Following a detailed investigation, BBC Panorama’s recent programme ‘Midwives under Pressure’ has revealed serious concerns about maternity services at Gloucestershire Hospitals NHS Trust.
Panorama’s investigation discovered that midwives had said a poor culture and staff shortages at the Trust had led to baby deaths which could have been avoided.
Panorama investigation findings
BBC Panorama has been talking to former and current maternity staff at the Trust for over a year.
The investigators were told that the situation at the Trust is “desperate”, and that there was a dangerous lack of staff which had been raised repeatedly with Trust managers.
The investigation also found:
- In the first six months of 2023, the Trust was short of more than 50 midwifery staff, on average.
- Between 2018 and 2022, seven women under the care of the Trust died while pregnant, or shortly after giving birth. This is around twice the UK average for maternal deaths.
- An investigation into the death of one baby, where there were delays in inducing labour, found that sufficient staffing may have altered the outcome for the baby.
- A newborn baby died after the Trust failed to take action against two midwives following concerns raised by colleagues. Both are now being investigated by their regulator, the Nursing and Midwifery Council.
The Trust’s response
In response to the baby deaths, the Trust said it is “deeply sorry…that failings in our care led to these tragic deaths” and that independent investigations have resulted in “significant learning and changes.”
In a statement, the Trust told the BBC that it had increased midwifery posts from 243 to 264 in the past three years, adding that it took “a proactive approach to staff well-being” and had strengthened ways for staff to be able to speak up safely.
Staff shortages – a wider problem
Unfortunately, the staffing issues underpinning a lot of the problems in Gloucestershire Hospitals NHS Trust maternity services, are currently a regular occurrence across England.
Three independent reviews into maternity failings at individual trusts in England have taken place in the last decade, and another is ongoing in Nottingham.
There are now calls for a national inquiry in order to seek to deal with the deep-rooted problems each investigation has identified.
As part of their investigations, Panorama submitted a Freedom of Information request in October 2023 to every NHS Trust in England and Wales requesting details of their ‘red flag’ data. Red flags should be raised if staffing levels fall to unsafe levels. The responses received showed that the average number of red flag incidents rose by 64% over 2020, 2021, and 2022.
Panorama spoke to Sally Pezaro, a midwife and researcher at Coventry University. She said that the figures are “highly shocking and concerning” and that these staff shortages can cause delays in care. Ms Pezaro said:
“When those delays occur, midwives may well miss opportunities to escalate risks and spot where things are going wrong. And the consequences of that could be perinatal and neonatal death.”
What action is being taken?
The Department of Health and Social Care told Panorama that there were almost 20% more midwives working in the NHS in England in October 2023, than there were in 2010.
In addition, NHS England said that it is increasing investment to £186 million annually with a view to growing its maternity workforce.
However, it seems that this is far from enough as the charity Baby Lifeline says that the maternity services budget in England is not increasing in line with other NHS services.
Comment
The devastating consequences of the issues in maternity care at Gloucestershire Hospitals NHS Trust is sadly reflective of just how significant the problem is with maternity services across the UK at present.
Patient safety is hugely at risk in our maternity services, and this cannot be allowed to continue.
The calls for a national inquiry are entirely justified, and indeed necessary, if we are to have any hope of improving services and keeping pregnant women and babies safe.
You can watch Panorama’s Programme ‘Midwives under Pressure’ here.
How can we help?
Danielle Young is a Legal Director in our Medical Negligence team, which is ranked in Tier One by the independently researched publication, The Legal 500.
If you have any questions about the subjects discussed in this article, please contact Danielle or another team member in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online form.
Contact us