost loved ones as a result of failures in maternity care during labour and birth. These claims seek to ensure that any child who has suffered a preventable injury can access the services they require such as care, therapy, aids and equipment, and suitably adapted accommodation which may assist them during their lives.

For those who have sadly suffered loss we can help to secure support and therapy to help those suffering to come to terms with these devastating events. We can also help secure an apology from the Trust responsible and seek to ensure the same mistakes are not made again.