In a twist that makes bedside manner look like a distant memory, a senior midwife at Nottingham University Hospitals NHS Trust (NUH) reportedly used the acronym "FOH" - shorthand for a three-word phrase involving a swear word, "off," and "home" - to signal that heavily pregnant women should leave the maternity unit. The revelation comes from a 2018 resignation letter unearthed by BBC Panorama, offering a window into the trust's cozy culture of casual cruelty.
The same letter mentions another midwife allegedly advising colleagues to send worried pregnant women home with the gem: "Don't be too kind, she'll keep coming back." Because nothing says "compassionate care" like treating labor as an annoying repeat customer.
The trust is currently under the microscope of the largest maternity inquiry in NHS history, investigating care for roughly 2,500 families between 2012 and 2025. The inquiry, led by senior midwife Donna Ockenden, has already heard from 800 staff and is due to publish its findings on June 24. Ockenden notes that Nottingham apparently thought it was "some kind of superior NHS trust" - superiority that apparently included a determination to keep women home until their babies were beyond saving.
One midwife recalled a woman who called to say she was in labor and was told not to come in. "When she came in, her baby was dead. The mother's perineum and vaginal wall collapsed because she'd been left to labour for so long. She now has a stoma bag." Another staffer overheard a colleague say: "I've never had to tell a woman so loudly, and so often, that she would kill her baby if she didn't push."
The toxic culture extended beyond words. One midwife recounted a junior staff member being ignored when she buzzed for help because "the co-ordinator and her cronies were busy shopping for handbags online." Chronic understaffing was the rule, with one community midwife noting that management's safety claims were as reliable as a chocolate teapot. "You have to be resilient, and to be resilient you have to lower your compassion," she explained.
In 2018, senior midwife Sue Brydon sent a letter signed by over 50 staff warning of an "ongoing failure of workforce planning." The trust's response? "All they did was blame the HR department." A 2023 investigation by current CEO Anthony May found no meaningful action had been taken. Instead, the board relied on expensive external reviews that gathered dust.
The trust also developed its own "high level incidents" classification to avoid reporting serious cases to regulators, reducing external scrutiny. Ockenden cited "very serious issues of maternal harm that were not reported." Racial discrimination was rampant, with staff mimicking accents and dismissing South Asian women's pain as mere complaining. "I think it was just discrimination," Ockenden said flatly.
May, who took the helm in 2022, has publicly apologized and vowed to fix things. The Care Quality Commission recently upgraded the trust from "inadequate" to "requires improvement" - which is like getting a D- instead of an F. NHS England says new clinical standards are being introduced, and the Department of Health and Social Care is investing £149 million and recruiting 2,000 more midwives. For the families in Nottingham, it's a little late for a do-over.