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In February, one of the busiest NHS trusts in England was fined a record £ 1.6 meter on maternity failures regarding the death of three infants.

Nottingham University Hospitals (NUH) NHS Trust is already at the center of the largest maternity review of its kind in NHS, after the death and injuries of hundreds of children.

When this was fined in the Nottingham Magistrate Court, the judge said that the Trust was working at a shortage of about £ 100m, and said “there was no money to pay any adequate penalty without the need of the trust to further cut the trust”.

District Judge Grace Lyong considered other court decisions and guidelines for comparable offenses before handing over the fine.

So why was there already struggling, publicly funded service was given such a large penalty, and what was the penalty to the families?

Adele O’Sullivan died on 7 April 2021 – at just 26 minutes of age – Kahla Rawson died on 15 June at four days old and Quin Lais Parker died on 16 July at two days.

NUH blamed six cases of failure to provide safe care and treatment to children and their mothers, in prosecution brought by the Health Service Watchdog, Care Quality Commission (CQC).

The court heard that there were similar failures in all three cases, including failure to accelerate infants’ delivery, serious conditions, issues of communication and employees not being equipped to explain discrepancies in fetal monitoring.

This was the second time the trust was prosecuted by CQC for maternity failures.

In 2023, the trust was fined £ 800,000 on the death of Winter Andrews, who died shortly after his birth at Queen Medical Center in 2019.

By this year, the penalty was assigned the largest for maternity failures.

NUH prosecution makes two of the five maternity prosecutions brought by CQC.

Watchdog gained powers under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in 2015.

This CQC prosecution is different from any prosecution that can be generated from a corporate mangilator investigation, which was opened earlier this month.

On 2 June, the Nottinghamshire police said that it was investigating that the maternity care provided by NUH was quite negligent.

In response to the BBC, a statement by NUH Chief Executive Officer Anthony May said: “We fully accept the conclusions from the court, including the fine given by the judge.

“The mothers and families of these infants have to bear things that no family needs after the care provided by our hospitals, and I really regret it.

“We will work to ensure to reduce the impact of fines on our patients, including ongoing efforts to improve our maternity services.”

NUH did not want to put anyone forward for interview, and it was not a desire to expand how the penalty could affect services.

Former Chairman of Old Homewood NHS Trust in Roy Lily, Charts, Surrey – who later merged with Ashford and St. Peter’s Hospitals NHS Trust – and now an independent commentator on healthcare issues, said some impact on services would be “unavoidable”.

“Apparently a part of money like £ 1.6m is going to impact the trust’s ability to operate the trust.

He said, “The trust of day-to-day running, of course, is quite difficult with all financial pressures, but to get such money out of its revenue, it makes it even more difficult,” he said.

Mr. Lily – Who has not worked for NUH – said: “This will definitely slow down some plans that they had in terms of reform.”

“It usually has a very bad effect, a major impact on the trust’s ability to respond,” he said.

Mr. Lily said that due to financial difficulty for the trusts, it was possible to take a loan from the Health Department of the Health Department (DHSC).

The BBC understands while NHS trusts are expected to meet their legal and financial obligations – including prosecution fines – they can reach the loan in some examples.

The annual budget of the trust is £ 1.8bn.

Families affected by NUH’s maternity failures have constantly called for accountability.

After the sentence, Solicitor Natalie Cosgrav – representing Baby Quin’s parents – said in a statement that the prosecution “has the only system” to achieve it.

An Associate Clinical Negligence Solicitor Solicitor Saddy Simpson, who represents the families of Edel and Kahlani, told the BBC the Trust’s guilty petition that “there was some level of accountability, but it is only a part of a very large picture”.

For bereaved families, it is a person who should be held accountable, not just a organization, Ms. Simpson.

Ms. Simpson has also represented the families of Edel and Khalani in civil claims against NUH.

In each stage of various investigations and proceedings, he has tolerated – including inquiries, internal reviews and court hearing – families have called for more changes and investigations.

Ms. Simpson said: “The judge was very clear that a fine is the only sentence she can impose, and no fine is ever enough when you lose your child.”

During the punishment in February, in the earlier case of Winter Andrews – who was born 23 minutes later – was referred to several times.

His parents Sara and Gary Andrews “saw the hearing” as anxious parents from the public gallery, but did not know that his daughter’s case would be mentioned “very prominently”.

“I think it is important for us to highlight that this process is the only avenue that families have to get some accountability,” he said.

“The judge is really in a difficult situation, I think, but we are counting penny on infants’ lives.”

The fine is paid to the HM Treasury – the government’s Finance Ministry that controls public spending – as is the fine with any prosecution.

In this case, the affected families will not get any money from the prosecution.

The trust was also asked to cover the prosecution cost of £ 67,755.23 and the aggrieved surcharge of £ 190.

The cost of prosecution in this case will be paid to CQC.

The victim surcharge – which is imposed on criminals to ensure that they have some responsibility about the cost of support victims and witnesses – go to a normal fund and not directly for those involved.

This money makes a contribution to the help-funded assistance services for the victims and witnesses.

The £ 1.6M fine is different from millions of pounds, the trust has paid for loss to civil claims in relation to maternity care.

In the maternity services of the trust, the investigation of the Nottinghamshire Police – called Operation Perth – has seen more than 200 family matters, which have been referred to so far.

Meanwhile, the separate maternity review by senior midwife Donna Okenden is currently investigating the testimony of more than 2,000 cases.

The review began in September 2022 and closed in new cases in late May.

The final report of the findings of Ms. Okenden is scheduled to be published in June 2026.

And last week, the trust announced a plan to cut at least 430 jobs in an attempt to save £ 97m in the following year.

The trust stated that employed job cuts follow the government’s instructions for all trusts to reduce the size of their corporate and support services, and were not as a result of record penalty.

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