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Leaked report details ‘largest maternity scandal in NHS history’ in Shropshire

Toxic culture led to catastrophic consequences for mothers and babies over 40-year period

Ingrid Torjesen

Wednesday, 20 November 2019

At least 42 babies and three mothers are believed to have died at the Shrewsbury and Telford Hospital Trust (SATH) in what is being branded the worst maternity scandal in NHS history.

A leaked report seen by The Independent details the deaths and other cases of avoidable harm between 1979 and 2017: more than 50 new-borns suffered avoidable brain damage after being deprived of oxygen during birth, and there were at least 47 other cases of substandard care, the investigation found.

A senior NHS source told The Independent: “I think you can say with absolute confidence this is the largest known maternity scandal in the UK – significantly larger than Morecambe Bay – and early findings show dozens of avoidable deaths.”

That toll is likely to grow. More than 600 cases are now being examined, and there are hundreds still to be looked at.

There was a “toxic” culture at the trust which allowed poor practice to continue over a period of 40 years.

The report was produced for NHS Improvement who has commissioned midwife Donna Ockenden to produce a review of maternity care at the trust. In a statement to The Independent, Ockenden said that the leaked document “appears to be an internal status update as of February 2019” that “was not meant for publication”. Families involved “were very clear they wanted one, single, comprehensive independent report covering all known cases of potentially serious concern within maternity services at the trust,” she said. “My independent review team and I are working hard to achieve this.”

Paula Clark, interim chief executive at SATH, said: “We have been working, and continue to work, with the independent review into our maternity services.

“On behalf of the trust, I apologise unreservedly to the families who have been affected. I would like to reassure all families using our maternity services that we have not been waiting for Donna Ockenden’s final report before working to improve our services. A lot has already been done to address the issues raised by previous cases.

“Our focus is to make our maternity service the safest it can be. We still have further to go but are seeing some positive outcomes from the work we have done to date.

“We have not seen or been made aware of any interim report, and await the findings of Donna Ockenden’s report so that we can work with families, our communities and NHS England/Improvement to understand and apply all of the learning identified.”

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