Shocking allegations have emerged from an independent inquiry into maternity care at Nottingham University Hospitals (NUH) NHS Trust, revealing that over 500 mothers and babies suffered harm or death due to inadequate treatment. The comprehensive report, led by childbirth expert Donna Ockenden, paints a grim picture of substandard care provided over a 13-year period, highlighting chronic understaffing, a failure to learn from patient safety incidents, and a culture of bullying among staff.
The inquiry, which commenced in 2023 after families raised serious concerns about unsafe maternity care, examined events spanning from 2012 to 2025. It heard evidence from approximately 2,500 families and 850 current or former NUH staff, investigating 27 maternal deaths between 2006 and 2024 and pinpointing care failures that may have significantly impacted the outcome in six of these cases.
Failings identified included a lack of prompt action on concerns raised by women and delays in providing necessary scans. The review also found inadequate care contributed to severe neonatal injury, stillbirth, and neonatal death in a number of cases. In some instances, babies suffered oxygen deprivation during birth, hospital-acquired infections, or poor management of labour or postnatal care.
The report highlights consistent clinical failures, including the misinterpretation of CTG trace readings, not recognising fetal distress, and midwives failing to escalate worrying cases to doctors for urgent decisions. These shortcomings endangered mothers and babies, sometimes with catastrophic results. Furthermore, a “bullying and toxic culture” within NUH was found to be entrenched for many years, hindering efforts to improve care.
A lack of effective solutions implemented by maternity service managers and senior trust leaders contributed to the problems. The inquiry also noted that staff were observed to have a “culture of not admitting women who were seeking admission in labour,” despite the inherent risks. Both maternity units were consistently understaffed, struggling to cope with the volume and complexity of births.
In one particularly distressing case, a baby girl who died early in gestation was “inadvertently disposed of as clinical waste by laboratory staff after her postmortem examination.” The report explicitly states that these failures contributed to severe harm or death in numerous cases, often due to recurring problems with monitoring babies during labour and escalating concerns.
The findings highlight the need for urgent improvements in maternity care at NUH NHS Trust. Recommendations from the inquiry are expected to be implemented, aiming to restore trust in the service and prevent further harm. NHS sources have confirmed that a comprehensive action plan is being developed, including measures to address staffing shortages and improve communication among staff.