Shropshire maternity scandal: Hospitals boss satisfied with Ockenden Report progress

Louise Barnett, chief executive of Shrewsbury & Telford Hospital NHS Trust (SaTH, was speaking ten months after the publication of the damning Ockenden Review into its maternity services.

That report found 60 areas where improvements could be made at SaTH and identified 201 cases of stillbirth and neonatal deaths that could have been avoided if better care had been provided.

Maternity expert Donna Ockenden made a series of recommendations for improvements at the trust, and in the wider NHS.

To date SaTH has delivered more than half of the 210 recommendations for its services, from both the interim, and full Ockenden reports.

Mrs Barnett said she was satisfied with the progress on the improvement – but added that they were under no illusions about the importance of the task, and making sure the improvements are more than just 'box ticking'.

The chief executive said they had accepted the failings uncovered in the report, but are determined to ensure there is no repeat – and were eager for people to see the improvements and changes at the trust.

She said: "Clearly we have failed our communities and the report set out a whole series of actions for us to take and that has had a massive impact, not only on maternity, but across the whole organisation, so we have really taken action to make sure we have listened to what families said, fed into that and move forward.

"We have still got a way to go. We are definitely not complacent, but we have made a lot of progress."

Mrs Barnett said they wanted to ensure that changes were genuine and lasting.

She said: "We are absolutely where we thought we would be. We might be slightly ahead, but what we have set out to do is meaningful work, which will make it stick.

"There is a lot to do so what we did not want to do is skip through the actions then find they are not in place any more."

Mrs Barnett spoke of her pride in the efforts of staff to make the changes detailed in the report, particularly as they dealt with the scrutiny that came with the damning criticism contained in the Ockenden review.

As part of the work to improve the service the trust has brought in 24/7 consultant cover at its maternity unit at Princess Royal Hospital, with Hayley Flavell, director of nursing at the trust adding: "We have reduced the risk because we have got those staff on site 24/7."

She said the move had helped give assurance to women and staff – with the unit currently having not a single vacancy in its staffing.

Currently the progress on the recommendations is reviewed by the trust's 'Ockenden Assurance Committee' – a committee that has an independent co-chair, the presenter Jane Garvey, and is attended be members of other health organisations.

Mrs Flavell said that one of the key elements in the wake of the recommendations was looking at how they would provide the evidence to prove they have been achieved.

She said that had taken time, but was making sure that the improvements have a concrete impact.

"This is not having an action plan and ticking the box, this is about having actions with evidence, with tangible outcomes for women and children in our communities," she added.

Mrs Flavell said they had taken a "really measured" approach to tackling the issues highlighted in the report – and would only sign work off when the evidence can be provided.

To date the trust has completed 46 of the 52 actions from the interim Ockenden report – with Mrs Barnett saying the rest are reliant on work from outside bodies.

One of the issues highlighted at the trust previously has been a number of staff being fearful about speaking out over concerns.

Annual staff survey results published last year found that a third of workers were not happy to say they were "secure about raising concerns about unsafe clinical practice".

That figure had improved from the previous year but Mrs Barnett admitted it has been a continuing area of focus for the trust.

She said there had been progress, but she recognised there is still improvements to be made.

"In terms of raising concerns I definitely think we are in a better place than we were – especially in maternity," she said.

"Staff feel much more comfortable to raise their concerns."

Mrs Flavell said there were a number of routes for workers to raise concerns, including the use of an app, but added that they were increasingly encouraged by open discussions about issues within teams at the trust.

She added that both she and the chief executive had also been meeting staff one-on-one, in an attempt to understand their concerns, and assessment of what the trust is doing well – and what it needs to improve.

Mrs Barnett said there was a desire from management to ensure worries were addressed in an open manner.

She said: "We want to be the best we possibly can be for our communities and our staff so we want to know if things are not going well for staff."