Maternity improvements have stalled, says inquiry lead

Donna Ockenden launched the inquiry into Nottingham's maternity services in September 2022

Improvements at a hospital trust that is being investigated over maternity failings have "stalled", an inquiry chief has said.

Senior midwife Donna Ockenden has been examining how hundreds of babies died or were injured under the care of Nottingham University Hospitals (NUH) NHS Trust.

She said the trust needed to "get back on track" after receiving recent reports of poor standards from concerned families.

The cases of 1,925 families are being reviewed as part of the inquiry.

Ms Ockenden's comments come after it was revealed that the Care Quality Commission (CQC) carried out an unannounced inspection at the Queen's Medical Centre and City Hospital in June.

Staff bypassed management and raised concerns directly with the watchdog regarding the numbers, skills and experience of staff.

An independent review into maternity services at Nottingham University Hospitals NHS Trust is ongoing

Ms Ockenden said the trust was “over-relying” on newly-qualified midwives.

“The findings of the CQC mirror the interim findings and the ongoing work that we are doing around staffing,” she said.

“I am absolutely clear that the trust wants to do the best it can but I think progress has stalled.

"Staff are telling me not enough is being done around skill mix and the juniority of the workforce.

“They are over-relying on newly-qualified midwives who are not appropriately supported."

The CQC report has not yet been published but limited findings were disclosed in NUH board papers.

Concerns had been raised around staffing levels and that the mix of workers’ skills had been insufficient during the health watchdog’s visit.

The independent investigation has been exploring stillbirths, antenatal and neonatal deaths, injured babies and mothers, and maternal deaths dating back more than a decade.

'We are exhausted'

Ms Ockenden said parents who had received maternity care under NUH in recent months had reported concerns to her regarding “a lack of compassion” and poor hygiene on some wards.

Families had also shown her imagery detailing “the poor state” of some areas where bereavement care was provided, she added.

Ms Ockenden said she kept receiving the same feedback from families despite reporting similar issues to the trust in the past.

“The feeling of staff on the ground is that they’re giving of their best,” she said. “They have asked me to tell local people that 'we are exhausted, we are on our knees, but we are genuinely giving of our best'.

“My disappointment is that the feedback I heard from families [on Wednesday] is the same feedback that I provided to the trust up to 18 months ago.

"There remains an awful lot to do."

The trust said an action plan to address any levels of concern had been created and will be monitored through its Maternity Improvement Programme.

Despite concerns raised in the report around staffing, Tracy Pilcher, chief nurse at NUH, said there had been “some key areas of continued improvement” in the CQC’s feedback.

She added: “[The feedback] included improvements to our risk assessments and documentation, positive feedback from the majority of our mothers and the response from our staff.

“However, we know that there is still some way to go, and we are thankful for the feedback and input from the CQC in identifying areas where we do need to continue to focus our improvement.”

The inquiry, which began in September 2022 and looks to establish the extent of avoidable harm that happened, is on track to be published in September 2025.