Shrewsbury maternity scandal: Sajid Javid promises ‘swift’ changeson March 30, 2022 at 5:42 pm

Sweeping changes to maternity services in England are expected after a report laid bare catastrophic failures at an NHS trust which led to the deaths of more than 200 babies.

Over 20 years, errors at Shrewsbury and Telford NHS Trust led to babies being stillborn, dying after birth or being left severely brain damaged.

Health Secretary Sajid Javid apologised to the families affected – and pledged to hold those responsible to account.

The trust has also apologised.

It said it had already made changes and promised to continue to make improvements.

The inquiry – which marks the UK’s biggest maternity scandal – looked into nearly 1,600 incidents at the trust in Shropshire over two decades.

It found:

The report also said the trust was not held to account by external bodies – and it either failed to undertake investigations or when an investigation did take place it was inadequate.

The reason for the failures included: lack of staff; lack of ongoing training; lack of effective investigations and governance; and a culture of not listening to the families involved.

The trust also had a tendency to blame mothers for poor outcomes – in some cases for their own deaths, the report found.

It made a range of recommendations – including more than 60 for the local trust involved, 15 for the wider NHS and three for the government.

Mr Javid said the government was accepting all recommendations and “will act swiftly so no families have to go through the same pain in the future”.

Speaking to MPs in the House of Commons, Mr Javid said. “To all the families who have suffered so greatly, I am sorry.

“The report clearly shows that you were failed by a service that was there you help you and your loved ones to bring life into this world, we will make the changes that the report says are needed at both a local and national level.”

The report was the culmination of an inquiry, first launched in 2017, into concerns over maternity care at Shropshire hospitals.

Initially set out to examine 23 cases, it has now examined almost 1,600 and is thought to be largest of its kind in NHS history.

The findings of the inquiry, Mr Javid said, were “stark and deeply upsetting”.

He told of one case where he said, “important” medical information had been kept on Post It notes which were swept into a bin by cleaners which had “tragic consequences for a newborn baby and her family”.

Addressing MPs, he said: “This report paints a tragic and harrowing picture of repeated failures in care over two decades which led to unimaginable trauma for so many people.

“Rather than moments of joy and happiness for these families their experience of maternity care was one of tragedy and distress.”

Mr Javid said the report “provides a valuable blueprint for safety and safe maternity care for years to come”.

The health secretary added: “I’d like to reassure MPs that a number of people who were working at the trust at the time of the incidents have been suspended or struck off from the professional register, and members of senior management have also been removed from their posts.

“There is also an active police investigation, Operation Lincoln, which is looking at around 600 cases.”

Det Ch Supt Damian Barratt said the investigation was “very much active”, although no charges had yet been brought.

Donna Ockenden – the senior midwife who chaired the inquiry – said “there can be no excuses” in the future.

The report’s recommendations included:

Mr Javid has asked NHS England to write to all trusts instructing them to assess them and said the organisation will be setting out a delivery plan to reflect the recommendation.

He said the report recognised changes made since an interim report published in in 2020, which included £95m for services across England to boost the workforce, with a £127m boost announced last week.

Two families spearheaded the campaign for the inquiry.

Richard Stanton and Rhiannon Davies’s daughter Kate died hours after her birth in March 2009, while Kayleigh and Colin Griffiths’ daughter Pippa died in 2016 from a Group B Streptococcus infection.

Ms Davies said: “All we ever wanted was to understand why Kate died. It was as simple as that.”

While Mrs Griffiths added: “Just for me, the sight of the report and how thick it is, and how comprehensive it is, I think we want to thank Donna, and her team, and all the families for coming forward.

“It’s so important that the learning is taken.”

“No woman should ever have to face going into hospital to give birth and not know whether she and her baby will come out alive,” Labour shadow health minister Feryal Clark said.

Prime Minister Boris Johnson earlier said his heart went out to the families, adding: “Every woman giving birth has the right to a safe birth.”

A number of health bodies have responded to the inquiry including the Nursing and Midwifery Council (NMC), which said the report’s findings were “appalling”.

The NHS Shropshire, Telford and Wrekin Clinical Commissioning Group (CCG) said it deeply regretted the “horrific experiences these families went through” and it would work with partners to ensure further improvements are made.

Louise Barnett chief executive at the Shrewsbury and Telford Hospital NHS Trust said: “We offer our wholehearted apologies for the pain and distress caused by our failings as a trust.”

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