Having a child should be one of the happiest times of your life, but for the parents of Wynter Andrews what should have been a happy moment, turned into tragedy.
An inquest at the Nottingham Coroners Court heard that baby Wynter died just 23 minutes after being born. She may have survived but for the “gross failings” in her care. The Court heard how staff failed to recognise that Wynter’s mother, Sarah, was in established labour, failed to act on high blood pressure readings and carried out four “inaccurate and insufficient handovers” to colleagues as part of a catalogue of errors.
At the inquest, Coroner Laurinda Bower said that “systemic issues” contributed to the neglect of Wynter. She added that the unit was so short staffed, midwives on duty were looking after a high number of patients all at the same time. Concerns had been raised in a 2018 letter from midwives on the unit, which they sent to bosses at the Trust, warning low staffing levels could be “the cause of a potential disaster”. They felt unable to professionally challenge colleagues at the hospital.
The Care Quality Commission have said that Nottingham University Hospitals NHS Trust will now be prosecuted for “failure to provide safe care and treatment”. This comes after a string of failings, going back many years, involving maternity services operated by the Trust. The Health Watchdog had already rated them “inadequate” after other complaints.
Senior Midwife Donna Ockenden has been put in charge of a new review of services after a previous heavily criticised thematic review was scrapped halfway though. The CQC can prosecute for a breach of this regulation or part of it, if failure to meet it results in avoidable harm to a person using the service, or if a person using the service is exposed to a significant risk of harm.
The new independent inquiry into failings at the Nottingham hospitals will begin in September.
This is clearly a tragic and heart-breaking case, and the fact the CQC is seeing fit to prosecute the Trust serves to highlight the alarming extent of the failings on the Trust’s part. The CQC has had the power to prosecute health and social care providers for failing to provide care and treatment in a safe way since April 2015. The inquest in 2020, and the findings of gross negligence on the part of the Trust, highlighted an unsafe environment and culture within the maternity unit at the time. I welcome the review now being carried out by Donna Ockenden and hope that the findings of such can ensure that measures are put in place to make sure no more parents have to suffer the same entirely avoidable devastation felt by the family of Baby Wynter.
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