Shrewsbury and Telford NHS Trust (SaTH) have been fined over one million pounds after admitting failures in medical care that contributed to the deaths of two patients.

SaTH were prosecuted by the Care Quality Commission (CQC) under the Health and Social Care Act 2008. Appearing before Telford Magistrates, SaTH admitted three charges of failing to provide treatment and care in a safe way, resulting in harm.

In the first case, Mohammed Zaman, 31, died of severe blood loss while undergoing dialysis at the Royal Shrewsbury Hospital in 2019. A catheter came out of his jugular vein which set off an alarm. However, he was not checked before staff switched it off, and by the time staff had noticed what had happened, he had lost half of his supply of blood. SaTH admitted failings and were fined £800,000.00.

In the second case, Max Dingle, 83, was placed on a larger bariatric bed which staff were not trained on how to use correctly. He suffered a cardiac arrest after his head became trapped between a mattress and the bed rail, and sadly could not be resuscitated.

Prosecuting, the CQC said both patients and their families had been "severely let down" by SaTH. "People using health and social care services have the right to safe care and treatment, so it's unacceptable that patient safety was not well managed by Shrewsbury and Telford Hospital NHS Trust," Fiona Allinson, from Watchdog, said.

Following the hearing, SaTH issued a statement in which its director of nursing Hayley Flavell said: "We are truly sorry for the pain and distress caused as a result of the failures in the provision of care. We offer our sincere apologies and heartfelt condolences to the families we let down".

Sadly, this is not the first time SaTH have caused or contributed to avoidable deaths. In March, a damning review into the maternity services at SaTH was released by Donna Ockenden which found "repeated errors in care" at the Trust contributed to the deaths of 201 babies between 2000-2019.

West Mercia Police are presently carrying out Operation Lincoln - an investigation into the care of mothers and babies who died or suffered serious harm under maternity services at SaTH between 1 October 2003 and the present day.

Lanyon Bowdler are assisting a large number of families who are part of Operation Lincoln and the Donna Ockenden review, therefore if you require any assistance or if you need advice, please contact us.

1. Control

By taking the positive step of making a Will, you can control the distribution of your estate, rather than relying upon the Statutory Intestacy Rules.

The Statutory Intestacy Rules, govern how a deceased person’s estate is to be distributed if they have not made a Will, and who should deal with the administration and more often than not, they do not provide for the desired outcome.

2. Choice

By preparing a Will, you can choose your:

• Executors
• Guardian(s) for any infant children
• Beneficiaries

3. Specific Gifts

When preparing your Will, you have the opportunity to provide for specific items to pass to beneficiaries of your choice.

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In addition, you may wish to include monetary bequests to individuals or charities.

4. Inheritance Tax

If you seek specialist advice when you prepare your Will, you will be advised on your Inheritance Tax position and whether it is likely your estate will be taxable.

Also, where appropriate, advice can be provided as to the options available to you in potentially reducing any Inheritance Tax liability.

The rules relating to Inheritance Tax can often be complex so seeking specialist advice, to ensure that you Will is drafted in the most tax efficient manner is vital.

5. Options - Your situation is not “too complicated”

Until you seek advice from a suitable qualified Lawyer with regards to the preparation of your Will, you cannot fully understand or appreciate the options available to you regarding the distribution of your estate.

It is our job to understand your particular circumstances and prepare a bespoke Will accordingly.

Often, clients put off seeking advice believing their situation is too complicated. We are well aware that the average family no longer consists of a married couple with two children but instead, blended families with unmarried parents or second marriages. We can assure you, we will always find a solution.

In the case of second marriages, where spouses have children from previous relationships, there are ways your Wills can be drafted so as to ensure that the surviving spouse is catered for, but that also, your children from a previous relationship also benefit.

If your assets are complicated and consist of business and/or farming interests (meaning your estate is assets rich, cash poor) and/or you are trying to achieve fairness between your children and can’t quite figure out how – we are here to help!

If you worry that there will be no money left in your estate to pass on to your children because it has all been spent on care fees, or that following your death, your spouse may re-marry putting your children’s inheritance at risk. By seeking professional advice, there are ways in which your Will can be drafted to potentially protect some of the value of your estate from the payment of care fees, from remarriage or indeed, unwise spending (be that by a spouse or children). This could also cover situations where perhaps a child is encountering matrimonial or financial difficulties.

