The ‘almost certainly preventable’ death of a stillborn baby has resulted in the Crown Prosecution Service and the Health and Safety Executive being urged to intervene.
Harriet Hawkins was born at Nottingham City Hospital after a ‘horrific’ five-day labour in April 2016 – nine hours after parents Jack and Sarah Hawkins were told she’d died.
An independent investigation into Harriet’s death, published in December last year, found a series of contributing factors, including a ‘lack of midwifery leadership’, ‘inadequate processes to support communication of clinical information’, a ‘poor safety culture’ and a ‘lack of governance in relation to reporting serious clinical incidents.
Jack and Sarah, pictured with a photograph of still born Harriet, were told their daughter was dead nine hours before the baby was delivered
Now Jack and Sarah are referring their daughter’s death to the Crown Prosecution Service and Health and Safety Executive Nottingham University Hospitals (NUH).
The NHS Trust, which manages City Hospital, has ‘apologised unreservedly’ to the couple for the shortcomings in care.
But Jack and Sarah, who both worked at NUH at the time, believe the trust is yet to accept responsibility for their daughter’s death.
As a result, they are taking the ‘unusual’ step of referring their daughter’s case to the CPS and HSE.
The NHS Trust that runs the hospital has ‘apologised unreservedly’ after a report found a lack of safety and leadership
They will also be referring the doctors and midwives involved in Harriet and Sarah’s care to the relevant professional bodies for further investigation.
Sarah, 34, explained the couple’s decision to take the case further.
She said: ‘It is such a relief to have the external people listen to us, to be open and honest and for them to be transparent.
‘Unfortunately that’s not the experience we had with the hospital – and that’s all we’ve really wanted.
‘After we were told Harriet was dead, we knew something had gone wrong and we wanted someone to listen to us and that didn’t happen.
‘It felt like it was barrier after barrier, so it’s such a relief that we’ve got this [the external report] through.
‘I think it’s sad because we worked at the trust and we believed in them and trusted them to deliver our perfectly healthy, full-term baby alive and they failed in that.
‘They’ve failed in listening to us since that, so that’s why we thought we should try and escalate it so that other mothers and parents don’t have to go through the same thing.’
Jack, 48, added: ‘I would like to be believed and I would like our daughter’s death to be valued.’
The couple’s lawyer, Janet Baker, of Switalskis Solicitors, said: ‘This report is so damning that we are considering the unusual stop of referring a number of the staff involved in Sarah’s care to their professional disciplinary and regulatory bodies and asking the HSE and CPS to respectively investigation the systemic and institutional failings and the lack of candour identified in the report.’
Tracy Taylor, chief executive of NUH, expressed her condolences to the couple again.
Jack and Sarah Hawkins are taking their case to the Crown Prosecution Service after Sarah endured a five-day labour that ended in the still birth of her child
She said: ‘I profoundly apologise that we let them and Harriet down so badly. NUH has acknowledged that it is likely Harriet would have survived had it not been for several shortcomings in care.
‘We welcomed the independent review commissioned by our local commissioner, following the previous external review, which provided a further opportunity for our teams to reflect and learn from this incredibly sad case.
‘We accept the recommendations that have arisen from the external review, and have worked to ensure appropriate further actions have been taken where needed.’
Mrs Taylor added that the trust has made ‘substantial changes’ to address the shortcomings in care and carried out a ‘broader review of maternity services’.
She also said NUH does not ‘offer different standards of care for women who work for the trust’.
Mrs Taylor also apologised for not communicating as ‘effectively as we should have early in this process’ and said they have sought to ‘communicate openly and frequently’ with the couple since.