Importance Score: 85 / 100 🟢
Report Exposes Troubling Infant Mortality Rates in England’s Maternity Units
A concerning report has today revealed the distressing situation within England’s maternity units, specifically identifying NHS trusts with worryingly elevated instances of baby deaths. This analysis casts a stark light on the performance of several healthcare providers in ensuring the safety and well-being of newborns. The findings are likely to intensify scrutiny on maternity services and prompt calls for immediate action to address the identified issues within these critical healthcare settings.
NHS Trusts with High Infant Mortality Rates Identified
The investigation pinpointed seven NHS trusts that recorded infant mortality rates exceeding the national benchmark by at least five percent. These higher-than-average rates raise serious questions about the quality of care and potential systemic issues within these institutions.
Worst Performing Trusts
The NHS trusts with the most concerning figures were Sandwell and West Birmingham Hospitals NHS Trust and University Hospitals of Leicester NHS Trust. Both of these trusts surpassed the critical threshold in five out of the seven years examined during the Health Service Journal’s investigation. This consistent underperformance over several years suggests deep-rooted problems that require urgent attention and intervention.
Leeds Teaching Hospitals NHS Trust Faces Scrutiny
Following closely were Leeds Teaching Hospitals NHS Trust, where families who have lost children recently demanded an inquiry into the potentially preventable deaths of 56 infants. In this trust, mortality rates surpassed expected levels in four out of the seven years under review.
Analysis Follows Preventable Birth Injury Concerns
This report emerges shortly after a separate alarming analysis highlighted NHS Trusts in England with the highest incidence of preventable birth injuries. This sequence of revelations underscores a broader pattern of potential systemic challenges within NHS maternity care across the country.
Manchester University Foundation NHS Trust – High Compensation Claims
Manchester University Foundation NHS Trust may be considered among the riskiest places for childbirth, as data indicates it has paid out more in compensation to new mothers than any other healthcare provider in England over the past two years, according to legal analysis by Been Let Down.
Data Based on MBRRACE-UK Reports
The latest statistics are drawn from annual reports published by MBRRACE-UK, an organization that reviews stillbirths and neonatal deaths. However, it is important to note that MBRRACE-UK’s analysis does not determine whether these deaths were potentially avoidable.
Mortality Rates at Specific Trusts
- Sandwell and West Birmingham Hospitals NHS Trust (2023): 4.98 deaths per 1,000 births (compared to a group average of 4.05).
- Leeds Teaching Hospitals NHS Trust: 5.34 deaths per 1,000 births (compared to a group average of 4.49 for trusts with similar levels of neonatal intensive care).
Trusts Respond to Analysis
In response to the analysis, some trusts argued that MBRRACE-UK’s methodology does not adequately consider the fact that they manage births where babies have extremely low chances of survival due to pre-existing conditions, such as severe heart problems.
Socioeconomic Factors and Deprivation
Several of the seven trusts with the most frequent “red” ratings, including Sandwell, serve communities with significant levels of deprivation and large populations where English is not the primary language. These socioeconomic factors can contribute to health disparities and potentially impact maternity outcomes.
MBRRACE-UK Defends Analysis Methodology
MBRRACE-UK informed HSJ that its analysis is designed to ‘enable fairer comparisons between organisations of different sizes and populations’. The organization further stated that they adjust rates to account for ‘key risk factors such as maternal age, socio-economic status, baby’s ethnicity, sex, multiple births, and gestational age.’
However, MBRRACE-UK acknowledged that ‘some factors — such as maternal smoking and [body mass index] — are not universally collected and therefore cannot be included in the adjustment.’
Regulatory Scrutiny and Concerns
Maternity service deficiencies have already been identified at some of the listed trusts by the Care Quality Commission (CQC), the healthcare regulator.
CQC Ratings and Interventions
- Sandwell and West Birmingham Hospitals NHS Trust: Issued a warning notice last year and rated ‘inadequate’ for safety and ‘requires improvement’ overall.
- Bradford’s Maternity Unit: Inspected in 2024 following whistleblower concerns, currently rated ‘requires improvement,’ although its neonatal service received an ‘outstanding’ rating.
