Connect with us

Published

on

An NHS trust has been fined £1.6m after admitting it failed to provide safe care and treatment to three babies who died within days of their births.

The Care Quality Commission (CQC) had charged Nottingham University Hospitals (NUH) NHS Trust over the deaths, which all occurred in 2021.

The trust pleaded guilty to six charges of failing to provide safe care and treatment to the three children and their mothers at Nottingham Magistrates’ Court on Monday.

The charges were in connection to the deaths of Adele O’Sullivan, who was 26 minutes old when she died on 7 April 2021, four-day-old Kahlani Rawson, who died on 15 June 2021, and Quinn Parker, who was one day old when he died on 16 July 2021.

District Judge Grace Leong told the hearing, which was attended by the trust’s chief executive since September 2022 Anthony May, that the “catalogue of failures” in the trust’s maternity unit were “avoidable and should never have happened”.

Family members cried in the courtroom as the judge expressed her “deepest sympathy” to each of them and said the trust they put in NUH to deliver their babies safely had been broken.

“The death of a child is a tragedy beyond words, and where that loss is avoidable the pain is even more profound,” she said.

“Three-and-a-half years have gone by, yet for the families no doubt their grief remains as raw as ever and a constant presence in their lives that is woven into every moment.

“The grief of a baby is not just about the past, it is about the future that is stolen. It is a lifetime of missing first words, first steps, first days of school, missing memories that should have been made.

“It is very difficult, if not impossible, to move on from the failures of the trust and its maternity unit.

“The weight of what should have been done differently will linger indefinitely.”

‘Systematic failures’

District Judge Leong highlighted concerns over a lack of escalation of care, an inadequate communications system and a failure to provide “clear and complete” information sharing.

She said: “I accept there were systems in place but there were so many procedures where guidance was not followed or adhered to.

“The failures in combination amounted to systematic failures in the provision of care and treatment.”

The trust has an average turnover of £612m, but District Judge Leong said she was “acutely aware” that all its funds as a publicly funded body were accounted for and that the trust is currently operating at a deficit of around £100m.

“I can’t ignore the negative impact this will have… but the significant financial penalty has to be fixed to mark the gravity of these offences and hold the trust to account for their failings,” the judge said.

Read more:
Wrexham player in car crash after cup game
Man charged with murder of ‘much-loved’ mum
RuPaul’s Drag Race star died of ‘unnatural’ cause

The £1.6m fine was broken down into £700,000 related to the death of Quinn Parker, £300,000 each for the deaths of Adele O’Sullivan and Kahlani Rawson, and three amounts of £100,000 related to the care provided to each of the mothers.

Lawyers acting on behalf of the trust told the families in court they offered their “profound apologies and regrets” and that improvements have been made, including hiring more midwives and providing further training to staff.

‘Contemptuous and inhumane’

The court was told that one of the pregnant women, Emmie Studencki, went to the hospital four times suffering bleeding before her son Quinn was born.

On the final occasion before Quinn was born, Ms Studencki called an ambulance at around 6.15am on 14 July 2021 with paramedics estimating she had lost around 1.2 litres of blood both at home and in the ambulance on the way to City Hospital.

Despite this, the paramedics’ observations did not “find its way into the hospital’s notes”, with staff only recording a 200ml blood loss.

Quinn was “pale and floppy” when he was born via emergency Caesarean section that evening, and despite several blood transfusions, he was pronounced dead after suffering multiple organ failure and lack of oxygen to the brain.

An inquest concluded it was a “possibility” he would have survived had a Caesarean section been carried out earlier.

In a statement, Ms Studencki said the trust’s treatment of her, her son, and her partner Ryan Parker had been “contemptuous and inhumane”.

‘We lost our beautiful daughter’

Adele O’Sullivan died 26 minutes after being born following an emergency Caesarean at 29 weeks in April 2021, the court also heard.

Her mother Daniela had noticed bleeding and suffered abdominal pain but in a victim impact statement said she was left “screaming in pain” with no painkillers. Despite having a high-risk pregnancy, she was not examined for eight hours before Adele was born.

Adele was born in “poor condition” and a decision was made to withdraw care, with a post-mortem examination finding she died as a result of severe intrapartum hypoxia.

Daniela said: “People who were supposed to help me did not help but harmed me mentally and physically forever.

“We lost our beautiful daughter. Instead of bringing her home I had to leave the labour suite empty-handed in a lot of physical and mental pain.”

The trust also admitted liability in another case involving mother Ellise Rawson, who had reported abdominal pain and reduced foetal movements. She was delayed in receiving an emergency Caesarean section in June 2021. Her son Kahlani suffered a brain injury and died four days later.

Kahlani’s grandmother Amy Rawson told the court that her grandson’s death was a “preventable tragedy” that had left the family “devastated, broken and numb”.

