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Improvements required at Nottingham maternity hospital after being rated inadequate overall
Maternity units at Nottingham University Hospitals trust are now under review after dozens of babies died and have been rated inadequate by the health watchdog since 2020.
The Care Quality Commission (CQC) made an unannounced inspection of the Nottingham City Hospital maternity unit at the beginning of March and the CQC published its report on Friday. The service is still rated as 'inadequate' nased on a number of issues.
The most concerning issues are that a basic safe level of staffing is still missing (as the report states “The service did not have enough staff to care for women and keep them safe”); the level of training is still poor (“Not all staff had training in key skills” and “not all staff received and kept up to date with their mandatory training”); and the standard of triage of women arriving on the unit is still poor and in fact has been deteriorating.
The review was launched following dozens of baby deaths and injuries but has faced sustained criticism from families and campaigners. They said its remit was too narrow and it was not independent enough. Many also felt the locally-based inquiry team had neither the experience nor independence to deal with such a large-scale issue.
Now NHS England has confirmed Donna Ockenden, who led an inquiry into maternity failings in Shropshire, is to chair the review of services in Nottingham with new terms of reference. Gill Edwards continues:
Some families have expressed relief at the announcement that Donna Ockenden, Senior Midwife, will be Chair of the new independent review into maternity services at Nottingham University University Hospitals NHS Trust. Families who have been affected by the poor maternity care in Nottingham say that they have trust in her to look into the issues thoroughly.
When a woman arrives in the maternity unit, she has every right to expect that she and her baby will receive advice and safe care within a reasonable time. The midwife is expected to place her in a triage category to determine the urgency with which the mother should be assessed. Worryingly, the CQC reported that in December 2021, 14% of women had not been given a triage category within 15 minutes of arriving at the hospital, and this increased to 20% in January 2022 and 39% by February 2022. The Trust has still not done enough to improve this and so the CQC has issued an enforcement notice against them to make “significant and immediate improvements” to ensure that action is taken to prevent the risk of harm to women and babies.
Families who suffered at Nottingham Hospital say they're not surprised the trust is involved in a scandal over baby deaths, nor that it is still rated inadequate after all this time.
One family at the heart of this terrible scandal is Sarah Hawkins and her husband Jack whose baby daughter, Harriet, sadly died at Nottingham University Hospitals NHS Trust in April 2016 after Sarah was in labour for six days.
The latest report from Nottingham is devastating for those families who have spoken out for years about their own experiences, but also deeply concerning for those families in the area who are embarking on pregnancy and childbirth and are looking for safe care.
The independent review cannot come soon enough. Some of the poor care in Nottingham which will be reviewed by Donna Ockenden took place as long ago as 2016. The same issues appear again and again in maternity units. If only Trusts were open with families from the outset, improvements could be implemented sooner, and fewer mothers and babies would have been injured. Instead of focusing on how to save the NHS money by curtailing the ability of families to investigate poor care through civil claims, the government should be ploughing money into training, recruiting and retaining maternity staff, providing them with the training budgets and salaries that reflect the importance of their role in society and the level of responsibility they carry.
Gill Edwards is a Partner in clinical negligence here at Potter Rees Dolan. Should you have any queries about the maternity review, birth injuries or indeed any other aspect of clinical negligence and wish to speak to Gill or any other member of the team, please contact us on 0800 027 2557 or contact Gill directly.