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Found 816 results
  1. News Article
    The midwife leading a review into failings by Nottingham's maternity services said the scope was wider than the UK's biggest maternity scandal. Donna Ockenden previously led the review at Shrewsbury and Telford NHS Trust that found failings led to the deaths of more than 200 babies. The terms of reference for the review in Nottingham were set out on Tuesday. A category of severe maternal harm has been added to include cases that did not lead to a death or injury. Earlier this year Ms Ockenden completed her inquiry into the UK's biggest maternity scandal at Shrewsbury and Telford NHS Trust. She said the scope of the review in Nottingham was wider because an additional category had been added to the investigation. It aims to identify cases of severe maternal harm, like an unexpected admission to intensive care or a major obstetric haemorrhage. Ms Ockenden said: "We felt adding in the category of severe maternal harm would help us to understand women's experiences and help us to learn and help the trust to learn from those cases as well. "So actually there's been a widening of the scope which our review team felt was important and when we tested it out with some families they felt it was important too. "Perhaps there's a mum out there saying 'well I'm ok, and my baby's ok, but x,w,z of my maternity experience really worried me or frightened me' then she can send in her experiences." She said fathers could also send in their experiences. Read full story Source: BBC News, 14 September 2022
  2. Content Article
    Unsafe maternity care has cost the National Health Service in England (NHS) £8.2bn in 15 years. How many more surveys of women’s experiences, reports of poor quality care and failings of senior management at NHS maternity units do we need to know that there is still a massive problem with maternity services in England? Judy Shakespeare, Elizabeth Duff and Debra Bick discuss why a joined-up policy and investment in maternity services is urgently needed.
  3. Content Article
    This document outlines the terms of reference for the independent review into maternity services at Nottingham University Hospitals NHS Trust (NUH), commissioned by NHS England and led by Donna Ockenden. The review has been established in light of significant concerns raised about the quality and safety of maternity services at NUH, and concerns voiced by local families. It replaces a previous regionally-led review after some families expressed concerns and made representations to the Secretary of State for Health and Social Care. The review began on 1 September 2022 following early engagement with families and NUH from June 2022. It is expected to last 18 months, although this timeframe is subject to review. Learning and recommendations will be shared with NUH as they become apparent, to allow rapid action to improve the safety of maternity care. The only and final report is expected to be published and presented to NUH and NHS England around March 2024.
  4. News Article
    More than 350 families have already contacted a review team which is examining failings at maternity units in two Nottingham hospitals. The review was opened on 1 September by Donna Ockenden, who previously led an inquiry into the maternity scandal at Shrewsbury and Telford NHS Trust. She will examine how dozens of babies died or were injured in Nottingham. Nottingham University Hospitals NHS Trust has apologised for "unimaginable distress" caused by its failings. More affected families, as well as staff with concerns, have been asked to come forward. Ms Ockenden said: "We are really pleased with the large numbers of families and staff that have already come forward in the first week of the review, and we actively encourage others to do the same." Read full story Source: BBC News, 12 September 2022
  5. Content Article
    This article tells the story of Ruth, whose baby son was left with severe cerebral palsy and several other injuries following oxygen starvation during his birth. Ruth's labour was badly mismanaged and she found gaps, omissions and additions to her medical notes when she requested copies. Following a lengthy legal case, Kate received compensation that allowed her family to pay for her son's medical and care needs and adapt their home.
  6. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
  7. Content Article
    This report by Best Beginnings, Home-Start UK and the Parent-Infant Foundation highlights the impact Covid-19 and measures introduced to control its spread have had on babies. It highlights a “baby blindspot” in Covid-19 recovery efforts and a shortage of funding for voluntary sector organisations and core services like health visiting to offer the level of support required to meet families’ needs. The authors of the report spoke to mothers of babies born during the pandemic and surveyed professionals and volunteers who work with babies and their families.