This case is the second time the CQC has prosecuted the trust over failures in maternity care.

It was fined £800,000 for a “catalogue of failings and errors” that led to the death of a baby 23 minutes after she was born at the Queen’s Medical Centre in Nottingham in September 2019.

NUH is also at the centre of the largest maternity inquiry in NHS history, with midwife Donna Ockenden leading the investigation.

In February she confirmed the number of families taking part has increased to 2,032 – forcing a delay to her report’s publication until June 2026.

‘We fully accept the findings’

In a statement released after the hearing, NUH chief executive, Mr May said: “The mothers and families of these babies have had to endure things that no family should after the care provided by our hospitals failed them, and for that I am truly sorry.

“Today’s judgment is against the trust, and I also apologise to staff who we let down when it came to providing the right environment and processes to enable them to do their jobs safely.

“We fully accept the findings in court today and have already implemented changes to help prevent incidences like this from this happening again.”

He added that a CQC report published in September 2023 showed there had been an improvement in the overall rating for the trust’s maternity services.

Helen Rawlings, CQC’s director of operations in the Midlands, said in a statement after the sentencing: “The care that these mothers received, and the death of these three babies is an absolute tragedy and my thoughts are with their families and all those grieving their loss under such sad circumstances.

“All mothers have a right to safe care and treatment when having a baby, so it’s unacceptable that their safety was not well managed by Nottingham University Hospitals NHS Trust.

“The vast majority of people receive good care when they attend hospital, but whenever a registered health care provider puts people in its care at risk of harm, we seek to take action to hold it to account and protect people.

“This is the second time we have prosecuted the trust for not providing safe care and treatment in its maternity services, and we will continue to monitor the trust closely to ensure they are making and embedding improvements so that women and babies receive the safe care they deserve.”

Continue Reading

UK

Inside Britain’s largest nuclear weapons site – as scientists race to build a new warhead by the 2030s

Published

on

By

Inside Britain's largest nuclear weapons site - as scientists race to build a new warhead by the 2030s

Vaults of enriched uranium and plutonium to make nuclear bombs are dotted about a secure site in Berkshire along with Anglo-Saxon burial mounds and a couple of lakes.

Surrounded by metal fences topped with barbed wire, much of the nuclear weapons facility at Aldermaston in Berkshire looks frozen in time from the 1950s rather than ready for war in the 21st century.

AWE in Aldermaston
Image:
The AWE site in Aldermaston is one of the UK’s most secure nuclear sites

But a renewed focus on the importance of the UK’s nuclear deterrent means the government is giving much of its nuclear infrastructure a facelift as it races to build a new warhead by the 2030s when the old stock goes out of service.

Sky News was among a group of news organisations given rare access to the largest of Britain’s nuclear weapons locations run by AWE.

AWE in Aldermaston

The acronym stands for Atomic Weapons Establishment – but a member of staff organising the visit told me that the public body, which is owned by the Ministry of Defence, no longer attributes the letters that make up its name to those words.

“We are just A, W, E,” she said.

She did not explain why.

Perhaps it is to avoid making AWE’s purpose so immediately obvious to anyone interested in applying for a job but not so keen on weapons of mass destruction.

AWE in Aldermaston

For the scientists and engineers, working here though, there seems to be a sense of genuine purpose as they develop and ensure the viability and credibility of the warheads at the heart of the UK’s nuclear deterrent, this country’s ultimate security guarantee.

“It’s nice to wake up every day and work on something that actually matters,” said a 22-year-old apprentice called Chris.

Sky News was asked not to publish his surname for security reasons.

Inside a top secret nuclear weapons site

The workforce at AWE is expanding fast, with 1,500 new people joining over the past year.

The organisation has some 9,500 employees in total, including about 7,000 at Aldermaston, where the warhead is developed and its component parts are manufactured.

Designing and building a bomb is something the UK has not needed to do for decades – not since an international prohibition on testing nuclear weapons came into force in the 1990s.

It means the new warhead, called Astrea, will not be detonated for real unless it is used – an outcome that would only ever happen in the most extreme of circumstances as explained in a new podcast series by Sky News and Tortoise called The Wargame.

The last time, Britain test-fired a bomb was at a facility in Nevada in the US in 1991.

With that no longer an option, the scientists at AWE must rely on old data and new technology as they build the next generation of warhead.

This includes input from a supercomputer at the Aldermaston site that uses 17 megawatts of power and crunches four trillion calculations per second.

Another major help is a giant laser facility.

Inside a top secret nuclear weapons site

It is built in a hall, with two banks of long cylinders, lying horizontal and stacked one of top of the other running down the length of the room – these are part of the laser.

The beams are then zapped in a special, separate chamber, onto tiny samples of material to see how they react under the kind of extreme pressures and temperatures that would be caused in a nuclear explosion.

