Baby deaths trust claimed £2m 'good care' payments

Senior coroner for Lancashire James Adeley concluded that Ida had died due to the gross failure of three midwives to provide basic medical care.

Ida, who was born at the Royal Lancaster Infirmary (RLI) on 9 November 2019, died a week later after suffering a serious brain injury due to a lack of oxygen.

Dr Adeley ruled her death had been caused by the midwives' failure to deliver the infant "urgently when it was apparent she was in distress" and contributed to by the lead midwife's "wholly incompetent failure to provide basic neonatal resuscitation".

He said eight opportunities had been missed "to alter Ida's clinical course".

Her five-week inquest at Preston County Hall heard that many of the issues identified in a 2015 independent review of UHMB's maternity services were still evident in November 2019.

The RLI is run by the UHMB trust.

Under the Maternity Incentive Scheme run by NHS Resolution, the health service's insurance arm, maternity departments in England are encouraged to provide good care by meeting 10 safety standards, including properly investigating deaths and listening to parents' concerns.

Trusts which certify they have met these standards receive a rebate on their insurance premiums, in addition to a share of money paid by NHS trusts which do not.

In the five years that the scheme has been running, UHMB said it had met the 10 standards four times.

In 2018, the first year of the programme, the trust's self-certification led to it being paid £1,288,241.

In 2019, the year of Ida's death, it received £734,112 after again claiming to have hit all of the criteria.

The UHMB trust also claimed a perfect 10-out-of-10 record in 2020 but their submission was reviewed by NHS Resolution following a critical inspection of maternity services by the Care Quality Commission.

The regulator's report rated maternity services as "inadequate", with UHMB's score downgraded to three out of 10.

Consequently, UHMB was not given any money that year by NHS Resolution, and the trust was made to repay most of the amount it had received in 2019.

When told about the payments scheme and how the trust had benefitted from it, Mr Lock said it was "disgusting".

He said: "It's painting a false picture so they can receive money."

A former maternity risk manager at the trust, Rox-Anne Hetherington, said Morecambe Bay's actions were in keeping with her experience.

"I can, hand-on-heart, say that it wasn't a case of 'What have we done to [make things better]?'

"It was a case of 'What are we going to say we've done?'"

Dr Bill Kirkup, whose 2015 inquiry exposed widespread failings in maternity care, including the preventable deaths of 11 babies and a mother at the trust's Furness General Hospital in Cumbria, also said he wasn't surprised.

"Some trusts put a lot of effort into how they can present the best picture of themselves, and much less effort into whether they're actually making improvements underneath," he said.

UHMB's claims are in line with other struggling trusts which have also made similar erroneous submissions under the Maternity Incentive Scheme.

The Shrewsbury and Telford NHS trust was forced to repay almost £1m after it similarly claimed to have met all of the safety standards.

A review of its maternity care, published in 2022, found more than 200 babies and mothers could have survived with proper care.

The East Kent University Hospitals trust, where an inquiry found at least 45 babies could have survived, was also forced to repay £2m after falsely claiming it had met the safety criteria.

In a statement, NHS Resolution said "University Hospitals of Morecambe Bay NHS trust initially self-reported full compliance with the Maternity Incentive Scheme in years 1, 2, 3 and 5.

"However subsequent NHS Resolution reviews of the Trust's evidence for years 2 and 3 following the publication of their CQC report demonstrated that they were not fully compliant for those years.

"The Trust was required to repay any funds for those years. The previously granted rebate was returned to NHS Resolution and was redistributed to all compliant Trusts."

The UHMB, which has previously apologised for its failings in Ida Lock's death, declined to comment about its participation in the Maternity Incentive Scheme.