  8. Content Article
    Medication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, and administering, monitoring or providing advice on medicines. Medication errors can occur at many steps in patient care, from ordering the medication to the time when the patient is administered the drug. From April 1 2015 to 31 March 2020 NHS Resolution received 1,420 claims relating to errors in the medication process. Of those claims, 487 claims settled with damages paid, costing the NHS £35 million (excluding legal costs). NHS Resolution initial data for medication errors indicates that anticoagulants, opioids, antimicrobials, antidepressants, and anticonvulsants are the most common medications to be implicated in incidents.
  9. News Article
    A troubled acute trust has been sent a further warning notice after inspectors found severe shortages of midwives were causing dangerous delays to labour inductions. During one day in June, the Care Quality Commission found eight high-risk women at Blackpool Victoria Hospital had waited prolonged time periods for their labour to be induced. They said one woman had waited five days, while another who was forced to wait more than two days despite her waters having broken on the ward. Delays to labour induction can lead to serious safety risks for mothers and babies. The hospital’s maternity services, previously rated “good” for safety, have now been rated “inadequate” in this domain. The overall rating for maternity has dropped to “requires improvement”. The problems were caused by severe shortages of midwives at the hospital, which had struggled to bring in agency staff due to a lack of availability in the area. However, inspectors also said there was a lack of any discussion or attention to the issues within the trust, despite the Healthcare Safety Investigation Branch previously highlighting concerns. Read full story (paywalled) Source: HSJ, 1 September 2022
  10. Content Article
    This report from the Healthcare Quality Improvement Partnership (HQIP) aims to explore how the multiple national data sets and national audits are used in maternity services across the UK. Based on data from a survey of over 100 people working in a variety of roles across maternity services and a series of in-depth interviews with a diverse group of clinicians and methodologists working in this area, the report explores what data is being reviewed and how it might influence quality improvement, as well as the burden of data.
  11. Content Article
    This article and video tell the story of Rihan Neupane, a baby born prematurely in Dhapasi, Nepal, who was left in a vegetative state following a series of medical errors including a missed diagnosis of meningitis. His parents had chosen a private international hospital for their maternity care, but were let down by a series of medical errors including Rihan being mistakenly given a massive paracetamol overdose. Although external hospital safety inspectors found the hospital negligent on many counts, the hospital continued to deny any wrongdoing or responsibility for Rihan's condition. Rihan's father Sanjeev Neupane talks about his family's experience in the embedded video.
  12. News Article
    More than two-thirds of trusts have been forced to suspend or pause a high-profile service improvement aimed at reducing neonatal and maternal deaths, because of widespread staffing shortages. HSJ research revealed a majority of trusts have been unable to implement the continuity of carer maternity model, after they were told to look again at whether it could be safely implemented. The model intends to give women “dedicated support” from the same midwifery team throughout their pregnancy, with a 2016 review saying it would reduce infant and maternal mortality rates and improve care more generally. It is particularly aimed at improving care for patients from minority ethnic groups and those with other risk factors, and has been championed by Jacqueline Dunkley-Bent, NHS England’s chief midwifery officer. Key targets around the model were included in the 2019 NHS long-term plan. However, there is consensus nationally that it can only be rolled out safely where there are adequate numbers of staff to do so – otherwise the risks outweigh the benefits. Earlier this year, the final Ockenden report into maternity care failings at Shrewsbury and Telford Hospital Trust was critical of the model, and said it should be suspended until trusts have enough staff to meet “safe minimum requirements on all shifts”. Read full story (paywalled) Source: HSJ, 30 August 2022 Read more about the continuity of care maternity model on the hub
  13. Content Article
    In this article, Maryanne Demasi looks at the continued prescription of Makena, an injectable synthetic hormone approved by the US Food and Drug Administration (FDA) to women who are at high-risk of premature delivery. Makena claims to reduce the risk of pre-term birth and was approved in 2011 on an accelerated pathway by the FDA following an initial trial that showed positive outcomes. However, Demasi explains, the study has been discredited as flawed in its methods and findings, and a confirmatory trial conducted by the manufacturer showed that Makena does not actually prevent preterm birth. In spite of this, and in the face of known risks, Makena is still being prescribed to pregnant women as the manufacturer has refused to withdraw it from the market. She highlights the dangers of the FDA not taking stronger action against the manufacturer of Makena, by looking at the example of Diethylstilbestrol (DES), a synthetic hormone use by women from the 1930's to the 1970s to prevent miscarriages and premature births. DES was later found to cause cancers, immune and cardiovascular disorders and other abnormalities in pregnant women, their children and their grandchildren.