The heat is up to 10 million degrees – the same as the outer edge of the sun.

“You take all those beams at a billionth of a second, bring them altogether and heat a small target to those temperatures and pressures,” one scientist said, as he explained the process to John Healey, the defence secretary, who visited the site on Thursday.

Looking impressed, Mr Healey replied: “For a non-scientist that is hard to follow let alone comprehend.”

John Healey
Image:
Defence Secretary John Healey visited the site on Thursday

The Orion laser facility is the only one of its kind in the world, though the US – which has a uniquely close relationship with the UK over their nuclear weapons – has similar capabilities.

Maria Dawes, the director of science at AWE, said there is a sense of urgency at the organisation about the need to develop and then build the new bomb – which is a central part of the government’s new defence review published in early June.

“You’ve probably read the strategic defence review,” she said.

“There’s very much the rhetoric of this is a new era of threat and therefore it’s a new era for defence and AWE is absolutely at the heart of that and so a sense of urgency around: we need to step up and we need to make sure that we’ve got what our customer needs. Yes, there’s very much that sense here.”

AWE

It means an organisation that has for years been purely focused on ensuring the current stockpile of warheads is safe and works must shift to becoming more dynamic as it pursues a project that will be used to defend the UK long into the future.

In a sign of its importance, the government is spending £15bn over the next four years alone on the programme to build the new warheads.

Part of the investment is going into revamping Aldermaston.

Driving around the 700-acre site, which was once a Second World War airbase, many of the buildings were constructed into the 1950s, 1960s and 1970s.

The construction of new science and research laboratories is taking place.

But bringing builders onto one of the UK’s most secure nuclear sites is not without risk.

Everyone involved must be a British national and armed police patrols are everywhere.

No one would say what will be different about the new bomb that is being developed here compared with the version that needs replacing.

One official simply said the incumbent stock has a finite design life and will need to be swapped out.

Continue Reading

UK

‘Loving father’ shot dead in suspected case of mistaken identity prompts appeal for information

Published

on

By

'Loving father' shot dead in suspected case of mistaken identity prompts appeal for information

The family of a father shot dead in a suspected case of mistaken identity in north London have said he “deserves justice” as they appealed for information.

Mahad Abdi Mohamed, 27, died from a gunshot wound to the head in hospital after he was hit with bullets fired from a stolen Mitsubishi Outlander, which was later found burnt out.

Detectives believe those responsible for his murder had set out to hurt someone else in a “pre-meditated and targeted attack” in Waverley Road, Tottenham, at 8.45pm on Thursday 20 March.

Mr Abdi Mohamed’s younger sister, Amal Abdi Mohamed, 23, said he was a “loving father” to his five-year-old son, who “looked up to him like a superhero”, and was planning to get married in the summer.

Mahad Abdi Mohamed with his sister. Pic: Met Police
Image:
Mahad Abdi Mohamed with his sister, Amal Abdi Mohamed. Pic: Met Police

“He was taken away from us through gun violence,” she said.

“A bullet didn’t just take his life, it tore through our family, through our heart, and it’s truly shocking, it’s devastating, and it’s so senseless, because this type of violence should never be normal.

“It should never be something a family ever has to expect, prepare for, or live with.”

More on Crime

Mr Abdi’s 26-year-old friend, with whom he had been breaking his Ramadan fast, was also shot in the leg and was treated in hospital for a wound police said was not life-changing.

The Metropolitan Police arrested four men on suspicion of murder, who have been released on bail pending further investigations.

Detectives are appealing for witnesses who saw a silver Mitsubishi Outlander in the area, which was found burnt out in Runcorn Close, the following morning.

A Mitsubishi was found burnt out. Pic: Met Police
A Mitsubishi was found burnt out the following day. Pic: Met Police
Image:
A Mitsubishi was found burnt out the following day. Pic: Met Police

“This tragic event and Mahad’s death, has had a profound impact on the community and all those who loved him. Someone out there knows what happened. And that person, or people, must come forward,” said Detective Chief Inspector Rebecca Woodsford.

“Regardless of how small you think your information is, please share it with us. It could be the missing link we need to secure justice for Mahad and his family.”

Read more from Sky News:
Government whip quits over Starmer’s welfare cuts
Patrols to protect women and girls from violence at concerts

Compensation scheme for Capture victims announced

‘To stay silent is to be complicit’

Many of Mr Abdi Mohamed’s family members were in tears as they visited the scene of his murder as part of the appeal for information.

“My sweet Mahad was the kind of person who could light up a room without even trying,” said his sister.

“His laugh was so loud, and it still echoes in our memories.”

Ms Abdi Mohamed said her brother “was funny, he was honest, and overall he was just a good man” but “wasn’t perfect”.

