By Anna Whittaker, Local Democracy Reporter
The chair of the Nottingham maternity review has raised concerns with the hospital trust at the centre of the inquiry about a “very entrenched problem of discrimination” within services.
Senior midwife Donna Ockenden is examining cases of maternity care at Nottingham University Hospitals (NUH), which runs the Queen’s Medical Centre and City Hosptial.
As of February 27, 1,813 families are part of the review, which is expected to be the largest of its kind in NHS history.
It includes cases of stillbirth, neonatal deaths, brain damage to the baby, harm to mothers or mothers who have died.
A total of 56 families have chosen to opt out of the process and Ms Ockenden said she is expecting contact details from another 70 families who have been identified by NUH as having relevant cases. More than 700 staff are also in contact with the review.
Ms Ockenden meets NUH’s Chief Executive Anthony May and Chair Nick Carver every two months to discuss issues raised by families.
In her most recent letter to the trust, written in December 2023, and published in February 2024, Ms Ockenden outlined concerns.
Responding to the letter, Chief Executive Anthony May said parts of it made for “difficult reading” and said the trust has a “determination to address these issues as quickly as we can”.
Ms Ockenden wrote in the feedback letter: “Service users across many of Nottingham’s communities continue to report racist and discriminatory behaviour from a range of care givers throughout maternity services.
“Women and their husbands have reported to me that non-white mothers are spoken to more rudely and in a more dismissive way than their white counterparts. I have now heard this from families from a wide range of backgrounds on countless occasions this year.”
She included examples including one mother who described having a bedsheet “thrown” by a member of staff after she asked for help in changing a bloodstained bed.
Another woman said she received “dirty looks” because of the way she was dressed.
One mother, who had just lost a pregnancy, “described a member of staff mimicking her accent, voice and mannerisms”.
“Instead of being reprimanded, other members of staff who the mother believed were senior were laughing at the behaviour of their colleague”, the letter added.
Ms Ockenden added that translation and interpretation services in maternity care “remain very poor”.
Mothers from the Roma community said interpretation was “very poor” and that interpreters were often male, which was not culturally appropriate.
Ms Ockenden said a discharge information video was only available in English.
She said some mothers felt they could not provide consent about clinical procedures because translation services “are often so minimal/ non- existent”.
She said for some families there is a long wait from raising concerns to receiving a response from the trust, including one family who had waited for a year to receive answers about their case.
Ms Ockenden wrote: “We have discussed the work of the Inclusivity Maternity Taskforce, set up since the April 2023 Learning and Improvement Meeting.
“Whilst I look forward to hearing of further progress from their work I raised concerns that the leaders of this work must have the support, influencing skills and ‘seniority’ to deal with what now appears to be a long term and very entrenched problem of discrimination and lack of inclusion in the delivery of maternity care at the Trust.”
Responding to the letter, Chief Executive Anthony May said: “Whilst it is disappointing to learn of the experiences which have been shared with you, I want to assure you that we are learning from the feedback. On behalf of the Trust, I want to apologise to these women and families for any shortcomings.”
He said actions being taken include the provision of face-to-face, video and telephone, female Roma interpreters (when given advanced notice) from February 2024.
He said the maternity ward clinics are piloting a translation device from February 2024 which provides direct voice translation, starting with Polish.
A pilot of bi-lingual, all-female antenatal classes for non-English speaking women will also begin in April 2024.
Mr May said the discharge video transcript referenced by Ms Ockenden is being translated into Polish, Urdu, Arabic, Romanian and Farsi.
He added that a trust wide mandatory training video on interpreting and translation services will be available from April 2024.
He added: “I am disappointed to hear that women and families have experienced discriminatory behaviour. This is contrary to our values and beliefs, and I take it very seriously.”
Speaking to the Local Democracy Reporting Service, Ms Ockenden said: “Back in December I was hearing accounts of racism, discriminatory behaviour and poor access to translation and interpretation services and some staff who were unkind.
“I also heard about the excellent service provided by the community midwives who work through the Mary Potter centre.
“Anthony May and Nick Carver have absolutely pledged that they are taking this issue extremely seriously and that the changes that need to happen will happen throughout women’s health, and eventually throughout the whole trust.
“It does underline the amount of work that needs to happen.
“It is a concern that I’m having to sometimes say the same things over and again. Equally, I feel the trust are taking this seriously.”
Mr May told the Local Democracy Reporting Service that he wished to apologise to women and families for the “shortcomings identified” by Ms Ockenden.
He added: “I also apologise if anyone has experienced racism in our hospitals – this is not something we will accept, and we are determined to make the Trust a more inclusive organisation.
“We know we have much more to do and we are focussed on improving our services. Overall, we are improving – this is evidenced in the latest CQC inspection report, and the recently published CQC maternity survey for 2023.
“However, these improvements must be across the board.”
He said anyone who has experienced discriminatory behaviour to contact the Patient Advice and Liaison Service (PALS) Team.
