The chief executive of the NHS trust at the centre of the largest maternity review in NHS history has said he is “shocked and upset” by its damning findings.

The review into Nottingham University Hospitals (NUH) NHS Trust, published on Wednesday, said “deeply embedded systemic failures” led to hundreds of deaths and avoidable harm to babies and mothers.

Chief executive Anthony May said he came away from the announcement with a “renewed commitment” to continuing to improve, including implementing all of the essential actions detailed in Donna Ockenden’s report.

But he admitted the trust had not always “met their aspirations” in terms of staff being held accountable for failings.

About 2,500 families and more than 800 staff members – past and present – contributed to the review, which began formally on 1 September 2022.

The independent maternity review, led by senior midwife Ockenden, concluded there were “potentially avoidable” outcomes for mothers and babies in 520 cases.

It also found different care may have altered the outcome for 260 babies – 155 who died and 105 who suffered serious brain injury due to substandard care – the review team told the BBC.

The report also identified a “bullying and toxic” workplace culture, which prevented staff members from speaking up, and Ockenden added a small number of powerful leaders had “infected the unit”.

NUH was given a list of actions it must now take to address the failures found by the review team.

May earlier called the review’s publication a “watershed moment”.

Speaking to BBC Breakfast on Thursday, he said: “Anyone who’s in the room yesterday, as I was, would have been shocked and upset and although Donna has kept us up to date with her findings as she has gone along, it was still shocking and upsetting.

“I was also greatly affected, as I have been over the past four years, by the courage of the families who have told their experiences time and time again, because they want us to learn and do better and I came away with a renewed commitment to continue to improve.”

He also emphasised engaging with both the report and the families was key to making sure problems were dealt with effectively.

“We will implement the immediate and essential actions – many of which because Donna has fed them back to us over the years of the review.

“So for example, we’ve already implemented Martha’s Rule in our maternity services and are one of the first in the country to do that.

“We absolutely must listen to women and families and the families have been good enough to share their experiences with us and I’ve met many of them.

“If we don’t listen to them, we won’t continue to improve,” he said.

It was also confirmed a Learning and Improvement Board was to be chaired by Labour MP Michelle Welsh, who suffered birth trauma at the trust in 2020.

Some of the families affected by NUH’s failings have renewed their calls for a statutory public inquiry into maternity services across England, stressing the need for accountability of individual staff and executives.

Natalie and David Needham, whose son Kouper died just hours after being discharged in July 2019, said the years of campaigning did not diminish the impact of the findings.

David said: “[The report] was just really powerful and shocking at the same time.

“Together I think we’re much stronger – as a support group and going forward as well – but it was just so shocking some of the stories that were coming out.

“Even the majority of the core group families couldn’t imagine.”

Felicity Benyon, whose bladder was wrongly removed during an emergency hysterectomy, said one issue stood out for her.

“The fact that they knew,” she said. “As a senior leadership team, as a governance team, they knew.

“They had so many investigations internally and externally, mums repeatedly saying ‘something’s not right, the care isn’t right, this has happened to me’, and they had whistleblowing staff.

“And yet they didn’t do enough.”

The report said 66 former and current senior colleagues were approached by the chief executive of the trust, of which 37 came forward and 35 were interviewed as part of Ockenden’s review, but a number of senior staff refused to take part.

As a result, on Wednesday the government announced – as part of the extension of Martha’s Rule – that any NHS staff past and present who refused to engage with future reviews could face up to two years in prison.

May said: “Accountability is an enormously important issue for the families. I know we don’t always meet their aspirations, but it is important to us and we have acted on accountability.

“All the senior executives currently employed by the organisation I represent have engaged with Donna’s review.

“I encouraged them to do that and they did.

“Those who have left the organisation may have made a different choice.”

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