Ockenden Report — House of Lords, 2022-03-30
Topic: Health
Syed Kamall (Conservative, Centre-right): I begin by thanking both noble Baronesses for their questions and resisting the temptation to bring too much politics into it. This is an issue that we all feel very strongly about. I will try to answer as many questions as I can; I apologise in advance if I do not answer all the questions today. I have quite a big briefing pack, which I have been through a number of times. I commit to writing to noble Lords and the noble Baronesses to fill the gaps As the noble Baronesses said, we accept all the actions outlined in the report. The Secretary of State has asked NHS England and NHS Improvement to write to all the trusts across England about the final Ockenden report, and will ask all maternity services across England to assess their services against the 15 immediate and essential actions outlined in the report —and take action where they fall short. As the noble Baronesses acknowledged, NHS England and NHS Improvement have announced that they will invest £127 million in maternity care; that money will go towards the NHS maternity workforce and improving neonatal care We have also seen work under way to tackle some of the key issues in the report, such as the £5 million for the Avoiding Brain Injury in Childbirth collaboration project, the establishment of a special health authority to continue the work, which I shall go into later, and the development of 17 new maternal medicine networks. We will update the House as appropriate on the monitoring We have to look at the culture; I completely understand the points made. Strong leadership will now be established across the system, with the appointment of named regional and local maternity safety champions led by two national maternity safety champions, Matthew Jolly and Jacqueline Dunkley-Bent. In every trust, front-line maternity safety champions—one obstetrician, one midwife and one neonatologist—will work closely with a board maternity safety champion to promote unfettered floor-to-board communication. We have also tried to make progress in shifting away from a defensive blame culture in healthcare towards a culture in which we recognise and accept when things go wrong and look to learn I thank noble Lords for their engagement, particularly over the HSSIB, during the passage of the Bill. I think we all agreed that it was important that we kept as many people as possible out of the "safe space" to encourage people to come forward. However, as we have seen in these cases, people were bullied and disincentivised from coming forward; some even withdrew their names Last year, there was a £500,000 fund to provide maternity leadership training for NHS maternity and neonatal leaders. We looked at addressing the issues raised in the first Ockenden report—to use that phrase again, "between ward and board"—to make sure that there was proper accountability and training On workforce, as I said, NHS England and NHS Improvement have the investment. In addition, there is £95 million in new funding to support the recruitment of 1,200 more midwives and 100 more obstetricians, and to support multidisciplinary team training. The department has also commissioned the Royal College of Obstetricians and Gynaecologists to develop a new workforce planning tool to improve how maternity units calculate their medical staffing requirements. The tool will calculate the number of obstetricians at all grades required locally and nationally to provide a safe, personalised maternity service within the context of the wider workforce. Health Education England has also been working with stakeholders towards a targeted increase of 3,650 midwifery student training places by the end of 2022-23 One concern that was raised when I spoke to officials and asked for briefings before this evening was whether reports such as this one would disincentivise people from coming forward to work in midwifery. We have to be very careful that we are as open as possible and that we make sure that the system learns where there are problems. People are human, and they will be concerned about coming forward. So we have to get the right balance and have safety, training and awareness all the way through, making sure that it is patient-centred. I shall try to answer as many questions as I can; I know that other noble Lords want to come in. In terms of deterring midwives from leaving—I know that there is a real concern here—the NHS people plan focused on improvement and retention. There is a well-being guardian role focused on: healthy work environments and safe spaces; empowering line managers to hold meaningful conversations; emotional and psychological support; a dedicated health and care staff support service; a bereavement helpline; free access to a range of mental health apps; a range of counselling and talking therapies; and online resources. Money has also been invested in 14 mental health hubs across the country, and £6 million has been set aside for a national support service for critical care staff We have to tackle bullying and harassment in the service. The people plan deals with a number of issues on that; there is also a visibility and respect framework and a toolkit. A number of projects and pilots are under way across the NHS to support organisations to see what works and where we can learn from that There were some questions about the special health authority, which we see as a key part of work to improve the investigation and learning culture. The investigators will carry out timely and independent individualised investigations into maternal and neonatal deaths and incidents across England. The SHA’s investigation will be family-centred and mother-centred, but it will also provide families with answers to questions about why an incident occurred or why their baby died, rather than just sweeping this away. The learning from these investigations will be shared at a local level and across the wider system. As an independent body, the special health authority will continue the work of the HSIB from 2023, and maternity investigations will continue during this time, without interruption, until the SHA is fully operational—this is specifically for maternity As for what the Government are doing to make sure that women’s voices are heard, we have the women’s health strategy—I know that noble Lords have heard that before—and we are looking at multidisciplinary training in the maternity workforce. There is a debate within the training community about whether you train someone to be a midwife first or whether they should start as a nurse and have nursing skills first. I will stop there to allow other noble Lords to ask questions.