  14. News Article
    The midwife leading a review into Nottingham's maternity services has urged families and staff to come forward with their experiences. Donna Ockenden was appointed in May to head the inquiry into the services at Queen's Medical Centre and City Hospital. It was launched after more than 100 families with experiences of maternity failings wrote to former Health Secretary Sajid Javid demanding the action. A much-criticised initial review was subsequently scrapped. Ms Ockenden, who uncovered 200 avoidable baby deaths at Shrewsbury and Telford NHS Trust across two decades, said the review is now open to families, NHS workers and others who wish to contribute. "By September 1 we'll be ready to receive contact from families," she told Nottinghamshire Live. "In the mean time if there are either families or members of the NHS that want to get in touch they can use our new email. And also those who represent communities, whether that's safe communities or women's groups in Nottingham." People can contact the review through the email nottsreview@donnaockenden.com, which was launched last week. Ms Ockenden said that positive steps were being made in putting in place the "building blocks" for the review, which is due to start on 1 September 2022. Read full story Source: Nottinghamshire Live, 17 August 2022
  15. Content Article
    Birthrights are receiving an increasing number of enquiries regarding restrictions of maternity services due to the staffing crisis, including closure of midwifery-led units and homebirth services. In order to get a full picture, including a regional overview, Birthrights would like to know if your local maternity service has been restricted in any way. To help gather evidence, Birthrights are calling for anyone who knows what the current situation is at their local Trust, including whether staffing is leading to: Their homebirth service being restricted. Their Midwife-Led Unit being closed. To take part follow the link below.
  16. News Article
    Dozens of referrals to specialist care for women with serious mental health problems during or after pregnancy are being turned down because no bed was available, data collected by HSJ reveals. HSJ submitted freedom of information requests to 19 trusts running mother and baby units (MBUs) – which are inpatient services where women who experience serious mental health problems during or after pregnancy can stay with their child – asking for the “total number of referrals… which could not be admitted because no bed was available”. Although all of the 19 trusts HSJ sent freedom of information requests to responded, many said they did not hold this information. However, five – Cumbria, Northumberland, Tyne and Wear Foundation Trust, Essex Partnership University FT, Greater Manchester Mental Health FT, Hertfordshire Partnership University FT, and Nottinghamshire Healthcare FT – together identified 197 referrals which were rejected. Greater Manchester identified a further three which were turned down in the calendar year 2022, although it did not specify which financial year this was. Several experts told HSJ the figures reflected a lack of capacity for mothers with serious mental health problems. Maternal Mental Health Alliance campaign manager Karen Middleton said MBUs offered “the best outcomes” for new mothers who needed inpatient treatment". Ms Middleton continued: “When a much-needed MBU bed isn’t available, women instead face admission to general adult psychiatric wards, separating them from their newborn babies at a crucially important time for relationship development. These wards lack appropriate facilities and expertise to support postnatal mothers with their specific physical and emotional needs.” Read full story (paywalled) Source: HSJ, 16 August 2022
  17. Content Article
    In this blog, Charlotte Clayton, midwife and clinical advisor at the Organisation for the Review of Care and Health Apps (ORCHA), explores how providing the right training and support for maternity staff is key to seeing the benefits tech can bring to quality of care and workload.
  18. Content Article
    This leaflet produced by Group B Strep Support and the Royal College of Obstetrics and Gynaecology provides information about group B Strep (GBS) aimed particularly at pregnant women. It includes; an explanation of what group B Strep is. what GBS could mean for a baby. how to reduce the risk of GBS infection to a baby. a list of the signs of GBS infection in newborn babies.
  19. Content Article
    This report by Richard Norrie, director of the Statistics and Policy Research Programme at Civitas, aims to scrutinise the Race and Health Observatory (RHO) rapid evidence review into ethnic inequalities in healthcare published in February 2022. The report highlights inconsistencies in the review's use of research and data and argues that its conclusions do not reflect the full body of evidence available concerning race and health outcomes. The author suggests that the review makes a false assumption that the needs of all ethnic groups are the same, which leads to its potentially inaccurate conclusions about the prevalence and causes of health inequalities.
