Baby deaths and toxic culture - the Nottingham maternity report at a glance

The review team described a "bullying and toxic culture" at the trust over years, with some staff members "specifically and consistently mentioned as forming intimidating cliques that were/are well known, but not confronted". There was also a belief in the "Nottingham way" and "tribalism" among staff groups. Leadership instability was a "major contributing factor" affecting the quality and safety of maternity services, the review found. Between 2017 and 2021 there was "sustained turnover in senior maternity leadership positions" and senior operational roles. One member of staff said "bad behaviours and toxic culture were normalised; people didn't even recognise it. [There were] entrenched ways of behaving that were unprofessional and cruel to women on labour ward". Staff also reported "a culture of organisational denial" over years, where poor outcomes "were regularly dismissed as 'known complications". Ockenden added: "What the evidence shows is that at Nottingham, a toxic culture was allowed to take hold and was allowed to persist. A small number of powerful leaders described in both family and staff testimonies as having infected the unit, creating an environment in which bullying was normalised, speaking up was dangerous and governance was shaped by self protection, rather than patient safety."