Martyn Pitman critical of trust over baby brain injury cases

As previously reported, an internal review is being carried out by Hampshire Hospitals NHS Foundation Trust (HHFT) after the rate of babies born with brain injury due to oxygen deprivation at birth increased last year.

The disturbing data was presented at a meeting in the trust, showing the rates of babies born with hypoxic-ischemic encephalopathy (HIE) had increased last year.

READ MORE: Review by Hampshire hospital trust after increase in babies born with brain injuries

When asked for the figures, HHFT provided data showing that the number of babies born in 2023 with (HIE) was five times greater than the number born in 2022.

However, the trust downplayed the statistics describing them as within the ‘expected range’ set by the British Association of Perinatal Medicine, which is between one and 3.5 per 1,000 live births, despite the association stating in 2020 that a reduction in neonatal brain injury is a ‘key national objective’.

The Gazette spoke to former consultant Dr Martyn Pitman about figures provided by HHFT and put his criticisms to HHFT, saying it was 'trivialising' the increase. 

HHFT then changed the statistics, giving new data showing a less significant rise in babies born with HIE.

When pushed for answers as to how this had happened, it said it had come up with the new statistic after “reviewing the data more closely”.

SEE ALSO: Hospital changes data on babies born with brain injury after consultant criticisms

It said the original data, showing a much more significant increase in HIE cases, related to babies born at the Royal Hampshire County Hospital, in Winchester.

Dr Pitman, a former consultant obstetrician and gynaecologist at HHFT who was dismissed last year from his job at the Royal Hampshire County Hospital in Winchester, where he had worked for 20 years, said he dedicated his career to reducing the rate of babies born with HIE.

Dr Pitman, who was clinically suspended in July 2021, said: “If you think what that means to that poor couple’s lives and that baby. The reason it’s so significant is a lot of these cases are avoidable, but in HIE cases it’s often difficult to prove that the babies should have been delivered two hours earlier."

He added: “The reason I feel so strongly about it is I devoted my entire consultant career to specifically minimise this outcome. What I saw from senior midwifery, this was a critical part of what I whistleblew about.

“I was repeatedly praised for the positive influence I had at Winchester for minimising HIE in babies during my time in post.”

He continued: “I devoted my entire career to this with proven success. They dismissed me in March 2022 and this data came out in December 2022. So, within the year of my dismissal, everything I warned them would deteriorate has been proved correct.”

The doctor added: “They are relying on the security of saying it’s gone up but ‘we’re within the national range’. You should be striving to make sure your unit is at the lowest end of that range.”

He described the HIE statistics as “gravely concerning” and said the trust should call for an external investigation.

Dr Pitman believes the trust should be using better foetal monitoring of babies and hopes by speaking up to raise awareness of the issue.

“The personal tragedy for me means I will never work again, it’s impossible for me to get another consultant post,” he said, adding: “What I was trying to introduce with foetal monitoring would have saved babies. I tried and sacrificed my career. If I can make a difference to prevent damage to patients and doctors and midwives, I won’t feel my sacrifice wasn’t worth it.”

A report published by the NHS last year titled The Saving Babies’ Lives Care Bundle says the NHS is working towards a National Ambition to halve stillbirths and neonatal baby deaths by 2025.

What is HIE and how does it happen?

Information from the charity Bliss, for babies born premature or sick, advises that HIE may be diagnosed if a baby’s brain does not receive enough oxygen and / or blood flow around the time of birth. It affects the brain but can also cause problems in the lungs, liver, heart, bowel and kidneys.

When diagnosed, HIE is graded as mild, moderate or severe. In severe cases, it can result in long-term disability and in some cases death.

It is now always possible to know what causes HIE. It can be caused by complications around the time of birth such as the placenta coming away from the uterus wall too soon; tearing of the uterus; having an unusually long labour; or a baby’s shoulders getting stuck behind the pubic bone during delivery.

The NHS advises effective foetal monitoring during labour through ensuring all staff responsible for monitoring the foetus are competent in the techniques they use and escalate accordingly when concerns arise, or risks develop.

HHFT response

The hospital trust gave a lengthy response to the Gazette following our interview with Dr Pitman.

HHFT said its maternity services are safe and that Care Quality Commission 2023 Maternity Survey results demonstrate “year on year improvements across the pregnancy, birth and postnatal journey”.

It disputes that there is a link between the number of babies born with HIE and Mr Pitman’s previous role at the trust, saying: “Mr Pitman has not worked within Hampshire Hospitals for three years and therefore will be unaware of current practices including the new ways in which we are identifying babies with HIE.

“This work has continued since Mr Pitman left the trust with training and support delivered by fetal midwives and consultants.

“There has not been a statistically significant rise in babies born with HIE in the three years since Mr Pitman left the trust. In fact, when comparing 2020 to 2023, there has been a decrease in babies born with HIE. The numbers are so small that there will be a variation in numbers of babies born with HIE over the years.”

Asked why it is undertaking a review, it said: “Every baby counts and every trust will always be striving to achieve a safe birth for every family. This is why we are undertaking a review. Undertaking a review in these circumstances is normal practice for any trust.”

The changed figures provided by HHFT show that 11 babies were born with HIE at the trust in 2020; 12 in 2021; seven in 2022; and nine in 2023.

It said the review of the figures, which will include input from midwifery, obstetrics and neonatal teams, will be “shared and presented with clinicians at governance meetings and with the trust in assurance meetings, as well as to the neonatal and maternity networks which are external to the trust.

“As with all thematic reviews, any findings will be shared with staff and implemented to ensure we continually provide the best care possible.”

Mr Pitman accused the trust of being more concerned about its reputation than patient safety.

The trust said this is “categorically untrue” adding: “Patient and staff safety is of the utmost importance, and we put it before all else. We have a strong safety culture at Hampshire Hospitals in which patient safety is everyone’s responsibility. Part of our safety culture is encouraging colleagues to speak up candidly and free of any concern, knowing that what they say will be acted upon.

"Today, our maternity units are fully recruited for midwives. Patient safety is always prioritised ahead of reputation.

It encouraged people to share feedback.