NHS perinatal staff ‘exhausted, on their knees’, says maternity safety expert

A damning report into the state of UK maternity services has found that poor care is frequently tolerated, with women giving birth treated as an ‘inconvenience.’

The Birth Trauma Inquiry heard from more than 1,300 women who’ve experienced traumatic birth, while exclusive new analysis by this programme shows how one in nine maternity services in England have been ‘double-downgraded’ by the regulator since 2022.

Donna Ockenden is chairing the review into maternity services at Nottingham University Hospitals.

Ciaran Jenkins: Donna Ockenden, you heard all the stories in this really harrowing report today. What’s your response?

Donna Ockenden: First of all, I’d like to thank the more than 1,300 women and their families who’ve come forward today, and actually in a very short timescale, to contribute to this report. The accounts that I’ve read, and I did listen to some of them in parliament, are just harrowing, and my heart goes out to each and every one of those women and their families.

Ciaran Jenkins: And what the report says, this inquiry says, is that poor care is basically tolerated as normal. Is that really the case in 21st century Britain in maternity services?

Donna Ockenden: As you will know, through my work, my work in Shrewsbury and Telford and my continuing work in Nottingham, and actually, in terms of contact from families around the country, I do hear an awful lot of accounts where avoidable harm happens and care is simply not good enough.

Ciaran Jenkins: You mentioned your review. That was supposed to be a turning point, that scandal at Shrewsbury and Telford. Now our exclusive analysis tonight shows that several maternity services units have been double downgraded, falling not one rating, but two, since that time. So things are not getting better, do you reckon?

Donna Ockenden: I think that progress has been far, far too slow. We need to remind ourselves that on the day that our final report was published, 30th of March 2022, the then secretary of state for health and social care, Sajid Javid, stood up in parliament and fully endorsed all of the findings. They were immediate, essential actions, and we’re more than two years down the line and progress has been woefully slow.

Ciaran Jenkins: Can I ask you specifically about units that have been double downgraded, because that’s now more common in recent ratings than actually improvement in maternity services. What sort of things have to be going wrong for a service to be downgraded twice in one inspection?

Donna Ockenden: I think that what the CQC (Care Quality Commission) would have to see is a very significant fall in the standards between one inspection and another. That does cause me great concern. Having said that, as well as speaking to families pretty much every day of the week, I also speak to midwives, obstetricians, neonatologists, anaesthetists and so on. And what I do hear is that members of that perinatal team, the team giving care across England, are exhausted. They’re on their knees. We know that there’s been significant understaffing in our services for more than ten years, and the investment that has been required, we’re not even halfway there.

Ciaran Jenkins: That’s what I was going to ask, because the government says it’s investing all this money in more midwives. But is the current staffing level safe?

Donna Ockenden: I talk to midwives on the ground pretty much every day of the week and they share with me accounts of running from room to room, looking after, you know, a woman in room one and a woman in room two at the same time. Midwives have said for a very long time they don’t have time to care. Health visitors tell me of services that are vaporised. They said, please use that word, Donna. Our services have disappeared. We’re not able to provide, you know, post-birth care in the way that we did two years ago, five years ago, definitely not ten years ago. So I think today has to be the final opportunity. Government now have to get on and deliver, because in addition to the 1,300 or so women of today, there were 1,500 families in Shrewsbury. There are more than 1,800 in Nottingham.