When it was confirmed that Leeds Teaching Hospitals NHS Trust (LTHT) would be part of the government’s national maternity investigation, many families were disappointed. In their minds, a rapid investigation could “not scratch the surface of the front-line care failings”. A slew of information released in supporting papers to a board meeting taking place on Thursday 25 September, and a new Care Quality Commission assessment of the trust’s leadership, suggest they are right to be concerned.
In August 2025, state the documents, “there was a significant increase in negative ratings for birth”. Feedback from women and their families “highlighted adverse themes associated with communication, compassion, environment, patient mood/feeling, treatment and care, pain management, staffing resources and waiting time”. In the same month, the trust delayed the admission of a bereaved mother whose baby had died at 32 weeks. And they were unable to provide her with one-to-one care during labour, “due to acuity”. It is not entirely clear what this means. But acuity – when used in a medical context – is a measure of the intensity of care a patient requires. It dictates how immediately they need to be seen, as well as how many staff are needed. The LTHT document seems to show that attending to a woman who needed to give birth to a baby she knew had died was not deemed urgent.
The board meeting’s supporting documents feature several serious announcements. They reveal that Leeds has been asked to repay close to £5m after it was found to have wrongly claimed it was providing safe care to mothers and their babies. The trust reviewed the claims it made to the Maternity Incentive Standards (MIS) scheme for 2024/25 and 2025/26, after its maternity services were rated “inadequate” – the lowest rating possible – by the CQC earlier this year. In a damning report, the regulator said that concerns of families and whistleblowing staff dating back several years had been “substantiated” during the inspection and “posed a significant risk to the safety of women, people using these services, and their babies”.
The MIS is run by the health service’s litigation arm – NHS Resolution – and allows a trust to claim a rebate on its insurance premiums, as well as further money if it meets all safety measures set out by the scheme. Although it has not explained how it had come to wrongly report that it was compliant with the MIS standards in the first place, Leeds Teaching Hospitals NHS Trust has told the BBC that while having to pay back £5m, it had been “allocated £2.1m to support our action plan to achieve compliance”. The New Statesman can reveal, however, that concerns were raised with NHS resolution that Leeds may have been non-compliant with the scheme as far back as 2020. Documentation confirms that representatives from the Maternity Incentive Scheme met with the CQC in January 2021 to discuss the concerns raised. It is unclear what either organisation did to meaningfully follow up with the trust and ensure it was eligible for the money claimed.
Perhaps most damning in the release of documents is a letter from NHS England to Leeds’s recently retired chief executive, confirming the findings of an external review of the trust’s neonatal critical care. While the reviewers did not identify any immediate risks when they examined the trust in July, the letter notes that NHSE found “several serious concerns that warrant[ed]… attention”. The “quality peer review” exercise judged that because of “persistent underfunding”, staffing levels fell short of the required standards. This “shortfall”, NHSE noted, not only affected compliance with national guidance, but also “non-compliance with the service specification for inpatient neonatal care. As a result, there is likely to be a negative impact on long-term neurodevelopmental outcomes for patients and reduced support for families.” Official statistics on neonatal deaths show the trust had the highest extended perinatal mortality rate in England in 2023, 2022 and 2021 – the most recent years for which data is available.
The independent reviewers also noted that staff in the neonatal teams were being denied access to psychological support, resulting in “increased levels of staff burnout and moral distress”. Without access to appropriate mental health resources, staff “ability to cope diminishes over time”, the NHSE team said.
Alongside the information published by the trust, the CQC announced on 24 September that it has judged that the leadership of LTHT “requires improvement”. In its latest inspection, prompted by the downgrading of Leeds’s maternity and neonatal services (and focusing solely on whether Leeds was “well led”), the hospital watchdog noted that “the board was not working as cohesively as it should to be” and that it was concerned that “sufficient and appropriate check and challenge could be lacking due to some exceptionally strong personalities within the board”. Rob Assall, CQC director of operations in the north, said: “Leaders didn’t always listen to concerns, and some staff had negative experiences when they voiced issues, which impacted their wellbeing and the quality of people’s care. We received several in-depth accounts from staff of bullying and harassment in the workplace which provided evidence of behaviours which didn’t align with the trust’s values.”
Inspectors were told of concerns that the trust’s priorities were perceived to “skew toward finance over quality” and that this was potentially “affecting the escalation of concerns”. The CQC heard from staff that “issues requiring additional finances to make a positive impact on patient experience or quality may not have been escalated or highlighted due to perceived financial priorities”. Some senior leaders were aware of this impact, the report noted, and explained that “there was a risk that a heavily skewed focus on commercial aspects… could detract from ‘getting the basics right’”.
Reflecting on everything that featured in the trust’s board meeting’s supporting papers and the CQC inspection, one family in receipt of poor maternity care at Leeds described this as a “shit show” that supported the call for a full independent inquiry into the trust. In papers circulated ahead of today’s meeting, Brendan Brown, who became the LTHT chief executive on 15 September, told the board that, while the trust has already taken significant steps to address improvements to its maternity and neonatal services following the CQC reports, there is still much more to do. He welcomed the inclusion of Leeds in the government maternity national review.
[Further reading: Trump, Tylenol and toughing it out]
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