Trust being investigated for safety failures saw over 100 neonatal deaths in eight years

Baby Harry Richford died seven days after his birth at the Queen Elizabeth, the Queen Mother, Hospital in Thanet in 2017.

Next week, the Care Quality Commission is taking East Kent Hospitals University Foundation Trust to court, alleging it failed to meet fundamental standards of care in the treatment of both Harry and his mother Sarah.

An independent investigation, led by Bill Kirkup, isalso looking into maternity and neonatal services at the trust.

In a statement, the Richford family told HSJ  they had had numerous contacts from other families who had had bad experiences of maternity and neonatal care at the trust. “We have encouraged such families to come forward to the Kirkup Inquiry and now believe that the number of families is approaching 200,” they said.

The investigation team has so far been reluctant to say how many families have been in contact and would neither confirm nor deny the Richfords’ statement. The investigation, which was commissioned after a coroner ruled Harry Richford’s death was “wholly avoidable” and contributed to by neglect, is expected to report in the autumn of 2022.

The prosecution next Monday will be the first time the CQC has taken a trust to court for providing unsafe clinical care. Three other prosecutions of trusts for failing to meet the fundamental standards of care focused on unsafe facilities.

Separately, the trust has revealed it has had 116 neonatal deaths between 2013 and 2020 and 199 stillbirths in the same time. Only 15 of the cases between 2016 and 2020 led to serious incident investigations, according to a Freedom of Information Act request.

While its stillbirth rate has been around the same as a comparable group of trusts, the neonatal death rate was significantly higher for the period 2016-2018. The national MBRRACE study, which looks at deaths adjusted for a trust’s circumstances, showed it had a rate of 2.84 deaths per 1,000 births in 2017, compared with an average of 2.09, and was the highest among trusts with a level three neonatal intensive care unit.

The trust is likely to also be an outlier in 2019 when it had 19 neonatal deaths. The MBRRACE study for 2019 has yet to be issued.

However, in 2020, the number of neonatal deaths fell dramatically to just seven and stillbirths were also at their lowest in the period covered, at 20.

Rebecca Martin, chief medical officer at the trust, said: “We investigate every stillbirth and neonatal death to identify any learning and help answer families’ questions. Where a death does not meet the national criteria for a serious incident investigation, it is investigated using a nationally recognised review tool. We also report to HSIB all baby deaths that meet the HSIB criteria.

“A high number of the neonatal deaths we sadly saw in 2019 were deaths of extremely premature babies and babies with severe congenital abnormalities. The death of a baby is a truly devastating experience for any family to go through and we offer our sincere condolences to every family.”

Of the 19 neonatal deaths in 2019, HSJ understands seven were of extremely premature babies (below 28 weeks of gestation) and sic had severe congenital abnormalities. Of the deaths in 2020, five involved extremely premature babies or those with a severe congenital abnormality. 

Updated 14.08 16 June to clarify when the serious incident cases covered..