Hundreds of mothers and babies died or were harmed at ‘toxic’ hospital trust – The Latest

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0:55Unprecedented, it's the largest maternity investigation in NHS history. What was found was completely shocking and damning. Mothers being dismissed, being denied pain relief. There were babies who were starved with oxygen. When your kid dies via NHS negligence, hardly anyone wants to talk about it. And I really want to change that. Sadly, it is very common. For over a decade, a lot of these inadequacies and failures were known. However, they were kind of swept under the carpet. People higher up and the staff just didn't want to deal with the fallout of what this could have been. From the Guardians today in Focus, this is The Latest with me, Lucy Hoff.

1:35The findings into Britain's worst ever maternity scandal have been published today. A report into Nottingham University Hospital's NHS Trust, two hospitals under that trust. It's hard to overstate, I think, how shocking the findings are. there were more than 500 babies or mothers who died or were harmed by inadequate care. As our UK Health and Inequalities correspondent, Toby Thomas, you've been right across this, you've been reporting into this for some time. Let's start on the medical inadequacies or poor care that mothers and babies received. Yeah, so this review has been highly anticipated.

2:17And I think you know the damning findings were kind of expected this has been in the pipeline for a long time um Donna Ockenden who led the led the report she'd interviewed over 2 ,500 families and 850 former staff members and current staff members at the trust which is unprecedented yeah unprecedented it's the largest maternity investigation in NHS history and what was found was you know completely shocking and damning. Ockenden found that there were systemic deep-rooted issues at the trust. This kind of ranged from both the workplace culture with staff shortages, the workplace culture was also described as being toxic, but also in terms of the care that mothers and babies received.

2:58There were, you know, many examples of mothers being dismissed, being laughed at, being denied pain relief when expressing they were, you know, uncomfortable and in pain. There were babies who were starved of oxygen there was a particularly shocking example where a stillborn baby was disposed of as clinical waste by accident by staff so it's not even just you know the care mothers and babies received during labour but also in the unfortunate circumstance if they were stillborn then even you know the post-death care was also inadequate there too. That is absolutely horrifying and I think one of the things that we're looking through the review before our conversation is that mothers felt that they were repeatedly being ignored, dismissed, not listened to, that they had valid concerns that weren't being adhered to, and that those were underreported.

3:48There was an issue of staff not noticing signs of potential harm or complications. Yeah, no, exactly that. But it also plays in both ways that, you know, in instances where staff were aware of these complications, and they were reported, like, you know, the more senior people on the trust didn't take action. One thing the report really highlighted was that for over a decade, a lot of these inadequacies and failures were known. However, they were kind of swept under the carpet or turned a blind eye to because people higher up in the staff just didn't want to like deal with the fallout of what this could have been.

4:21And I think, you know, it wasn't a surprise just how systemic these failures were. This is something families have been talking about for years, even before Ockenden launched her formal review. However, I think what this review really adds to is just the kind of really in-your-face examples of just how grotesque some of the care was that these mothers and babies did receive. For example, there was one mother who spoke to Ockenden's review who said that, you know, her partner was told to cover her mouth during labour. There was another one who said that she felt she was sneered at when asked for pain relief.

4:57Another mother, when she was asking for pain relief, who was told by a midwife, you know, there are other people here you're not and not the only important one in the ward and so yeah I think all of these glaring examples just really show how systemic these issues were within the trust. So you mentioned that there was this kind of suggestion that senior hospital staff members or senior consultants were kind of keen to under-report this you know that we can potentially use this word cover up or at least downplay the scale of harm at the hospital so what was the catalyst for this review to be carried out because it began in 2023 and it's taken until now for these findings to come back?

5:35Yeah I'd say this review has definitely been a long time coming. Families have been raising concerns about the care they've received in the trust for a long time way before Donna Ockenden launched her review. Ockenden had also investigated maternity failings in other NHS trusts, one in particular Shrewsbury and Telford NHS Trust. She led an investigation which span a 20-year period and found that several hundred babies had died or were seriously injured in instances that could have been avoided. And so I think she really had a precedent for, you know, leading these really in-depth, thorough reviews into maternity services.

6:12I think after that investigation came out, there were some families who had been, you know, received care at these hospitals in Nottingham who thought, you know, the care we've received wasn't right. We'd like something more thorough to kind of, you know, be looked into. I think a specific case is one of Jack and Sarah Hawkins, whose daughter Harriet was born stillborn. At the time, the trust had said that they investigated it and they found that there were no failings in their care. However, the couple really didn't accept that and they pushed. And eventually it was found that there were, I think, 13 instances that, you know, had gone wrong that could have been avoided.

