Many NHS trusts failing to report number of C-sections despite dangers raised in Ockenden report

·3-min read
Donna Ockenden, the midwife who chaired the review into the Shrewsbury and Telford Hospital NHS Trust, said “mothers must have the ability to scrutinise maternity data' - Jacob King/PA
Donna Ockenden, the midwife who chaired the review into the Shrewsbury and Telford Hospital NHS Trust, said “mothers must have the ability to scrutinise maternity data' - Jacob King/PA

Almost a fifth of trusts are failing to report caesarean section data, it has emerged, as the midwife behind a landmark maternity report warned mothers must be able to “scrutinise” the figures.

Donna Ockenden’s review into the Shrewsbury and Telford Hospital NHS Trust (SaTH) found that more than 200 babies and nine mothers would have survived if not for the failings of the trust.

SaTH’s caesarean section (c-section) rate was lower than the national average, something the trust was “proud of”, but it ultimately harmed some mothers and babies, the review found.

NHS trusts are mandated to report birth data, including methods of delivery, to the Maternity Services Dataset (MSDS), which is presented on a public dashboard via NHS Digital.

But, analysis by The Telegraph found almost a fifth of trusts (23 out of 121) have significant proportions of data missing for 2021.

Missing data

North Middlesex University Hospital NHS Foundation Trust has data missing for every month of 2021, except December.

Yeovil District Hospital NHS Foundation Trust has data missing from January to August, while almost a quarter (23 per cent) of Portsmouth Hospitals University NHS Trust’s data was missing in February.

Royal Free London NHS Foundation Trust has data missing in every month of 2021.

When asked why their data was missing, a majority of the trusts said they had submitted the figures, but “technical issues” between their systems and NHS Digital’s central platform meant it was not pulling through.

Trusts are required to submit data in a specific format that complies with NHS Digital's platform, it is understood.

Some, including Surrey and Sussex Healthcare NHS Trust, said they regularly publish their maternity figures via their social media channels or trust websites.

Right to see the figures

But Donna Ockenden, the senior midwife who chaired the review, said: “Mothers must have the ability to scrutinise maternity data for themselves if they wish.

“Only through maternity services having complete and accurate data can we be assured that women are truly able to make an informed choice.”

Jeremy Hunt, who commissioned the Ockenden review as Health Secretary in 2017, said: “Transparent and timely access to this data is vital to help support women’s choices.

“In the wake of Ockenden, expectant mothers need to know that all trusts are offering c-sections where it’s the safest option with no ideological preference for ‘natural births’.”

Richard Stanton and Rhiannon Davies, whose daughter Kate died six hours after she was born at SaTH in 2009 following a series of failings by midwives, criticised the poor data.

Accurate comparisons

Ms Davies said: “It shouldn't be down to individual families to have to wade through impenetrable or missing data to try and join the dots.”

In 2020-21, the most up-to-date annual figures, 33.5 per cent of all births in England were c-sections.

There is no suggestion the 23 trusts have low c-section rates, but due to the missing data on the dashboard it is not possible to create accurate comparisons.

An NHS Digital spokesperson said it works closely with providers to support data submissions and resolve any issues.

An NHS spokesperson said: “It is important that every pregnant woman and her maternity team are able to discuss and assess the risks and benefits of each delivery method and Trusts have an obligation to report the data on delivery method centrally.”

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