Expectant mothers at a scandal-hit NHS trust have experienced “discriminatory and racist behaviour” including staff mimicking their accents and refusing to provide interpreters, according to the head of an inquiry into its failings.
As part of the largest inquiry into a single service in the history of the NHS, Donna Ockenden’s team is conducting a review with more than 1,900 families who have experienced stillbirth, neonatal death, maternal death or babies diagnosed with brain damage at Nottingham University hospitals NHS trust (NUH).
Ockenden, a senior midwife, said she had concerns about reports of racist behaviour uncovered during her interviews with families and 744 staff members who have come forward to participate in the review.
“Both family and staff are reporting discriminatory and racist behaviour,” Ockenden told the Guardian. “Local women of Asian origin are reporting white women in the bed opposite being treated more kindly. They have had their accents mimicked, their facial movements mimicked, have been made fun of and seen staff laughing at them.
“A Roma woman who I met with described having a sheet thrown at them when they asked for their bed to be changed – that was very recent.”
Ockenden said women were often not able to give informed consent to difficult procedures as they were told they “understood enough” when they asked for an interpreter.
She added that she had found women from the most deprived backgrounds, of all races, were “certainly reporting to me very negative experiences of maternity services”.
The Nottingham maternity review was launched in September 2022 after a long-fought campaign by affected families. They asked for Ockenden to chair the review after her investigation into the Shrewsbury and Telford NHS trust in Shropshire.
That inquiry found that 300 babies died or were left brain-damaged because of inadequate care by the trust after analysing the experiences of 1,500 families. Ockenden recently announced she was returning to the matter in Shrewsbury after families complained about having had no contact from the trust since her report was published two years ago.
She said the same issues of “lifelong trauma” were present in Nottingham. Since starting the latest review, Ockenden’s team has referred more than 250 people for psychological support, and escalated 70 cases to the chief executive of NUH for immediate action.
“On a daily basis, I hear appalling accounts of life-changing damage, broken relationships, affected siblings, mental health issues, some women living with terrible physical harm and damage, with incontinence, pain and unable to work any longer,” she said.
“We see and hear a lot of raw emotion, a lot of anger. Some families are in desperate situations, caring for brain-injured children with minimal help. Some of these children need 24-hour care.”
She added that, “in a number of cases, the poor outcomes will have been caused by poor care”. The cases included in the review go back to 2012, and her team will continue hearing new cases until May 2025, with the final report expected to be published in September that year.
Nottinghamshire police have also launched a criminal investigation into NUH over its maternity care.
Last year, the trust was fined £800,000, the highest penalty for maternity care, after admitting to failings in the care of Sarah Andrews and her baby, Wynter, who died minutes after being born in 2019.
The case followed that of Sarah and Jack Hawkins, who received a £2.8m payout from the NHS in what was believed to be the largest settlement for a clinical negligence case involving stillbirth. Sarah was in labour for six days before Harriet was stillborn, almost nine hours after dying, at Nottingham city hospital in April 2016.
Ockenden said the two cases were examples of the recurring themes she was hearing from families about the breakdown of trust and communication with maternity services.
“Families have told us that they felt dismissed by the trust. They weren’t believed they were in labour. They weren’t believed they were in pain. They were denied admission to the trust,” she said. “And this could affect services across the country, but staff just don’t know about the trauma.”
There have been growing calls for a public inquiry into maternity services in the UK, particularly after the publication of the Birth Trauma Inquiry in May, a report by MPs that called for an overhaul of the UK’s maternity and postnatal care.
Ockenden said while she understood people’s anger and frustration, she did not believe a public inquiry would be the best way of improving maternity services.
“My concern is that a public inquiry would kick the can down the road. It would delay things when we already know what needs to be done. I’m calling on the new government to accelerate progress on maternity services,” she said.
A spokesperson for the Department of Health said: “It is unacceptable that too many women are not receiving the maternity care that they deserve. This government is determined to change that by ensuring all women receive safe, personalised, and compassionate care from maternity services.
“We will ensure that trusts failing on maternity care are robustly supported into rapid improvement, while training thousands more midwives. We will also take action to close the Black and Asian maternal mortality gap and tackle the unacceptable inequalities in care.”
Anthony May, the chief executive of NUH, said: “I want to apologise to these women and families for the shortcomings identified and pain caused. I also apologise to anyone who has experienced racism in our hospitals.
“I want all of our patients and their families to engage with our services in the knowledge that they are free of discrimination. I know this isn’t always happening but we are reaching out to our communities to learn from the population we serve. We have plans in place to improve translation and interpreting services, to better engage with seldom heard communities and to show greater cultural awareness.”
He added that recent Care Quality Commission inspections and feedback from mothers using the services showed that things were improving, with 98% of patients reporting positive experiences in a June friends and family survey.
