Shrewsbury and Telford Hospital NHS Trust Making Progress on Maternity Care Reforms

Published on 14 Aug 2023

In a recent update, Director of Midwifery Annmarie Lawrence reported that the Shrewsbury and Telford Hospital NHS Trust (SaTH) is making strides in addressing the recommendations outlined by the Ockenden Report – the independent review of SaTH’s maternity care services.

The Ockenden review conducted a comprehensive analysis of maternity practices at SaTH spanning two decades. The review found that failures in these practices contributed to the deaths of 201 babies and nine mothers, as well as causing life-changing injuries to other infants. At the time, it was the NHS’s worst maternity scandal in all of its history.

When the final report was published in March 2022, it identified wide-ranging actions for learning for SaTH to implement, as well as 15 immediate and essential actions for maternity services across England.

In a meeting with SaTH’s board of directors, Ms. Lawrence has proposed reducing the frequency of meetings for the committee overseeing the implementation of these recommendations, to allow for a greater focus on the remaining, more intricate actions. She conveyed her satisfaction with the current state of affairs, asserting, "We are exceeding expectations and I am very satisfied with where we are currently."

Key highlights from the update include:

  1. Action Delivery and Assurance: As of the last month, of the 52 actions highlighted in the initial Ockenden report, 47 have been successfully delivered. Of these, 45 have been rated as 'green', indicating that they have been both 'evidenced and assured';
  2. Final Report Progress: From the 158 actions identified in the initial Ockenden report published in December 2020, 133 have been completed, with 107 of these being 'evidenced and assured'.
  3. Color-Coded Ratings: Actions that have been delivered but are still awaiting full assurance are categorised as 'amber', while actions yet to be completed are marked as 'red';
  4. Continued Improvements: Since the report's publication, SaTH has further improved its performance with some actions previously rated 'red' have been upgraded to 'amber', and certain 'amber' actions have now been labelled as 'green’;
  5. Meeting Frequency Adjustment: As a result of the progress made, The Ockenden Review Assurance Committee (ORAC), which meets monthly, is proposed to shift to meetings every two months to provide the necessary time and capacity to focus on complex actions;
  6. Influence and Control: The board members noted that several actions rated 'red' or 'amber' were those considered outside of SaTH’s direct control, including recommendations for the broader NHS;
  7. National Leadership: Despite some challenges, SaTH is leading the way in certain aspects, as identified by the development and implementation of a new training package, which is hoped to be rolled out nationally.

SaTH are keen to demonstrate their dedication and commitment to reform and improve maternity care. While challenges persist, SaTH’s achievements to date signal a promising step forward in ensuring safer healthcare outcomes for all mothers and newborns.

Lanyon Bowdler are currently assisting over 300 families with claims arising out of poor maternity care at SaTH. If you require any further information, please contact us by emailing:

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