The BBC has found that the deaths of at least 56 babies and two mothers could have been prevented at an NHS trust over the past five years.

Two maternity units at Leeds Teaching Hospitals (LTH) NHS Trust have been given “good” ratings by England’s healthcare regulator, but two whistleblowers have told the BBC they believe the units are unsafe.

Separate data shows that Leeds has the highest neonatal mortality rate in the UK.

Bereaved parents say they are concerned that the chief executive of the trust during which the highest number of deaths occurred is now leading the regulator, which they say could impact its independence in investigating the LTH Trust .

In a statement, the trust told the BBC that the majority of births in Leeds were safe, and deaths of mothers and babies were fortunately very rare.

It adds that Leeds cares for a higher number of babies with complex conditions because it is one of “a handful of specialist centres” in the UK.

The trust’s maternity units are at Leeds General Infirmary and St James’s University Hospital.

Families describe a “tick box” and “wait and see” culture at the Trust, as well as a lack of compassionate care.

This is echoed by whistleblower Lisa Elliott, who worked at two sites in 2023. Describing the care as “appalling”, he highlighted the failure to listen to patients. “That’s when disasters happen and a lot of them are avoidable,” he said.

The families are calling for an independent review of the LTH Trust to ensure the issues are identified and lessons learned. They also want an independent, judge-led public inquiry to help improve maternity protection across England due to widespread concerns about the standard of care.

The BBC obtained data from the Trust showing potentially preventable infant deaths through a Freedom of Information request.

This led to at least 56 cases from January 2019 to July 2024, including 27 stillbirths and 29 newborn deaths – which are deaths within 28 days of birth.

In each case, a trust review group had identified care issues which they believed could have made a difference to the babies’ outcome.

Trust-led reviews were conducted by multidisciplinary teams that regularly included people who did not work for the Trust.

The trust also recorded two potentially preventable maternal deaths in the same period.

It did not provide any individual details about the 58 deaths, so we don’t know if they include the families we spoke to.

The deaths reviewed by the trust included children with congenital abnormalities and newborns and mothers transferred from other units after birth because they needed specialist care.

The trust said the number of potentially avoidable newborn deaths was “very low”.

The neonatal mortality rate for LTH in the UK was the highest in 2022, at 4.46 per 1,000 live births, according to the latest report from MBRRACE-UK – which reviews stillbirths and neonatal deaths but does not analyze whether either of these are likely Can be prevented or not.

BBC analysis of this data, which was made public last July, shows this has increased from 3.30 per 1,000 live births in 2017.

The LTH 2022 figure is 70% higher than the average rate for comparable NHS trusts.

MBRRACE-UK has grouped Leeds with 25 other trusts which it says provide the same level of care. Specifically, they all have a level three (the highest level) neonatal intensive care unit and perform neonatal surgery. This group is complex with various specialties.

The LTH told the BBC that the number of complicated pregnancies and births in the region is rising – including an increase in the number of babies born with serious heart problems – leading to a rise in neonatal mortality.

Fiona Winsor-Ramm and Dan Ram’s first child, Aliona Grace, died at Leeds General Infirmary in January 2020, 27 minutes after birth.

There was a delay in admitting Fiona after her waters broke and there were delays by midwives as concerns grew over Aliona’s heart rate during labour.

An investigation in 2023 found that “there were a number of serious failures of the most basic nature which directly contributed to Aliona’s death”.

“Leeds says they’ve learned their lesson, it won’t happen again. But it does happen, and children continue to die, or be seriously injured, from similar causes,” says Dan.

The couple, who connected with other bereaved parents after setting up a Facebook group, believe many more people are also affected.

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Fiona and Dan also believe that the regulator – the Care Quality Commission (CQC) – has failed to hold the trust accountable despite other preventable infant deaths.

The CQC inspects the quality of services in health and adult social care in England and can prosecute providers who fail to provide safe care.

The couple first raised their safety concerns with the civic body in November 2020. He says the regulator is not fit for purpose.

They are taking legal action against the LTH Trust, but also want the CQC to prosecute it for its care failings.

Fiona and Dan do not think any future CQC investigation into Leeds will be independent with the trust’s former chief executive being in charge of the regulator.

Sir Julian Hartley led the trust for 10 years, until January 2023, and was in the post when Aliona died. He took charge of the CQC in December 2024.

“There’s a huge conflict of interest there,” says Dan.

We contacted the CQC and Sir Julian for comment and the regulator responded on behalf of both, saying that while it is independent, it “has robust policies in place to manage any conflicts of interest”.

It said there is currently no criminal investigation into Leeds Maternity Services, but it is in contact with the families and is looking into the four incidents for evidence before any future legal action.

The bereaved parents include Amarjeet Kaur and Mandeep Singh Matharu, who were expecting their first child last February.

When Amarjeet was 32 weeks pregnant, she went to the maternity unit at Leeds General Infirmary twice within 24 hours with severe stomach pain. She says she was told she was having ligament pain in her torso and each time she was given paracetamol and sent home.

A few days later, Amarjeet had emergency surgery and he says a large blood clot was found in the exact spot where he described the pain.

Their daughter, Assis, was stillborn on 6 January 2024. The couple believe her mother would have survived if she had not been sent home earlier.

“This has been the toughest year of my life,” says Amarjeet.

A trust-led review of Amarjit’s care identified issues which could have made a difference to the child’s outcome.

According to the latest UK figures from MBRRACE-UK, black mothers are almost three times more likely to die than their white counterparts (35.1 per 100,000 live births), while Asian women are almost twice as likely to die (20.16 per 100,000 live births ) Is.

Last year, 15.7% of registrable births in LTH were Asian and 11.8% were Black.

Amarjeet believes that he was treated differently because of his Indian ethnicity.

During his first visit, she says she overheard a white woman telling the midwives that he could stay “as long as you want” because of his pain — but Amarjeet was sent home.

“The only difference between me and them was the color of my skin,” she says. “But I was in so much pain that I couldn’t even move.”

The trust’s review of Amarjeet’s care said “concerns about institutional racism have been taken seriously” and escalated to senior management.

Both whistleblowers described unsafe care while working at both units.

An experienced clinical staff member, who is currently based in Leeds and who asked to remain anonymous, told us that the service is “absolutely poor” due to long-term staff shortages, which has the effect of “women and “Babies are not getting the care we want to give them”.

These concerns are echoed by a former temporary staff member, Lisa Elliott, who says when she worked about 40 shifts as a maternity support worker during 2023, she witnessed “chaotic” care. While in this role, she supported midwives in the care of women. Says she witnessed “rude” treatment of patients by staff who lacked empathy.

Lisa, who says she started working shifts at hospitals in 2020, says she was up for a CQC inspection in 2024 but doesn’t think maternity services should be rated “good”. She says she raised concerns about staff attitudes at the time, but they were “not properly addressed”.

Professor Phil Wood, chief executive of Leeds Teaching Hospitals, told the BBC that the trust wanted to apologize to the women and families who shared their negative experiences.

He highlighted its status as a specialist center caring for “the worst babies”, and said that comparing MBres-UK neonatal mortality data from LTH to other hospitals, “even a is fraught with difficulty and confusing, even in the expert category”.

Chris Dzikitty, CQC’s interim chief inspector of health care, said LTH’s maternity services have been and will continue to be subject to strict monitoring.

She said maternity services at both hospitals were inspected last month “in response to concerns raised by families and risks identified through our ongoing monitoring”.

The findings of that inspection will be published shortly.

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