Basildon Hospital Pays £735,000 to 121 Maternity Staff Over Nitrous Oxide Exposure

NHS Resolution has confirmed that 121 claims from maternity staff at Basildon Hospital in Essex have been settled for a total of £735,000. The union and law firm behind the case put the figure at almost £750,000.

The claimants include 85 midwives, according to the Royal College of Midwives (RCM). They reported fatigue, anxiety, headaches and "brain fog" after breathing in nitrous oxide, the main component of the gas-and-air pain relief used in labour. The RCM calls it the largest group legal action ever brought by midwives in the UK.

It is public money paid out because a hospital did not fix a problem it had identified.

What happened on the maternity unit

An internal Basildon Hospital report found some staff were exposed to levels up to 30 times the legal workplace exposure limit between 2021 and 2023. The RCM blames poor ventilation on the maternity unit and leaking gas lines.

The trust had commissioned the testing that showed the breach. Staff were not told about the results for 16 months, according to the internal report.

An independent review by the Good Governance Institute found an "unacceptable delay" by Mid and South Essex NHS Foundation Trust in responding. It concluded staff were "exposed to unnecessary risk or potential harm." It also found the high gas levels should have been treated as a significant health risk when concerns were raised in July 2021, but that did not happen until October 2022.

Daniel Poet, a partner at Thompsons Solicitors, which represented the workers, laid out the sequence. "The trust knew about the dangers in 2021, but staff weren't told until the following year and it took another year for safety measures to be introduced. That delay is unacceptable," he said.

The trust settled after admitting that staff had been exposed to dangerously high levels of the gas. The legal action was first revealed by the BBC in May.

The trust's response

Louise Crosby, the trust's chief nursing and quality officer, said the trust had apologised to staff and acknowledged it should have acted more quickly. She said oversight of medical gas monitoring on the Basildon maternity unit has improved.

The trust says scavenger units, which remove waste anaesthetic gases, have been installed in the unit. Staff have been guided on using gas and air safely. It also says women can be confident that Entonox is safe for pain relief in all its maternity units.

The RCM makes the same distinction. Chief executive Gill Walton said: "This case was about the conditions midwives were working in, not the gas itself." The exposure risk was to staff on long shifts over months and years, not to women using the gas during birth.

The union's demands

Walton called the deal a "landmark settlement" that "should make every NHS employer sit up and take notice." She added: "If you don't protect your staff, the RCM will hold you to account."

She said that even after the problem was discovered, it was more than a year before staff were told. "That is simply not acceptable and no midwife should ever be treated that way," she said.

The RCM has written to every NHS trust in England about the risks of the gas. It also raised concerns about the trust's lack of action with the Health and Safety Executive (HSE) and has since worked with the HSE to update guidance on Entonox use.

Walton also pointed to the wider estate. "No settlement can fix the crumbling buildings midwives are working in across the UK," she said. By her account, too many units still have failing ventilation, leaking equipment and outdated facilities.

The government's position

A Department of Health and Social Care spokesperson said every patient and staff member should feel safe in NHS hospitals. The department says the government is investing £271 million to address critical safety risks in the maternity and neonatal estate.

That figure is the government's own claim. Walton has called on the government to invest urgently to bring maternity buildings up to standard.

What remains open

Not every claim is resolved. The RCM says one claim has yet to be settled. NHS Resolution said "some other claims remain outstanding" but has not given a number or a figure for what they could cost. It said it is unaware of any larger group of claims brought by midwives.

The revised Entonox guidance the RCM worked on with the HSE is the next thing to watch. It will show whether other trusts are being told to test and ventilate maternity units before a claim like this one reaches them.