6. Financial Advice

We do not as Lawyers provide financial advice, but often during our initial fact finding it will become apparent that you may benefit from financial advice – this could be in relation to life insurance, pensions or Inheritance Tax planning. We can help you get the correct/trusted advice.

7. Professional, specialist advice

Please, when you do make the decision to make a Will, seek advice from a suitable qualified Lawyer. If you have previously seen a Lawyer to make a Will and they have taken your instructions and prepared a Will for you, as directed, without giving you advice on any of the above, you have not sought the correct specialist advice! Review your Will.

8. We are not ogres

Clients often feel worried about taking that first step in making a Will. I promise we are not scary, we are all very friendly and approachable and do our very best to make you feel at ease throughout. The initial appointment consists of taking information regarding your personal and financial circumstances and understanding what you are trying to achieve. We will provide advice on your Inheritance Tax position and ensure that you understand the options available to you in distributing your estate.

9. Peace of Mind

Often, once a client has executed their Will, they speak of having a sense of peace, knowing it has been sorted.

10. Review your Will

Once you have prepared your Will, review it every three to five years or sooner if there has been a change in your circumstances or a change in the law, to Income Inheritance Tax.

By review, we mean take it out of the drawer, read through it and consider whether you feel it is still fit for purpose.

The Donna Ockenden Review reported in March 2022 found repeated failures at the Shrewsbury and Telford Hospital Trust (SaTH) spanning over a 20 year period whereby both babies and mothers died or were left seriously disabled. The widespread media attention of this review has incited families cared for by the Nottingham University Hospital (NUH) NHS Trust, including Queens Medical and City Hospital, to ask for Donna Ockenden’s input into an ongoing review into the Nottingham Maternity Unit.

A review similar to that completed by Donna Ockenden is in progress in Nottingham relating to the failings at the NUH Trust after dozens of babies died or suffered life-altering injuries. However, families have complained about the lack of progress being made with the investigation, saying that the review is “moving with the viscosity of treacle".

The Nottingham Maternity Unit was rated as inadequate by the Care Quality Commission (CQC) in 2020 when an inspection concluded that there were serious concerns and that staff did not always understand how to keep women and babies safe. The inspectors warned of unsafe staffing levels and patient safety incidents potentially being wrongfully downgraded i.e. incidents were not being investigated properly and people were therefore put at risk of harm as lessons were not being learnt.

A re-inspection in March 2022 resulted in the CQC issuing a warning notice to the NUH Trust highlighting specific concerns over triage services and increases in still births. Investigations have found that at least 46 babies have suffered brain damage and 19 were stillborn between 2010 and 2020.

These findings are all too familiar to those families involved in the Ockenden SaTH Review which examined 1,486 cases between 2000 and 2019 and found at least 201 baby deaths with significant or major concerns over the care received.

The NUH maternity review is currently chaired by NHS Manager, Cathy Purt. However, families involved have questioned her experience in maternity services, as well as of running an inquiry of this magnitude. It has been reported that 84 families were originally involved in this review and this has since increased to 461 following publication of the Ockenden Review.

The NUH maternity review has been ongoing for the past 6 months and is due to be completed by 30 November 2022. However, only 3 clinical leads are involved compared to the 76 clinicians employed in the Ockenden Review. The families are concerned that the review team are unprepared and lack experienced leadership to handle such a large and vitally important review.

Families involved in the NUH Trust review have contacted the Health Secretary Sajid Javid directly raising their concerns and have requested for Donna Ockenden to take over the investigation. Donna Ockenden has since responded to the families directly and noted that she is deeply honoured by their request but any involvement on her part would be subject to approval from the Health Secretary.

As nationally recognised clinical negligence solicitors, we at Lanyon Bowdler are representing a number of families relating directly to the Ockenden Review, and it is hoped that their patient journeys will lead to positive changes and improvements at SaTH. A public enquiry into the NUH Trust, similar to that of the SaTH Ockenden report, is important to ensure that those families affected are provided with support and compassion to come forward and share their experiences, and thereafter highlight and improve upon any identified failings in maternity care.