Tonight's Panorama is about how poor care in maternity services at the hospital led to the deaths and serious injury to both mothers and babies.
There is a BBC article on it here:
www.bbc.co.uk/news/health-60434299
Mothers who helped uncover the biggest NHS maternity scandal
The full report into the scandal is due next month.
The article covers a lot of different issues but one of the key ones for me is this:
That criticism, Panorama can reveal, did lead the family's lawyer to raise in court whether there was "any kind of inbuilt policy or inbuilt bias towards trying to achieve natural births in as many cases as possible". The question also built on inquiries made by Kathryn's parents, Phil and Sonia. "I wondered about the fact that I'd been left so long before going to C-section," said Sonia. "I did a lot of research and found out that Shrewsbury Hospital had the lowest rate of C-sections in the whole of the UK."
Most of the cases the Ockenden review is examining date from 2000-2019. In their interim report, the essence of Sonia Leigh's concerns was strongly highlighted. The inquiry found that rates of caesarean sections at the trust in Shropshire were up to 12% lower than the England average for the period they are examining.
The trust's reputation for unusually high numbers of vaginal births was known. Panorama has discovered that just a month before Kathryn Leigh's inquest, a parliamentary hearing was held to discuss concerns about the rising number of caesarean births across England.
There was concern that child birth was being over-medicalised, and that too many women were having to undergo unnecessary surgical procedures, which like any operation carries risk. It also costs more money.
One hospital was praised for its approach however - the Royal Shrewsbury. At the time, its caesarean levels were half the England average, and a team from the hospital travelled to London.
In the evidence session, seen by Panorama, the then clinical director of the Royal Shrewsbury told MPs: "The culture of our organisation is that we have low intervention rates and once that is known we attract both midwives and obstetricians who like to practise in that way."
His colleague, the manager of women's service at the time, added that midwives who had worked elsewhere "almost need retraining to be able to work in Shropshire. We have recruited people who are like minded. If you want to keep something going and you believe in it, you do not want to employ people who do not believe in what you believe in.
Discussing the initial findings of her inquiry, Donna Ockenden told Panorama, "There were cases where an earlier recourse to caesarean section rather than a persistence towards a normal delivery may well have led to a better outcome for mother or baby or both. Low caesarean section rates were a prize." And the trust had been lauded for them.
The push for natural births at all costs was one of the key findings of the report into Morecambe Bay Trust Scandal.
This week the NHS changed their advice on CS. They decided that they would drop the target rate.
Prior to this, Trusts could lose funding if they missed the target. This had two effects:
Women were pushed to have a VB long after was safe often resulting in traumatic injuries.
Even though the NICE guidance said that any woman who wanted a maternal request CS should have, this was often barred from that in practice as Trusts aimed to meet their target.
Now, this particularly upsets me because the arbitary target for CS is something I've been banging on about on MN for years. Like over a decade. My philosophy has been that women should get the best and most appropriate care for their circumstance and ideology has no place in maternity. Method of delivery is irrelevant.
Some background - the idea that there was an optimum level for CS stemmed from ideological belief that was dominating over actual science. There is a notorious study by WHO that concluded that a planned ELCS were much less safe than planned VB. Except that when you looked at the data the numbers contained in the study said quite the reverse. None the less, WHO recommended that the % of CS be limited and that there should be a target. This was later dropped a few years later as it became clear that this recommendation was a pile of arse.
And yet the NHS decided that they should still have a target. They picked a figure out of thin air without any clinical data to support the decision. And that shaped a lot of maternity care until this week.
Anyway, whats REALLY upset me about the Royal Shrewsbury report is the fact it was always so bloody obvious to ANYONE who looked at the data available and thought 'hang on, whats going on here?'.
Indeed someone did. Me.
My thread from 2016 on the 'outlier' data that troubled me
www.mumsnet.com/Talk/childbirth/2598442-New-Data-Comparing-Hospitals-and-Outcomes-in-Childbirth
And then when it became obvious that there was a problem at the Royal Shrewbury, this data was the first thing that sprung to mind for me. I started this thread in 2018:
www.mumsnet.com/Talk/womens_rights/3370657-Shrewsbury-and-Telford-Hospital-Trust-with-significantly-lower-CS-rate-in-scandal
To see it put in black and white today after the annoucement this week axing the target has really upset me. God knows how the poor women and babies who got caught up in this feel. My heart goes out to them.
I am NOT a statician. I am not an expert of any kind. But these numbers immediately triggered my sense that something was amiss and needed investigating. My initial concern was BEFORE the death of one of the babies of the two women who got the ball rolling on the inquiry.
It was that bloody obvious
People further up the NHS food chain, RCOG and the NMC should be hauled over the coals on this. It should have been questioned much much sooner. It wasn't. With devastating consequences.
Instead I am betting the Royal Shrewsbury alone will be criticised.
Kayleigh Griffith and Rhiannon Davies, you are my absoluete heroines. I hope that you have changed maternity services in this country once and for all.
