Mollie Sutton has spent the past seven years waiting for answers.
Her son Rupert, aged 7, was born with severe disabilities and is now unable to walk or talk. He also has the mental capability of a four-month-old baby.
Ms Sutton, 27, endured a harrowing labour before Rupert’s birth and believes failures by Nottingham University Hospitals (NUH) NHS Trust, both before and during her labour, may have caused his severe physical and mental disabilities.
She is one of hundreds of families now seeking answers as to why their babies died or were left with disabilities at Nottingham hospitals.
An review by Donna Ockenden, which has looked at thousands of cases of alleged poor care at the hands of the trust, has published a report into its failings as part of what has become the largest ever maternity review in NHS history.
The report found more than 500 mothers and babies suffered potentially avoidable harm or died due to “deeply embedded systemic failures” at the “toxic” hospital trust.
Ms Sutton told The Independent: “This can't continue to happen. How many more dead babies, dead mothers, harmed babies, harmed mothers do we have to see until somebody actually finally puts their foot down and does something about it?”
It was in September 2018, at 34 weeks pregnant, that Ms Sutton was admitted to the hospital and diagnosed with sepsis. Three weeks later, at 37 weeks, her labour was induced.
Ms Sutton, who was aged 19 at the time of the birth, described the intense pain she experienced during her labour. But she believes her begs for help were ignored due to her age.
“I was begging for pain relief. But I was told that I'm only two centimetres – I'm being dramatic. ‘I don't know why you're screaming because there are women on this ward with real problems,” she said.
Ms Sutton claims she was told by staff as she screamed in pain: “There are women and babies who have just had babies, and we don't need you shouting.”
At 4am, Ms Sutton, alone with her husband, said the baby suddenly seemed close to arrival so her husband pressed the emergency buzzer. Midwives came running into the ward, Ms Sutton remembers. The curtains had to remain wide open due to the number of people, and Ms Sutton says she was given no dignity at all.
Rupert was born, with disabilities, and Ms Sutton took him back to their home in Rainworth, Nottinghamshire. A week later, she was taken back into the hospital due to a group B strep infection, which Rupert was never tested for but she suspects may have contributed to his injuries.
Ms Sutton is waiting to receive a report into her family’s individual case and will find out whether her son’s disabilities may have been caused by the care she and him received during and after her labour. But, as she awaits a report from the Nottingham inquiry team and a separate one from NUH, she said she wants urgent change.
She said: “They [the government, regulators and NHS] knew what was happening and they did nothing to stop it. The [watchdogs] CQC, the GMC, the NMC, and previous secretaries of state, they all knew what was happening. And they should be held accountable in a judge-led inquiry.”
The trust has been contacted for comment.
‘Scandal in plain sight’
The scandal, first uncovered by The Independent, would not have been exposed without the families who came forward to tell their stories in 2020.
Among the families who came forward were Jack and Sarah Hawkins, both former doctors who worked at the trust.
Their daughter Harriet was stillborn in 2016 following a catalogue of failures by NUH.
Mr Hawkins was a consultant in acute medicine, with Mrs Hawkins a senior physiotherapist at NUHT when Harriet was born, and became one of the first to raise concerns over care failings at the trust.
Harriet died on April 17 2016, as a result of mismanaged labour at Nottingham’s Queen’s Medical Centre, which lasted six days and included 13 contacts with NUH.
Between 13 April and Harriet’s birth, the couple made ten phone calls and two visits to the Queen's Medical Centre. Each time, they were discharged and reassured.
When she was eventually admitted for labour, doctors and midwives at Nottingham City Hospital struggled to find a foetal heartbeat for Harriet.
When an ultrasound was eventually carried out, it revealed that Harriet had died. Sarah was left struggling in an overly long labour. Nearly 10 hours later, Harriet was delivered, weighing 6lbs 12oz.
The couple were falsely told that their daughter had died from an infection and that NUHT were not at fault. However, knowing something was wrong, they continued to fight for answers. Then, in 2018, an independent external review found 13 significant individual failings in Harriet’s care.
In 2021, NUH reached an agreement to pay the couple £2.8m, following a negligence claim against the trust.
Mr Hawkins, 57, said: “Our biggest thing is, how has this happened in plain sight of the state, the mandarins in the Department of Health and Social Care, the board of NHS England?
“How on earth have we allowed it that there are 1,000 avoidable baby deaths in this country every year, and in a particular place, there are this many schools’ worth of children missing or damaged beyond belief, and dead mums and damaged mums? How have we got here?”
He added: “There needs to be a statutory public inquiry. The public needs to know what’s been going on, and we need to stop it happening again.”
Ms Hawkins added: “I think there needs to be individual sanctions, because at the minute – and in Nottingham – you can harm or kill babies and nothing happens. There is no accountability.
“And if you set that as a standard, you’re not going to have an open and honest culture, because it’s just going to be swept under the carpet.”
‘Gross failings’
Gary and Sarah Andrews, whose daughter Wynter Sophia Andrews died in 2019, some 23 minutes after being born, also came forward to The Independent in 2020.
Sarah had been left in labour for four days before having an emergency caesarean and was initially told she was in latent labour, but in fact was in active labour.
Over several days, Sarah underwent several examinations, and despite signs, she was in established labour and, with worrying CTG scan results, she was left to continue. Four days later, the staff carried out an emergency caesarean, and Wynter died 23 minutes after being delivered.
An inquest into Wynter’s death in 2020 concluded that there was a “clear and obvious case of neglect” and “gross failings” that led to her avoidable death from a loss of oxygen flow to the brain.
In 2023, the trust was fined £800,000 over the death of baby Wynter, following a first-ever prosecution by the Care Quality Commission for maternity failings.
The district judge Grace Leong said there had been a “catalogue of failings” and detailed the “avoidable errors” which led to Wynter’s death and devastating post-traumatic stress for her parents.
Mr Andrews, 38, said: “The report being published today needs to serve as a wake-up call to the NHS locally and nationally, that what’s gone on before cannot be allowed to continue.”
He said he believes there is “still going to be this question mark over accountability, a call for a national public inquiry, because so many different organisations have failed to do their bit that feeds into a safe system”.
Nick Carver, NUH trust chairman and Anthony May, chief executive, who both joined in 2022, apologised in an open letter following the publication of the report and said while improvements have been made, there is more to do.
They added: “We apologise unreservedly to the women and families who have suffered harm, loss, trauma or distress while receiving care in our services.”