6:47And also they also received the highest medical negligent settlement in NHS history for stillbirth. I think it was over two million pounds. And so all of these instances coupled together, more and more families coming forward. Yeah, Donna Ockenden getting involved because the families, you know, really trust her and her team to lead a really thorough investigation. And so although it's only been published now, it's been in the pipeline for, you know, a lot of years now, even before it was formally launched, concerns were being raised time and time again. Yeah, and one of the things that's come up into previous reports into maternity scandals has been pre-existing health inequalities and the way they play into failures in maternity care.

7:28And that was certainly the case at Nottingham. There were disparities of care for people from ethnic minorities or from deprived backgrounds and how that played even further into poor standards of care that they received. Yeah, no, definitely. There was a lot of content within the review, even though it's 400 pages long. It was very extensive. That really highlighted how, you know, women from more marginalised backgrounds, from like black and Asian minority ethnic backgrounds, teenage mothers, mothers from more deprived backgrounds, socially, economically, also faced, you know, more disadvantages.

8:03The report did highlight a few instances where language barriers meant that women couldn't be confident in asking for care. And there were some shocking instances of, you know, one woman from an ethnic minority background being told by a doctor quite dismissively, oh, why are you having more babies? Like, why are you back here again? There was like a teenage mother who complained about, you know, severely bleeding. And, you know, when speaking to maternity staff felt dismissed and eventually her baby did die in the womb. and yeah I think that a lot of you know these pervasive stereotypes that you know women from more marginalized backgrounds can can experience especially in the maternity space where these equalities already do exist they were only kind of exacerbated the poor care that they already would have received at this trust.

8:50Yeah you mentioned in your first answer that one of the things that's really been highlighted is the toxic workplace culture that there was a culture of bullying, staff shortages. And that's something that Donna Ockenden has really pulled out as being really particularly pervasive at Nottingham. Yeah, definitely. I mean, Ockenden described the workplace culture at the Trust as being toxic. I don't think that's a word that would have been used lightly at all. 40 % of the staff who were reviewed as part of the investigation found that they had either been bullied or seen bullying or experienced it in some way or the other.

9:25it was really revealing some of the particular instances for example midwives being called idiots instead of their names there was an instance where urine was thrown over some staff members car and HR didn't look into that properly so there were some really really shocking examples of this kind of workplace bullying and this entrenched toxic culture that existed in the trust I think another issue that ties into I guess hierarchies and concerns being dismissed is the fact that more junior and newer staff members felt that they couldn't raise concerns they may have had about inadequate care being provided or felt that anything they raised would be dismissed by higher ups.

10:06So that kind of perpetuated that cycle where issues would be happening, nothing would be done about it because of, you know, that toxic culture. And this hierarchical structure that you spoke about earlier, where senior staff members were keen to downplay the levels of harm that were happening at the hospital. So in terms of what happens next, Nottingham police are considering whether to charge the trust with corporate manslaughter. Is there any precedent for that? How big a deal would that be? Yeah, so I think that would be a massive deal, despite the fact that there have been previous investigations into several maternity trusts that has never, you know, ended with any charges being made on the grounds of corporate manslaughter.

10:44And so if corporate manslaughter was to actually become a charge that would definitely be unprecedented in like NHS history. And in terms of the political response, it's been strong from the new health secretary, James Murray, given the shocking and unprecedented scale of this review. He says it's not one that he wants to just sit on a shelf. What has he indicated about what next steps might be in terms of accountability? Yeah, exactly. I definitely think that's something that the government are wanting to take seriously. They don't want this to just be like another review like we've had so many before.

11:17I think one really big concrete step that the health secretary has made is to introduce Martha's Law across all maternity units and so what Martha's Law is it was campaigned for by our colleague Maropi Mills and essentially means that every patient and family has the right to ask for a second clinical opinion and so I think that would you know that's the first step to making a big difference although early next week we also are going to be given the final findings of Baroness Vali Amos's investigation into maternity care more generally across England and what that investigation has done is examined 14 NHS trusts that had been flagged as you know potentially having phalings in their care and so I think that although this report into Nottingham and past ones were looking at individual trusts and the failures there I feel like what we'll get next week is a more kind of overarching picture about what was going wrong in English hospitals and also what can be done to prevent it happening.

12:14Yeah, less a case-by-case basis and more of a unified response. Toby, thank you so much for your time. Thank you. That's it for today. My huge thanks again to Toby Thomas, The Guardian's Health and Inequalities correspondent. You can keep up with all her reporting over at theguardian.com. And before we go, I just want to remind you that The Guardian's award-winning Football Weekly podcast has turned into World Cup Daily. Join Max Rushton, Barry Glendenning and the team as they discuss every big match and every big moment every day of the World Cup. Listen now or wherever you get your podcasts and you can also watch on YouTube.

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