Progress in Nottingham maternity services has stalled, review chair Donna Ockenden fears

The chair of an independent review into maternity failings across Nottingham says she fears progress being made at city hospitals has stalled. Nottingham University Hospitals (NUH) is subject to the largest maternity review in NHS history following hundreds of baby deaths and injuries, with almost 2,000 families' cases being included.

Its chair, experienced midwife Donna Ockenden, said she had met with "hundreds and hundreds" of families and had heard "really concerning, very recent" themes. This, it's said, includes women still not being believed when they say they are in labour or in pain and a "lack of kindness and compassion" from staff.

She said there was "extremely poor hygiene" on some of the wards across the Queen's Medical Centre and City Hospital, with one family who had lost their baby being put in a room where a bed still had blood on it. "They were shown into a room where the bed had clearly previously been slept in, where there was blood stained matter from previous patients and dirty toilets," she said.

Families wishing to contact the independent review can do so by emailing nottsreview@donnaockenden.com or by filling out an online form here

“To be presented with that in a Nottingham hospital is just not acceptable." She said NUH had stepped up its cleaning monitoring on the wards.

“My concern as I sit here today is they have undeniably made progress but I have a real fear in the back of my mind that that progress may have stalled," she said. “What I’m finding is a sense I am repeating myself over and over again, the issues around racism and discrimination are still coming up."

Ms Ockenden said NUH had also wrongly closed the cases of a small number of women who are in need of "immediate answers" from the review. She said the trust told her some of the women who require continuing healthcare said they did not want the treatment.

“It didn’t ring true so we went back to those women and they said they hadn’t said they didn’t want the treatment," she said. "There were issues with communication, some cases where women were told there was an extremely long wait and a case where a very vulnerable woman was shouted at over the phone."

Officials at NUH said it was concerning Ms Ockenden had said progress had appeared to stall. Chief executive Anthony May said he was confident the trust was making improvements in a number of areas and that the trust would respond to the issues raised.

An inspection by the Care Quality Commission (CQC) carried out last month found an "insufficient" level of staffing across both hospitals. The health watchdog's visit was prompted by staff who raised concerns about the lack of qualified and experienced workers, Ms Ockdenden said.

The midwife said the level of exhaustion among the workforce is "huge" due to understaffing, with one of the 750 staff who are in touch with the review telling her: “We want to give good care, we’re tired, we’re on our knees but we’re doing our best and we do care."

Ms Ockenden said the trust is highly dependent on newly qualified midwives, and described the skill mix as poor and the service still "very cliquey". She added there was a lack of support for newly qualified midwives and poor visibility from leadership teams.

Anthony May, chief executive at NUH, said: “It is concerning to me that Donna Ockenden is describing stalled progress. I met with Donna earlier this week to talk through her concerns and how we are addressing them. We have a comprehensive maternity improvement plan in place and it is important that we continue to incorporate Donna’s feedback into the plan.

“We have been meeting with Donna regularly for some time now, and I am grateful for the feedback Donna is able to give us as a direct result of her engagement with women, families and staff. Clearly, whilst some of what Donna shares is difficult to hear, it is important for us to listen carefully and to respond quickly.

“I am confident we are improving in a number of areas. The feedback we are getting from mothers using the services now is encouraging. This was reinforced recently by the CQC when they gave us high level messages from the latest inspections of maternity services. These messages are supported by the June 2024 Friends and Family test in maternity where 98% of patients reported positive experiences. We have brought in key new leadership roles in recent months and I am confident this will have a positive impact.

“We will respond to the issues identified by both Donna and the CQC. We have taken a number of direct actions in relation to the comments made around staff mix and visibility and will continue to monitor progress closely. I am confident that our maternity services are properly staffed and that we have effective monitoring systems in place. At the same time, I am committed to ensuring we have sufficient resources in place to maintain safe and effective care.”

The last full CQC inspection report into maternity, published last September, found improvements across NUH, resulting in the rating moving from 'inadequate' to 'requires improvement'.

Families wishing to contact the review can do so by emailing nottsreview@donnaockenden.com or by filling out an online form here

Staff can contact the review by emailing staffvoices@donnaockenden.com