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Interpretation services within Nottingham University Hospital's maternity services remain ‘poor’ for some women, according to the leader of a review into care, Donna Ockenden who is running the largest maternity review in NHS history

Interpretation services within Nottingham University Hospital's maternity services remain ‘poor’ for some women, according to the leader of a review into care.

Experienced midwife Donna Ockenden is running the largest maternity review in NHS history, which started in September 2022.

The review now includes the cases of 1,808 families including stillbirths, neonatal deaths, brain damaged babies and maternal harm and deaths.

Donna Ockenden
Donna Ockenden

Maternity services at the trust, which runs Queen’s Medical Centre and City Hospital, are currently rated — require improvement by healthcare watchdog the Care Quality Commission.

The Ockenden review now aims to publish its findings in September 2025 with a period of family feedback which could last until the start of 2026.

As part of the review process, Ms Ockenden and her team regularly share findings with the trust and NHS England.

Anthony May, chief executive at the trust, said the feedback from the review team remains valuable to our maternity improvement programme.

Speaking to the Local Democracy Reporting Service, Ms Ockenden said: “We’ve just had our fifth learning and improvement meeting with Anthony May, members of the executive team and NHS England.

“We talked about discrimination, inequality and racism.

“NUH are working hard to improve on this aspect but women that I’m speaking to in the here and now, who are still pregnant or recently had babies, said that interpretation remains poor.

“It’s better in the community than in the hospital.

“Many women do feel they are treated differently because of their background.

“The commitment that I’ve heard clearly from Anthony May is that this whole issue of inclusion is moving up to the board level.

“The review has shone a light on how deeply ingrained the issue was, and to an extent remains.

“The trust has got an awful lot of work to do in this area.”

In August, Ms Ockenden raised concerns with the trust over interpretation services and blood testing during Ramadan.

At the time she said mothers told her interpretation and translation services were very hit and miss with no consistency.

Earlier this year the review changed to an ‘opt out’ system, meaning women’s cases are automatically be included unless they withdraw consent.

The ‘opt out’ review was used in Ms Ockenden’s previous maternity investigation at Shrewsbury and Telford NHS Trust.

A total of 384 families have experiences which do not meet the terms of reference of the review – but they will be part of a learning exercise for the trust.

Ms Ockenden added: “Switching to opt out has been a significant success, the total opt outs have been 52.

“715 staff are a part of the review, but Ms Ockenden said she would not be able to hold interviews with staff until Spring 2024.”

The midwife said she has been meeting with communities around Nottingham and Nottinghamshire to hear their stories.

She said: “Community engagement takes time and trust needs to be built.

“What I’m seeing is a building of that trust and it has taken us a year for the Roma women to want to come forward.

“We agreed that this was the start of a journey.

“Their recent experiences were that where Romanian interpretation has been available, sometimes it has been with a male caregiver which for many of these women is culturally unacceptable.

“They told me that there’s a real need to build trust.

“Our representation from all Nottingham communities now means we have a very inclusive review.”

Ms Ockenden said families can access psychological support services in seven different languages through Trent PTS.

Anthony May, chief executive at Nottingham University Hospitals said: “The feedback that we receive from Donna Ockenden remains valuable to our maternity improvement programme. Donna has fed back that some women are not finding our services inclusive and that is clearly unacceptable.

“We are working hard on this already and at the meeting on 14 November we updated Donna and the review team on the work of our Inclusive Maternity Taskforce. This includes ongoing work to listen to our communities and significant improvements ensuring information for mothers and families is available in the right language.

“I know there is more work to do on this vital issue, and we are all committed to improving our maternity services for everyone.”

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