By Anna Whittaker, Local Democracy Reporter
The head of a review into maternity care in Nottingham says there is a “reccurring theme” of midwives not listening to women who say they are in labour.
Donna Ockenden is running the largest maternity review in NHS history at Nottingham University Hospitals Trust (NUH).
As part of the review process, covering the Queen’s Medical Centre and Nottingham City Hospital, Ms Ockenden and her team regularly share findings with the trust and NHS England.
At the most recent meeting on June 21, Ms Ockenden met trust Chief Executive Anthony May, Chief Nurse Michelle Rhodes and Medical Director Dr Keith Girling.
On August 8, Ms Ockenden then sent a letter to Mr May describing her latest findings.
Concerns were raised over interpretation services, blood testing during Ramadan and parents being told that notes have been lost – despite these being provided to the review team.
Ms Ockenden explained how she met families including parents who experienced the death of their baby at the trust two years ago, two families of mothers who had died, and parents who are managing the 24-hour care needs of profoundly unwell children following birth at the units.
The letter, made public on Thursday (August 25), said: “During the recent Holy Month of Ramadan, despite the fact that I had highlighted it to the Trust before Ramadan as an issue that occurred last year women told me that this year they were still told to ‘break their fast’ for some blood tests and told there was no flexibility for early or later blood tests.
“Since the timing of the month of Ramadan is known about in advance, this extra provision in blood testing could have been planned for in advance and I sincerely hope it will be next year.
“Women repeatedly told they are not in labour ‘it’s Braxton Hicks’. One woman was recently told this at 33 weeks of pregnancy even though she had a history of previous pre term labour and she should have been admitted for assessment.
“Other women are told they could not be in labour and to stay at home ‘if they can ‘talk on the phone.’ Women not being believed they are in labour when they call the Trust for assistance seems to be a recurring theme.”
Ms Ockenden raised a number of other concerns in the letter.
She said mothers have told her interpretation and translation services are “very hit and miss” with “no consistency”.
This includes mothers who require emergency caesarean sections, some of whom signed consent forms without understanding what they were signing.
Others had to phone relatives to have a three-way conversation.
“Hospital interpretation services appear to be much worse than those provided in the community”, the letter added.
One woman told Ms Ockenden on behalf of her students learning English that “without interpretation we are left feeling deaf, dumb and blind throughout our maternity care”.
Ms Ockenden added that parents are being told by the maternity team that their notes had been ‘lost’ by the trust – despite these being held electronically by the review team.
She wrote: “As the trust provides them to the review team then clearly they cannot be lost.”
Other concerns which NUH have agreed to review are:
- Repeated examples of ‘manual removal of placentas’ being undertaken without appropriate anaesthesia in a labour ward room rather than in a theatre, often with only gas and air
- The maternity team apparently using genetic testing as a ‘first line’ of enquiry, before any governance investigation or enquiry following a baby being born in unexpectedly poor condition. The trust has agreed the use of genetic testing should be reviewed/ audited to try and understand this further
But Ms Ockenden also added that “communication between the trust and the independent Maternity Review appears to be working very well”.
The letter also explained one mother had told Ms Ockenden that an NUH midwife had ‘turned her life around’.
Ms Ockenden singled out midwife Deb Hampson for praise and said she had informed the Chief Nursing Officer Dame Ruth May.
Michelle Rhodes, Chief Nurse, said the team is “grateful for the continued and regular feedback”.
She said: “The format of the meetings enables us to act swiftly on the information we are given to improve services for our women and families rather than waiting for the publication of the review to act.
“We know that more work needs to be done in a number of areas and we are taking forward the most recent feedback from Donna alongside the continuing Maternity Improvement Programme.
“Our teams are absolutely committed to improving services, and we are proud that the work of the taskforce was recognised for making progress in a number of areas with black and minority ethnic groups, as well as the important work midwives are leading with the homeless and asylum seekers.
“It is also gratifying and humbling to hear the individual testimony of the difference one of our midwives made with a mother, which is the level of care that we all should aspire to.
“Women and families can be assured that the feedback and learning that is shared with us throughout the review is used to make improvements to our maternity services immediately.”