  20. Content Article
    This report provides a review of the Healthcare Safety Investigation Branch (HSIB) maternity investigation programme during 2021/22, including an overview of activity during this period, themes arising from investigations and plans for the future. It is intended for healthcare organisations, policymakers and the public to understand the work HSIB have undertaken.
  21. Content Article
    The Birth Injury Help Center is a US-based online resource centre that provides information on birth injuries, as well pregnancy and childbirth. This article provides information for pregnant women about foods, drinks, medications and activities to avoid during pregnancy.
  22. News Article
    Women have spoken to the BBC about the "nightmare" of giving birth during the restrictions imposed because of Covid. The London Assembly was told a de facto maternity ward ban on partners meant new mums often got very little support. Campaign group Pregnant Then Screwed said elective Caesareans spiked, as women tried to find a way to have their partner by their side. Patient care also suffered as maternity units struggled with what a midwifery group said was a 40% staff absence. A London Assembly health committee review of Covid pandemic pregnancy care has heard that more than three-quarters of the some 110,000 women who gave birth in the capital in 2020 were believed to have done so without their partner's support. Joeli Brearley, director of Pregnant then Screwed, said elective Caesarean rates increased from 15% to 24%: "Women were requesting severe surgery simply so their partner could be there." Suzanne Tyler, from the Royal College of Midwives, agreed that London hospitals were badly affected by staff shortages. "At its worst, staffing was 40% down," she said. "The babies didn't stop coming during Covid but services did have to be rationalised." Dr Tyler, who said the pandemic "ended up pitting midwives against women", criticised "confusing... contradictory" advice from the government and NHS England that "kept changing". Read full story Source: BBC News, 26 July 2022
  23. News Article
    Maternity failings continue to account for the majority of billions of pounds spent by the NHS on clinical negligence claims, as an NHS body warns of the “devastating” consequences of poor care. Two-thirds of the £13bn spent by the NHS in 2021-21 in respect of negligence claims was related to maternity care, according to new data. A report released by NHS Resolution said it was “a stark reminder that although the NHS remains one of the safest healthcare systems in the world within which to give birth, avoidable errors within maternity can have devastating consequences for the child, mother and wider family, as well as the NHS staff involved.” According to the figures, 1,243 maternity-related negligence claims were reported to the NHS in 2021-22, up from 1,571 in the previous year. The data also shows that 200 claims relating to cerebral palsy or brain damage were received in 2021-22 – a decrease from the previous year, in which there were 250. The organisation said that the growth in obstetrics claims over the past three years was due to trusts reporting cases of cerebral palsy and brain damage earlier through its early notification scheme, which was launched in 2017. Read full story Source: The Independent, 24 July 2022
  24. News Article
    The large number of unfilled NHS job vacancies is posing a serious risk to patient safety, a report by MPs says. It found England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, calling this the worst workforce crisis in NHS history. It said a reluctance to decisively plug the staffing gap could threaten plans to tackle the Covid treatment backlog. The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff. Former Health Secretary Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said tackling the shortage must be a "top priority" for the new prime minister when they take over in September. "Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it," he said. It said conditions were "regrettably worse" in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to retain existing workers. "Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction, even when it is desperately needed," the report said. Read full story Source: BBC News, 25 July 2022
  25. Content Article
    The Ockenden review into the failings in maternity care at Shrewsbury and Telford Hospital NHS Trust in the UK makes for sobering reading. The review focuses predominantly on the period from 2000 to 2019 and estimates that there were significant or major concerns in the care of nine women and more than 200 babies who died while receiving care at the Trust. Many more women and babies suffered serious injuries. It was clear that the Shrewsbury and Telford Hospital NHS Trust did not investigate, learn, change, or listen to families when adverse events occurred. The conclusions of the Ockenden review make it clear that safe staffing levels, a well trained workforce, an ability to learn from incidents, and a willingness and ability to listen to families are all crucial for safe maternity care.
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