Nottingham maternity review to become UK's largest

The review is looking into cases at Nottingham University Hospitals (NUH) NHS Trust, which runs City Hospital and the Queen's Medical Centre

A review into failings in maternity care in hospitals in Nottingham will be the largest ever carried out in the UK.

Donna Ockenden, chair of the inquiry, told a meeting on Monday that 1,700 families' cases would be examined.

She was in charge of the probe into services in Shropshire, which found at least 201 babies and mothers might have survived had they received better care.

The review comes after dozens of baby deaths and injuries at Nottingham University Hospital (NUH) NHS Trust.

It focuses on the maternity units at the Queen's Medical Centre and City Hospital, run by the trust.

So far, 1,266 families have contacted the review team themselves directly and to date, 674 of these have given consent to join it.

But Ms Ockenden has called for a "radical review" to ensure "women from all communities" were being contacted by the trust and "felt confident" to come forward.

The families had asked for the Department of Health and Social Care, NHS England and the trust to agree to change the review from "opt-in" to "opt-out".

NHS England has now written to affected families, confirming cases will be dealt with on an opt-out basis, with families having to opt out of giving consent.

Maternity services run by NUH were rated inadequate after an inspection in 2020

On Monday, NUH chairman Nick Carver joined Ms Ockenden and bereaved families at the trust's annual meeting.

He acknowledged more needed to be done to gain the trust of families and communities and committed "to working collaboratively to plan for an apology on behalf of the board that the families recognise as meaningful".

He previously said the trust would publicly apologise to people who experienced failings in maternity care.

He told the meeting: "For too long we have not listened to women and families who have been affected by failings in our maternity services.

"This brick-wall approach has caused additional pain, and this must change."

Updating the meeting on the extended reach of the review, Ms Ockenden said: "My promise to you as families today is the same as the promise I made to you in September at the start of this review, that as a review team we will do all we can to ensure this review is one for all Nottinghamshire families."

She added: "Already I can say that I have seen some positive changes in response to family accounts but the trust has a very long journey ahead.

"What has happened cannot be fixed overnight."

'Trust and transparency'

NUH chief executive Anthony May described the meeting as "a very important milestone".

He told BBC Radio Nottingham he had been meeting some of the mothers, and described their accounts as "very harrowing".

"When I hear those stories it makes me very sad and very determined to improve things in the hospitals," he said.

"Today what we want to do is signal that we want a new relationship with the families built on trust and transparency, and try to understand how they can help us improve things in the maternity services.

"I would like to say that I think they're really brave, I think they're very persistent, and the fact that we've got to where we are with the review is largely down to their efforts."

Donna Ockenden said there was not "anywhere near a representative sample" of families

Though he apologised after taking over the job last year, Mr May said a full apology on behalf of the NUH board would be done "on the families' terms".

He also said staff in the maternity services "work incredibly hard", adding: "It's the trust that's let them down."

Mr May said the trust had "made improvements" regarding equipment and staff training, adding more doctors and midwives are "in the pipeline", including some staff from overseas.

"The signs are there that slowly we are improving, but we have a mountain to climb," he said.

Responding to the statements from NUH, Jack and Sarah Hawkins - whose daughter Harriet was stillborn at the trust in 2016 - said the commitment to transparency was "massive".

"It's a bit of a shock to the system to be honest," Ms Hawkins said.

"For seven and a half years we have just been fighting to be heard.

"So for them to say they are going to take an open and honest approach is incredible really.

"Whether that happens is yet to be seen but it is certainly a step in the right direction."

In a statement, the group representing parents said: "We welcome today's pledge from the trust for a 'new honest and transparent relationship' with a sense of relief and optimism.

"For too long we have been fighting to be not just heard, but for action to be taken, and for there to be accountability.

"We deserve to learn who knew what and when, why it was allowed to continue; and how the trust avoided scrutiny for so long."

Sarah and Jack Hawkins said they were impressed by the trust's attitude

Ms Ockenden's previous review in Shrewsbury and Telford, which also used the "opt-out" approach, included more than 95% of affected families.

The Nottingham trust wrote to 1,377 families at the end of November and the end of January.

The letters went to families who had experienced stillbirth, neonatal deaths, brain damage to the baby, harm to mothers or relatives of mothers who died.

But only 360 families responded to these letters.

In total, 28% of white women contacted responded, while for black and Asian women, the figures were 10% and 5% respectively.

In Nottingham, only about 25% of families known to be affected have been included in the review.

Ms Ockenden said: "As it stands, with our 674 families who have joined the review, I can't say as the chair we have anywhere near a representative sample of the rich diversity that we know exists in Nottingham.

"There is significantly more work to do."