Posted: Thu 5th Oct 2023

Devastated parents of baby who died in hospital care fearful other families affected by ‘systemic failings’ of NHS Trust

Business, in Wales.
This article is old - Published: Thursday, Oct 5th, 2023

THE devastated parents of a baby who died following a traumatic birth in hospital care are fearful other families may have lost children due to the “systemic failings” of an NHS Trust.

Sarah Robinson and Ryan Lock, from Morecambe, were left heartbroken following the death of seven-day old Ida at Royal Preston Hospital in November 2019.

Ida was born a week earlier at Royal Lancaster Infirmary, and despite mistakes made during and after her birth – including failures during resuscitation – University Hospitals of Morecambe Bay Trust carried out an internal investigation and deemed there were no care delivery issues.

The Trust did not involve the family in the investigation and failed to notify the Coroners’ Court despite being advised to do so by the Healthcare Safety Investigation Branch (HSIB) in April 2020.

After failing to secure answers, Sarah and Ryan – with the support of Anna Mills-Morgan, a clinical negligence specialist and director at Mackenzie Jones Solicitors, based in North Wales and Chester – were forced to contact Senior Coroner Dr James Adeley themselves, who has now ordered a full inquest to be held next February as the Trust finally accepted care delivery issues.

Mr Lock said: “Anna and the team at Mackenzie Jones have been unbelievable from the day we approached them with our issues.

“This has been a very difficult journey to deal with, though with Anna’s compassion and diligence we now have the support we need to find the answers we deserve.


“Any other parents who are sadly suffering following maternity care issues like us should get in touch with them.”

University Hospitals of Morecambe Bay Trust were heavily criticised in 2015 in a report prepared by Dr Bill Kirkup, who stated there was ‘major failure at every level’ in maternity and neonatal services’ between 2004 and 2013, following the deaths of 11 babies and one mother.

He made more than 40 recommendations but after further scandals in Shrewsbury, East Kent and Nottingham, Dr Kirkup admitted earlier this year they had failed to ‘stop the recurring cycle of catastrophes’ in NHS maternity units.

At a pre-inquest held in Preston, Dr Adeley revealed that he could not recall any perinatal deaths having been reported to him and ordered a full and detailed and transparent investigation fully involving the family.

He added: “It appears to be an ongoing continuum from matters identified in Kirkup that are again replayed in this case, with distinct similarities. The information I am going to want from the Trust is going to be very extensive.”

Mrs Mills-Morgan, representing Miss Robinson and Mr Lock, said more babies and families could have been impacted over the years due to “systemic failings” at the Trust.

“The Trust knew there had been failings as early as April 2020 when the HSIB produced their report, and that it was very clear that they should have reported Ida’s case to the coroner, but they didn’t,” she said.

“That is a worry because how many other cases are there out there where the coroner hasn’t been notified?


“The hospital’s own internal investigation said there had been no problems. We also reported the case to the Care Quality Commission, but they did nothing.

“Instead, it was left to Sarah and Ryan to fight to make the Trust accountable for Ida’s death – that is totally wrong. Their case is evidence that little has changed since the Kirkup Report in 2015. What is the point of all these regulatory bodies and reports if they don’t make a difference?”

She added: “There are massive gaps in accountability in the NHS. Parents and families shouldn’t be the ones forcing action, hospital managers must be held accountable.

“If anyone reading this has any questions or concerns about their own situation, please get in touch, because there are undoubtedly going to be other parents and families affected by these findings.”


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