Community leader brands high baby mortality rates in Stoke-on-Trent and Staffordshire a 'scandal'

Concerns have also been raised about staffing levels at the area’s maternity departments as recruitment remains an issue, members of a Staffordshire County Council scrutiny committee heard this week.

Recently published figures have revealed that seven of the 10 Integrated Care Boards (ICBs) with neonatal mortality rates significantly higher than the 2021 UK average of 1.56 per 1000 live births are in the Midlands. Staffordshire and Stoke-on-Trent ICB had the second highest rate at 2.6, with Stoke-on-Trent at 4.74 – the highest in England – and Staffordshire at 1.83.

Councillor Charlotte Atkins, speaking at last Monday’s Health and Care Overview and Scrutiny Committee meeting, said: “It’s very worrying to see that Stoke-on-Trent has the highest neonatal mortality rate in England and that Staffordshire and Stoke-on-Trent ICB has the second highest in the UK. I would have hoped that would have required urgent intervention to deal with that issue.

“I’m sure there are lots of reasons for that, but one of the areas that stands out and one of the points of concern you have identified, is the influx of new recruits and induction of labour. Workforce seems to be a big issue because you’ve had four consultants on long-term sick.

“What is going on that not more attention is being given to the fact we top a chart we don’t want to top in terms of mortality? We’ve heard so many awful stories about maternity failures but it seems to me we top the whole lot, so what urgent intervention is taking place to resolve this issue?”

Karen McGowan, associate director for nursing quality and maternity at Staffordshire and Stoke-on-Trent Integrated Care Board (ICB), which oversees health services in the area, said: “We feel exactly the same – the urgency you’re talking about is now our key area of focus. The data reported here is national data reported annually and there is a two-year delay on that data.

“When it does come out it grabs the attention and makes us look at it closer – is it something about the chances they take on younger babies that other areas don’t take? There are things to unpick about why we have that high number – it’s awful and it’s dreadful.

“There was a neonatal improvement group that met monthly and that stopped at the beginning of the year because of the workforce challenges and the ability to release staff to go to those meetings. That has just been resurrected, so there’s monthly neonatal improvement group meetings which will look at these figures and the actions being taken to better understand them.

“There has been a real challenge around the neonatal consultant workforce, to the point where currently there is an arrangement where babies born under 27 weeks in Shropshire and Telford can come across to Staffordshire to be cared for because we have a Level 3 unit (which provides the highest level of intensive care). There was a challenge at one point as to whether we had the workforce to be able to continue to offer that service and that was looked at.

“At the time, of the eight neonatal consultants four of them were on long-term sick, which is something the trust is looking at to try and understand why. I’m pleased to report that they have recruited and I think they’ve got one vacancy now, so that workforce has increased – that’s a lot better than it was.”

Stoke-on-Trent City Council has launched a review into why the area has the highest rate of infant mortality – children who die before their first birthday – in England. Latest figures showed Stoke-on-Trent had an infant mortality rate of 7.5 per 1,000 people from 2019 to 2021 – compared with the England average of 3.9 per 1,000 people.

Ms McGowan said: “The majority of them are in those first 28 days in our neonatal, which is what this data is saying. What (Jon Rouse, City Director for Stoke-on-Trent City Council) is talking about is what can we do; there are already things in place around breastfeeding, around tobacco dependency and they are big projects being worked on.

“What Jon’s talking about is let’s look at the mothers when they’re pregnant but pre-pregnancy as well. Let’s look at housing conditions, how we make our mothers-to-be as fit and able as they can be.

“That piece of work is happening and it’s joined-up work – it goes across our neonatal consultants and local authorities. We’ve got all partners involved in looking at that infant mortality.”

But Councillor Atkins replied: “I hope we’re not falling back on the old adage of blaming mothers. This is a scandal; we’re not just a little bit above the rest, we’re well above the average – disastrously so.

“What amazes me is that we don’t seem to have established what the reasons are. One of the issues is influx of new recruits – we may not have vacancies but do we have the skill level and skill mix we need to have for what is clearly an area where there a number of very significant challenges in terms of neonatal mortality?”

Ms McGowan responded: “There is a dearth of neonatal consultants; so much so that when they put out the adverts recently for two appointments, one was made straight away and the second one was found to maybe not be consultant level. What the trust did was say let’s being this person in, let’s develop their skills.

“We are passionate about mothers and birth – I’m a mother of four children – and we’re absolutely not blaming mothers at all. What evidence is showing us is that tobacco dependency is a key factor and that’s one we’ve really got to go at.

“And when I talk about the housing I think that’s us saying what do we need to do about it? It’s looking at the social factors that we need to take responsibility for, to make sure these mothers are in the fittest place they can be when they choose to give birth.”