• Sources at Shrewsbury and Telford Hospital Trust said the number of maternity cases now reviewed has increased to at least 104
  • Review was initially set up in 2017 to examine 23 cases of alleged poor care
  • Scale of problems “could put Morecambe Bay into the shade”, a source has said

More than 100 cases of allegedly poor maternity care at a troubled NHS trust are now set to be independently investigated - after earlier concerns highlighted by HSJ led to more families coming forward.

Sources at Shrewsbury and Telford Hospital Trust said the number of maternity cases now being passed to an independent government review has increased to at least 104 in recent days.

The numbers are expected to grow further, HSJ understands.

NHS Improvement and the trust have agreed to pass the cases to independent midwifery expert Donna Ockenden who is already carrying out an inquiry into maternity care at the trust.

She is also expected to be widening her team to include more midwives and senior consultants to be able to examine the full scale of cases coming forward.

She was initially appointed by former health secretary Jeremy Hunt to examine 23 cases of alleged poor care in 2017.

But her review was widened by the Department of Health and Social Care last month after HSJ raised the concerns of families that multiple separate investigations into dozens more alleged cases of poor care risked lessons being missed without a single overarching independent view being taken.

The alleged poor care includes the deaths of babies and mothers as well as stillbirths and new-borns being left with significant brain damage. The cases are believed to span more than two decades with some of the most recent deaths taking place in December last year when a mother and two babies died in separate incidents.

The Ockenden review has not reached any conclusions on the 104 cases but the trust is already facing suggestions the scale of poor maternity care could “could put Morecambe Bay into the shade” according to a source who spoke to HSJ last month.

In a statement, the trust stressed that the review covers a period dating back about 20 years and said “no conclusions have been reached about the care provided in any of these cases”. It said it was committed to learning any lessons that arise from the review.

A number of the new cases at the Shrewsbury trust are from families who have come forward following media coverage of the issues at the trust last month. Others have been identified from coroners’ inquests, incident records and other documentation.

The trust’s consultant-led maternity department is at Princess Royal Hospital in Telford, but it also runs five midwife-led units.

Richard Stanton, whose daughter Kate died as a result of avoidable poor care at the trust in 2009, told HSJ: “The trust has buried its head in the sand and what we are seeing now is a tragedy unfolding that is beyond all belief. I think the trust has continually failed to learn and in that situation mothers and babies are going to continue to come to harm.”

He said the trust response to the concerns being raised showed there was a “culture of denial”, adding: “If this trust wants to redeem any semblance of trust in its maternity services then the widest possible independent review is what is required.”

Mr Stanton said the Ockenden review needed to be given the time and space to do its work adding its conclusions could lead to wider learning: “If a number of these cases are proven to be avoidable deaths or avoidable harm then very serious questions need to be raised about why this was being allowed to continue at a senior level.

“When we do have Donna Ockenden’s review we will have the widest possible view of what has gone on.”

Alongside the maternity concerns, a local authority leader has called for an independent investigation into allegations of bullying made by staff at the trust.

It is also facing action by the Care Quality Commission following an inspection earlier this year. The regulator has taken “urgent enforcement action” after it found patients were being treated like “animals and cattle” in “unsafe, demeaning, undignified, and disgusting” conditions.

Dr Kathy McLean, executive medical director at NHS Improvement, said: “We are committed to ensuring Shrewsbury and Telford Hospital Trust is able to learn as much as it can from the historical cases of concern where women or their babies suffered, or were at risk of, harm or have died. This is so that the trust can improve its maternity and neonatal services and give patients the necessary reassurance that they will receive safe and high quality care at all times.”

She would not confirm numbers of cases but said the regulator would examine “in detail” anything that would be relevant and seek consent from families in advance and check cases were not duplicated. She added: “We will confirm further details about our review as soon as we are able to.”

Trust response

Deirdre Fowler, director of nursing, midwifery and quality at Shrewsbury and Telford Hospital NHS Trust (SaTH) said: “We remain committed to providing the best care for all of our patients and to all women and families who use our maternity services. We are continuing to work closely with NHS Improvement and fully engaging and co-operating with their independent review.

“We welcome the approach of NHSI in considering cases of families who have come forward, including those who were initially referred back to us by them and those who have come forward since. We are committed to learning any lessons that arise from this review to ensure the best care for all of our patients.

“It is important that any families who have any questions or concerns over their care are given the chance to have them explored. Given the high profile of the NHSI independent review, it is understandable that more families have come forward.

“We recognise that, taken in isolation, the number of cases which are being considered may cause concern or anxiety for families currently using our services. It is important to remember that this review covers a period dating back some 20 years and that, at this stage, no conclusions have been reached about the care provided in any of these cases.

“SaTH provides a safe service for women giving birth. We would encourage any mums-to-be or families with any questions about their care to speak to their midwife. Any families who would like to contact us can email sath.womenandchildren@nhs.net