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Our initial response to the Ockenden Report

An independent review was set up in 2017 in response to concerns from bereaved families about maternity services at Shrewsbury and Telford Hospital NHS Trust.

Its original scope was to cover the cases of 23 families but since it began, sadly, many more families have reported concerns.

Early conclusions were published in an initial report in December 2020. This report set out seven immediate and essential actions for Trust maternity services under 7 key themes.  In County Durham and Darlington we were able to take these forward and we monitor our progress to continually improve our care supported by the Trust Board and our full maternity team.

On 30 March 2022, the second and final report was published.

The reports have been extremely difficult to read. They have been deeply upsetting for our own colleagues working in maternity services. We will take time to reflect on the contents of the final report and consider our response but at this stage wish to share some initial information.

We understand that anyone who has received or is currently receiving maternity care across County Durham and Darlington will have found reading this report particularly difficult. We would like to say that we are here for you and we will support you if you have any worries or concerns.

At County Durham and Darlington NHS Foundation Trust we strive to be open and transparent Trust and always try to do the right thing for our women, babies and their families.

We acknowledge that we don't always get things right and we are taking the time to reflect on the report in full to understand what we can do to provide even better, safer and more excellent maternity services in the future.

Therefore, we welcome the 15 essential actions for maternity providers that are included in the report. As part of this initial response we would like to briefly explain what we are already doing and what we will focus on to deliver against the actions in full over the coming weeks and months:

  • We encourage you to be involved in decisions about your care during your pregnancy, labour and birth and support you to make these decisions

  • We have launched an electronic notes system that can be accessed using your phone; we are using your feedback to shape the development of this

  • We continue to work closely with the County Durham and Darlington Maternity Voices Partnership (MVP) and other community groups to ensure we act on feedback from families who use our maternity services

  • We continue our efforts to recruit into our maternity services and expand our staff group

  • We have practice educator facilitators and a preceptorship programme to ensure that our students and newly qualified midwives are supported in their roles

  • We launched a Fetal Movement campaign to encourage women and families to be aware of monitoring movement during pregnancy and to share information about how and when to contact our pregnancy assessment units with any concerns 


  • We have Bereavement Midwives who provide compassionate, individualised, high quality bereavement care to families that sadly experience a miscarriage, stillbirth or neonatal death

  • We have robust processes in place to investigate incidents and we encourage the involvement of independent experts when required

  • We are working with other hospitals across the region and nationally to ensure that lessons are learnt and shared

This is an ongoing journey for all of us. We will be working and closely engaging with our maternity teams, women, families, and partner organisations to make sure that through collaboration, learning and most importantly by listening to the women and families we can deliver the best care for all.

If you are receiving maternity care at County Durham and Darlington NHS Foundation Trust, or have done so in the past and you are affected by anything you have read in the published report, please get in touch with us via your midwife or our Patient Experience Team by calling 0800 783 5774 or email Cdda-tr.patientexperiencecddft@nhs.net and we will support you as much as we can.

You can also contact your local Maternity Voices Partnership (MVP) if you would like to share details of your experience. Cathy Harvey is the County Durham and Darlington MVP Chair: cathyh12@btinternet.com

Please follow this link to read the Ockenden Report in full: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1064302/Final-Ockenden-Report-web-accessible.pdf

'I would like to thank all the staff for my treatment and their professionalism.'

Patient, Cardiology Department, Bishop Auckland Hospital