A letter sent by worried staff shows why maternity care is still failing too many families

Image source, Getty Images Image caption, A review of maternity services in Nottingham found hundreds of mothers and babies suffered potentially avoidable harm or died due to "systemic failures" By Michael Buchanan Social affairs correspondent Published 18 minutes ago In November 2018, health bosses in Nottingham were told there was "a crisis in our maternity services". A letter, signed by more than 50 staff at the Queen's Medical Centre, warned "mistakes will be inevitable" if problems weren't addressed. They told bosses of chronic understaffing, a scarcity of critical safety equipment and "a dire lack of leadership". But management reaction to the letter was "inadequate", its author told me recently . It was effectively ignored. Wednesday's review of maternity services in Nottingham , external - reveals the shocking extent of the mistakes made. Hundreds of mothers and babies suffered potentially avoidable harm or died due to deeply embedded "systemic failures". It is the fourth maternity review in little over a decade - all were heralded as being "never again" moments. But what happened to that letter goes to the heart of why maternity care in England is viewed as failing too many families. It had been sent to the chairman of the Nottingham University Hospitals trust, as well as the chief executive, the medical director and the head of midwifery. Yet staff were palmed off. We know this because five years later, a new management team at the trust investigated what had happened. Hundreds of mothers and babies died or were harmed due to 'systemic' failures, Nottingham review finds Racism and 'poor' staff relationships factors in maternity care failings, report finds Published 26 February Two weeks after the letter had been delivered, a response was sent to the staff outlining actions that had occurred over the previous few months, and offering to meet to discuss further. But the 2023 review found "no evidence" that the board had discussed the letter, with the new chief executive concluding that the response was "unsatisfactory". The review said: "It did not address the concerns that were being made." That refusal by the trust to take meaningful action in light of a cry for help from its own staff highlights the repeated refusal for years by senior leaders across the NHS to improve maternity services. Three maternity reviews preceded Nottingham – in Morecambe Bay, in Shrewsbury and Telford, and in East Kent. In all cases, the health service was aware of the problems but was unable, or unwilling, to get to grips with the extent of them until some determined families refused to take no for an answer. Those families pushed for the independent scrutiny that the NHS would never voluntarily conduct. Image source, PA Media Image caption, Donna Ockenden's inquiry into Nottingham University Hospitals NHS Trust maternity services found a "persistent failure to listen to mothers and fathers" England's former health secretary Wes Streeting was fond of highli