Mothers and babies being harmed in the NHS risks becoming normalised because of its toxic cover-up culture, a health leader will say, as it emerged that 14 trusts are the focus of a national maternity investigation in England.
Charles Massey, the chief executive of the General Medical Council, will tell a conference on Monday that “something must have gone badly wrong” when trainee obstetrics and gynaecology doctors are fearful of speaking up.
The “tribal” nature of medicine with doctors and other staff pitted against each other could be preventing people from raising their concerns or admitting when things go wrong, Massey will say.
His stark warning came as the government named 14 NHS trusts that are being examined as part of its rapid inquiry into maternity and neonatal services in England.
They are:
Barking, Havering and Redbridge university hospitals NHS trust.
Blackpool teaching hospitals NHS foundation trust.
Bradford teaching hospitals NHS foundation trust.
East Kent hospitals NHS trust.
Gloucestershire hospitals NHS foundation trust.
Leeds teaching hospitals NHS trust.
Oxford university hospitals NHS foundation trust.
Sandwell and West Birmingham hospitals NHS trust.
Shrewsbury and Telford hospital NHS trust.
The Queen Elizabeth hospital, King’s Lynn NHS foundation trust.
University hospitals of Leicester NHS trust.
University hospitals of Morecambe Bay NHS foundation trust.
University hospitals Sussex NHS foundation trust.
Yeovil district hospital NHS foundation trust/Somerset NHS foundation trust.
The investigation, first announced in June and being led by Valerie Amos, will use lessons learned from previous inquiries to create one “clear set of actions”, in an effort to improve NHS care.
Alongside the investigation, which is due to report preliminary findings in December, a maternity and neonatal taskforce has been set up, chaired by Wes Streeting and made up of experts and bereaved families.
Streeting, the health secretary, said: “Bereaved families have shown extraordinary courage in coming forward to help inform this rapid national investigation alongside Baroness Amos. What they have experienced is devastating, and their strength will help protect other families from enduring what they have been through.
“I know that NHS maternity and neonatal workers want the best for these mothers and babies, and that the vast majority of births are safe and without incident, but I cannot turn a blind eye to failures in the system. Every single preventable tragedy is one too many. Harmed and bereaved families will be right at the heart of this investigation to ensure no one has to suffer like this again.”
Massey will tell the Health Service Journal’s patient safety congress in Manchester on Monday that it is “profoundly concerning” that doctors are making life and death decisions in environments where they feel fearful to speak up.
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“Those are the very factors that lead to cover-up over candour and obfuscation over honesty. And it is in those cultures that the greatest patient harm occurs,” he will say.
“Everyone in this room will be aware of the scandals of recent years concerning maternity care. This is one of the most high-risk and high-pressure areas of medicine. One where the consequences of things going wrong can be especially tragic and far-reaching, affecting both a mother and her baby, not to mention their wider family.”
GMC data shows that more than one in four obstetrics and gynaecology trainees (27%) admit they have felt hesitant about escalating a patient to a more senior medic – a higher proportion than in other areas of medicine.
The speciality also has above average rates of workload stress, bullying and doctors who feel unsupported by colleagues, according to the GMC.
“These data suggest a situation where too often patient safety is falling victim to unhealthy culture,” Massey will say. “The unthinkable – harm to mothers and their babies – is at risk of being normalised. And toxic culture is in no small part to blame.”