Trusts’ Statements and Action Plans
Helen Hurst, Director of Midwifery at Sandwell and West Birmingham Hospitals NHS Trust, stated: ‘We always ensure that a comprehensive investigation is conducted in these unfortunate cases to guarantee that appropriate learning occurs as quickly as possible.’
‘We have observed a significant decrease in neonatal deaths during the past year.’
‘Furthermore, a broader review into the elevated rate was conducted by the Black Country Local Maternity and Neonatal System, which identified several crucial recommendations and actions.’
‘For high-risk pregnancies, this has resulted in early access to aspirin and senior clinician oversight, enhanced monitoring, and external clinical experts to review perinatal mortality. All stillbirth scan images undergo peer review by clinical experts, and LMNS-wide training is in place to support the quality of perinatal mortality reviews.’
‘Consequently, stillbirth and neonatal death rates have shown a decline since January 2024 in locally held data.’
Gang Xu, Deputy Medical Director at University Hospitals of Leicester, commented: ‘We are actively working to understand the factors we can influence to lower our perinatal mortality rate to the absolute minimum.’
‘This year, the stillbirth rate has improved in Leicester, and our overall mortality rate remains stable. All cases are thoroughly reviewed using a national tool, and we collaborate closely with other centers to ensure robust, reflective reviews.’
Magnus Harrison, Chief Medical Officer at Leeds Teaching Hospitals, added: ‘We review the MBRRACE data very regularly.’
‘We understand why this data will raise concerns, and although we have received assurances regarding these figures to date, we are continuing to review this further with independent partners to gain a deeper understanding.’
A spokesperson for the Royal Wolverhampton stated: ‘We are also collaborating with other provider trusts within the Black Country, which experience similar perinatal mortality rates, to address some of the health inequality issues that can contribute to poorer outcomes.’
Chris Dewhurst, Medical Director at Liverpool Women’s Hospital, explained: ‘As a specialist hospital, we care for high-risk babies from across the North West and further afield who need to be delivered at Liverpool Women’s Hospital due to significant problems identified during pregnancy and other factors.’
A Bradford Hospitals spokesperson also commented: ‘We have established a robust mortality review process that involves families, other hospitals within the region, and the neonatal network.’
‘The mortality data is regularly reviewed and presented at the safeguarding champion’s meeting. If any specific themes or issues are identified, we conduct an in-depth ‘deep dive’ to determine if there are opportunities for learning and improvement in our current practice.’
Lindsay Rudge, Executive Director of Nursing at Calderdale and Huddersfield, said: ‘We closely monitor our perinatal mortality rates as part of our commitment to providing safe, high-quality care.’
Wider Maternity Care Failures and Systemic Issues
The HSJ analysis follows a series of prominent maternity care failures, including those at Shrewsbury and Telford and East Kent NHS Trusts, with a record number of services currently failing to meet essential safety standards. This context underscores a larger systemic problem within NHS maternity services.
CQC Findings on Service Safety
In September, the CQC reported that two-thirds of maternity services either ‘require improvement’ or are ‘inadequate’ in terms of safety. This widespread safety concern highlights the urgent need for comprehensive reforms and improvements within maternity care.
Midwife Shortages and System Strain
Frontline midwives have previously warned that working in the NHS feels like a ‘warped game of Russian roulette,’ citing the constant threat of harm or death due to ‘dangerously’ low staffing levels. The Royal College of Midwives (RCM) attributes these issues to staff shortages and inadequate funding, which impede midwives’ ability to deliver optimal care.
Midwife Shortage Figures
The RCM’s latest estimates indicate that England is currently facing a shortage of 2,500 midwives. This substantial shortfall in staffing further exacerbates the pressures on already strained maternity services.
“Postcode Lottery” and Birth Trauma Inquiry
This analysis coincides with another recent report highlighting the “postcode lottery” of NHS maternity care, which concluded that good care is “the exception rather than the rule.” Furthermore, a highly anticipated parliamentary inquiry into birth trauma, which gathered testimony from over 1,300 women, revealed accounts of pregnant individuals being treated dehumanizingly.
Government Response and Pledges
In response to the birth trauma inquiry, Health Secretary Victoria Atkins described the testimonies as “harrowing” and pledged to improve maternity care for “women throughout pregnancy, birth, and the critical months that follow.” These commitments signal a recognition at the highest levels of government that significant improvements are needed to ensure safe and respectful maternity services nationwide.