The Nottingham University Hospitals NHS Trust is facing intense scrutiny following revelations of long-standing failures in its maternity services that contributed to hundreds of avoidable deaths and injuries between 2012 and 2025. An independent review led by expert midwife Donna Ockenden, which examined over 2,500 cases, has uncovered systemic shortcomings including poor care, underreporting of serious incidents, and a culture that dismissed concerns raised by both families and staff.
Ockenden’s inquiry, extended last year after the identification of an additional 256 neonatal deaths, found that the trust’s leadership repeatedly downgraded nurse and midwife failings to avoid regulatory scrutiny. This practice enabled the trust to classify serious incidents as lower-level events, thereby circumventing immediate investigations and excluding families from the process. Such downgrades impeded transparency concerning stillbirths, neonatal deaths, and severe brain injuries. The review also uncovered distressing accounts of racist treatment, including denial of interpreter services, dismissal of pain, and mockery of women from ethnic minority backgrounds.
Former and current staff reported a climate where warnings about unsafe conditions were ignored. A whistleblower who retired in 2019 recalled that letters raising safety concerns went unheeded. Chronic understaffing, high demand, and leadership disconnected from frontline realities further exacerbated the situation. One family, the Hawkins, whose daughter Harriet was stillborn in 2016, highlighted the trust’s failure to classify such deaths as serious incidents promptly. Harriet’s death was not officially recorded as a serious incident for 159 days despite clear criteria for immediate investigation, raising allegations of a cover-up designed to minimise reputational damage. Mrs. Hawkins also described insensitive treatment by staff, including mockery during her grieving process. The family later received £2.8 million in compensation after a prolonged legal fight.
The deterioration of the Nottingham maternity service has been linked in part to the 2006-07 merger of two city hospitals. Regulatory bodies appeared slow to respond, despite repeated failings. The Care Quality Commission prosecuted the trust twice for maternity-related issues, levying a record £1.6 million fine in 2025. Meanwhile, Nottinghamshire Police is conducting a criminal investigation, Operation Perth, looking into potential corporate manslaughter and gross negligence charges, although no arrests have been made to date.
Out of 60 former senior executives and directors approached by investigators, about half declined to comment on their roles in the scandal. Around 150 doctors and midwives are currently under assessment for their fitness to practise, which could lead to permanent removal from the profession.
The trust’s current chief executive, Anthony May, issued a statement expressing sorrow over the tragic outcomes and gratitude to families who have pursued accountability. He expressed hope that the ongoing investigations would provide long-awaited answers. Calls from families and campaigners for a full statutory public inquiry continue, aiming to compel evidence from senior NHS leaders and ensure lessons are learned.
Recommendations from Ockenden’s review are anticipated to focus on improving staffing levels and fostering a safety culture, concerns mirrored in maternity units across the country that are facing similar investigations.