She said he had “made mistakes but turned his life around” working at Waterloo Station, and part-time at the Tottenham Hotspur Stadium and Royal Ascot as a security guard.

Mr Abdi Mohamed with his mother Zahra Ali Seef. Pic: Met Police
Image:
Mr Abdi Mohamed with his mother, Zahra Ali Seef. Pic: Met Police

“How do you look at a child who adored him day and night, and tell them that he’s gone and you don’t have the answers why? That boy will have to grow up with no dad,” she said.

“If you think you may know anything or have seen anything – you may think it doesn’t matter, but it might be the key to giving us an answer, and it might be the thing that finally lets our family take a breath.

“To stay silent is to be complicit.

“To stay silent is to let a grieving mother suffer in confusion. To stay silent is to let a little boy grow up not knowing what happened to his father.

“If you know something and you haven’t come forward, please think about that. Think about a family that cannot begin to heal because the truth is still hiding in the shadows. My brother deserves better. He deserves justice.”

Continue Reading

UK

Post Office Capture scandal: Sir Alan Bates calls for those responsible for wrongful convictions to be ‘brought to account’

Published

on

By

Post Office Capture scandal: Sir Alan Bates calls for those responsible for wrongful convictions to be 'brought to account'

Sir Alan Bates has called for those responsible for the wrongful convictions of sub postmasters in the Capture IT scandal to be “brought to account”.

It comes after Sky News unearthed a report showing Post Office lawyers knew of faults in the software nearly three decades ago.

The documents, found in a garage by a retired computer expert, describe the Capture system as “an accident waiting to happen”.

Please use Chrome browser for a more accessible video player

Post Office: The lost ‘Capture’ files

Sir Alan said the Sky News investigation showed “yet another failure of government oversight; another failure of the Post Office board to ensure [the] Post Office recruited senior people competent of bringing in IT systems” and management that was “out of touch with what was going on within its organisation”.

The unearthed Capture report was commissioned by the defence team for sub postmistress Patricia Owen and served on the Post Office in 1998 at her trial.

It described the software as “quite capable of producing absurd gibberish” and concluded “reasonable doubt” existed as to “whether any criminal offence” had taken place.

Ms Owen was found guilty of stealing from her branch and given a suspended prison sentence.

She died in 2003 and her family had always believed the computer expert, who was due to give evidence on the report, “never turned up”.

Pat Owen and husband David
Screengrabs from Adele Robinson i/vs with case study. Family of Pat Owen from Kent who was convicted of 1998 from stealing from her post office branch. Now the Capture IT system is suspected of adding errors to the accounts. 
Source P 175500FR POST OFFICE CAPTURE CASES ROBINSON 0600 VT V2 JJ1
Image:
Patricia Owen (right) was convicted in 1998 of stealing from her post office branch. She died in 2003


Adrian Montagu reached out after seeing a Sky News report earlier this year and said he was actually stood down by the defending barrister with “no reason given”.

The barrister said he had no recollection of the case.

Victims and their lawyers hope the newly found “damning” expert report, which may never have been seen by a jury, could help overturn Capture convictions.

Read more: Post Office scandal redress must not only be fair – it must be fast

Please use Chrome browser for a more accessible video player

What is the Capture scandal?

‘These people have to be brought to account’

Sir Alan, the leading campaigner for victims of the Horizon Post Office scandal, said while “no programme is bug free, why [was the] Post Office allowed to transfer the financial risk from these bugs on to a third party ie the sub postmaster, and why did its lawyers continue with prosecutions seemingly knowing of these system bugs?”

He continued: “Whether it was incompetence or corporate malice, these people have to be brought to account for their actions, be it for Capture or Horizon.”

More than 100 victims have come forward

More than 100 victims, including those who were not convicted but who were affected by the faulty software, have so far come forward.

Capture was used in 2,500 branches between 1992 and 1999, just before Horizon was introduced – which saw hundreds wrongfully convicted.

The Criminal Cases Review Commission (CCRC), the body responsible for investigating potential miscarriages of justice, is currently looking at a number of Capture convictions.

A CCRC spokesperson told Sky News: “We have received applications regarding 29 convictions which pre-date Horizon.
25 of these applications are being actively investigated by case review managers, and two more recent applications are in the preparatory stage and will be assigned to case review managers before the end of June.

“We have issued notices under s.17 of the Criminal Appeal Act 1995 to Post Office Ltd requiring them to produce all material relating to the applications received.

“To date, POL have provided some material in relation to 17 of the cases and confirmed that they hold no material in relation to another 5. The CCRC is awaiting a response from POL in relation to 6 cases.”

A spokesperson for the Department for Business and Trade said: “Postmasters negatively affected by Capture endured immeasurable suffering. We continue to listen to those who have been sharing their stories on the Capture system, and have taken their thoughts on board when designing the Capture Redress Scheme.”

Continue Reading

Trending