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14 NHS trusts to be investigated over maternity care ‘failures’

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Fourteen NHS trusts will have their maternity services investigated after long-running system failures, the government has confirmed.

The investigations form part of a rapid review of England’s maternity services announced in June. Health secretary Wes Streeting praised the “extraordinary courage” of bereaved families who raised concerns spanning 15 years.

Some families have criticised the process, calling the review “not fit for purpose” and Streeting’s response inadequate.

Baroness Amos, who is chairing the review, told BBC Radio 4’s Today programme she hoped families would “get the justice that they want and that they deserve.”

She described the situation — where trusts had already been investigated, “hundreds” of recommendations made, yet new reviews are still required — as “completely unacceptable.”

Research by baby loss charities Sands and Tommy’s suggested better care could have prevented more than 800 baby deaths in 2022–23.

Streeting chose a rapid review instead of a national inquiry into maternity care, despite families calling for one.

The review, originally due to finish in December, will now report in spring 2026, with interim findings expected around Christmas. It will look at family and staff experiences in maternity care and why previous inquiry recommendations from Morecambe Bay, East Kent, and Shrewsbury and Telford failed to bring lasting improvements.

Past inquiries exposed issues including dismissal of women’s concerns, weak leadership, failure to learn from safety incidents, and damaging workplace cultures. Families continue to report poor care.

Baroness Amos said “particular attention” would be paid to why black and Asian families have worse outcomes.

The Department of Health said the trusts were chosen based on data analysis, family feedback, and geographical and demographic representation.

The Royal College of Obstetricians and Gynaecologists warned the focus would “create real anxiety among women, families and staff” at the 14 trusts.

It added that the review would need to re-build a world class maternity system.

“Too many women and babies are not getting the safe, compassionate care they deserve and the maternity workforce is on its knees, with staff leaving the profession,” said the college’s president, Prof Ranee Thakar.

The Maternity Safety Alliance (MSA), which represents families affected by poor care, delivered the strongest criticism.

It accused Streeting of “broken promises” over the investigation’s scope and management, saying families felt “used.”

They particularly condemned the decision not to examine NHS regulators, including the Care Quality Commission and NHS Resolution, the service’s insurance and litigation arm.

“The review seems to have already decided that all the responsibility for these 800 deaths a year lies squarely with NHS trusts and the clinicians who work in them,” said Tom Hender, who lost his son Aubrey in 2022.

“That’s just not true — the whole system is in crisis and we need a whole system approach.”

The MSA said the investigation was “not fit for purpose” and would not achieve Streeting’s stated aims, adding: “It is clear that only a statutory public inquiry can end the crisis in maternity care.”

Baroness Amos responded that the terms of reference were broad given the timeframe and regulators were “not excluded,” but added: “The kind of in-depth review that is being requested is not something that I am able to conduct.”

The two families who successfully campaigned for an investigation into maternity care in Shrewsbury and Telford called the review “an important and brave first step.”

However, the parents of Kate Stanton-Davies and Pippa Griffiths said it would be “safer” if the review proceeded more slowly, stressing the need for proper mental health support for families sharing their stories.

“It’s not enough to have a nominal support figure in the room and an email address for follow-up,” they said.

The ongoing challenges facing maternity services were highlighted last week.

On Monday, a review at Gloucestershire Hospitals found nine baby deaths between 2020 and 2023 could have been avoided.

Then on Friday, a report revealed over half of maternity and neonatal buildings were rated unsatisfactory, with 7 per cent at risk of imminent breakdown.

Charles Massey, chief executive of the General Medical Council, is expected to tell a Manchester conference that a “toxic” NHS cover-up culture leads to poor maternity outcomes.

He will say “patient safety is falling victim to unhealthy culture” and that “the unthinkable — harm to mothers and their babies – is at risk of being normalised.”

Hormonal health

Study links small bowel microbiome differences to women’s health

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Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.

The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.

Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.

The study was conducted by investigators at Cedars-Sinai Health Sciences University.

Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.

“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”

The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).

IBS is far more common in women than men.

Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.

“We must consider it as we move toward more personalised approaches to understanding and treating disease.”

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Menopause

Cancer drug could tackle osteoporosis menopause weight gain

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An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.

The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.

The treatment remains at an early experimental stage and has so far only been tested in animals.

The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.

Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.

Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.

Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.

“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”

The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.

They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.

The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.

Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.

Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”

Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.

The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.

“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.

The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.

Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.

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Fertility

Weight loss surgery improves menstrual health and PMOS symptoms, study finds

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Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.

The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.

Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.

Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.

Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.

Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.

Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.

Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.

Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.

“So much remains unknown about the impact of this type of surgery on women who are planning to have children.

“This raises the question of when the ideal time after surgery is to conceive.”

Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.

The researchers said 17 women had healthy pregnancies following surgery.

Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.

Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.

“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.

“By reducing this, what we have seen is that it can lead to improvements without the need for medication.

“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”

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