One to One Midwives collapsed owing millions to NHS after not paying bills

The collapse of One-to-One Midwives one year ago came as a shock to many – including hundreds of pregnant women using the service.

With a shop on Sankey Street in the town centre, the service proved popular with Warrington women preferring a home-birth experience rather than a hospital-led pregnancy.

However, the Warrington Guardian can reveal that the company racked up millions of pounds in debt after not paying NHS bills from the outset.

When a woman in their care experienced a complication or illness, they were sent to A&Es across the north west, often without their medical forms or information.

Maternity units in Warrington, St Helens, Liverpool, Chester, Mid Cheshire and Wirral then took over the woman’s care and sent invoices to One to One Midwives for the cost of treatment.

These bills were often not paid and hospitals were left with outstanding debts of more than £2.6 million.

Women would often be sent to be scanned at hospital trusts if the Sankey Street centre was unavailable, with bills again routinely unpaid.

The Warrington Guardian also understands that several hospital bosses raised financial and clinical concerns with NHS England multiple times.

The One to One Midwives shop on Sankey Street

A series of freedom of information requests revealed the scale of these debts.

Some hospital trusts including Wirral University Teaching Hospitals and Mid Cheshire Hospitals NHS Foundation Trust withheld information due to ongoing legal battles with One to One.

The statement of affairs from September outline the estimated claims from NHS Trusts as £2,691,289.

Employees with outstanding wage claims in relation to holiday pay are owed an estimated £92,600.

Two hundred and fifty pregnant women in the Warrington and Halton area were affected by the collapse but all women were contacted and supported by the hospital.

Eighteen women were transferred to a different provider, the others transferred their care to Warrington and Halton Hospital.

There were 194 pregnant women and 56 postnatal women and babies who the Trust ensured had ongoing care provision for maternity care.

The cost of transferring and delivering ongoing services to women who transferred from One to One to Warrington and Halton Teaching Hospitals from the period stands at £321,241.

There were 51 incidents and lapses of care the Trust had to put right because of failings by One to One Midwives.

In total, Warrington and Halton Hospital Trust is owed £877,691.37.

East Suffolk and North Essex Hospital Trust are owed more than £500,000 while it was estimated on initial records that Mid Cheshire Hospital was owed £166,000.

Liverpool Women’s Hospital is owed £473,000 and took on 258 women following the collapse.

This cost excludes overheads and any clinical negligence scheme for trust contributions.

The Countess of Chester Hospital NHS Foundation Trust is owed £148,000 and took 312 women into their care following the company’s collapse.

Another large debt is owed to the Mid Essex Hospital Service NHS Trust who are owed an estimated £114,842. The total debts stand at more than £3 million.

Who were One to One Midwives?

One to One Midwives was a community midwifery service contracted to provide care on the NHS and was set up in 2010.

The service was for women who did not want a hospital-led pregnancy.

A woman could get her scans and tests done at the Sankey Street shop and be assigned the same private midwife for the entirety of their pregnancy, birth and postnatal period.

Mums would give birth at home under the care of a One to One midwife.

One to One received its first NHS contracted payment from Wirral CCG in 2013.

It then won a contract to provide community midwifery services on behalf of NHS Warrington Clinical Commissioning Group in 2016 and this was due to run until March 2020 before it went out of business last summer.

Joanne Parkington, the founder and director of One to One Midwives

One to One Midwives was also commissioned to run NHS services in Liverpool, West Cheshire, South Cheshire, Vale Royal, South Sefton and Southport and Formby.

It also provided the same service in Essex, namely in the Colchester and Clacton areas.

READ: Women were 'totally misled' by skewed birthing stats, says midwife

In May 2018 the Warrington shop was vandalised twice in two weeks, with someone spraying ‘Not NHS’ across the shutters.

At the time of the company’s collapse in July 2019, thousands of women in the north west were then receiving pregnancy advice from One to One’s midwives.

Some women were more than 40 weeks’ pregnant at the time of the collapse.

What was the company paid?

• One to One Midwives was paid a total of £5,834,242 by Wirral CCG, the lead commissioner, between 2013 and 2019.
• 2013/2014: £1,244,339 paid quarterly invoice and reconciliation
• 2014/2015: £1,131,926 paid monthly invoice and reconciliation
• 2015/2016: £919,192 paid monthly invoice and reconciliation
• 2016/2017: £807,347 paid monthly invoice and reconciliation
• 2017/2018: £807,610 paid monthly invoice and reconciliation
• 2018/2019: £755,997 paid monthly invoice and reconciliation
• 2019/2020: £167,831 paid £60,000 per month April-July = £240,000 (no reconciliation)

The company received its first notice for voluntary strike-off in January 2020.

Administrators were appointed on August 1 following the company’s collapse. At the date of appointment, the company’s bank account was in credit at £280,027.

Joanne Parkington sent a letter two days before the company’s official collapse to inform health chiefs in which she called the CCG tariff ‘not viable or sustainable’.

She said: “Over the last few weeks it has become apparent that the proposed new service specification will not be viable or sustainable, as I believe was the intention of the CCGs, and there has been no support to seek a solution to the financial crisis of maternity services across the region, or indeed nationally.

“These are the main reasons for being unable to continue, along with the clear message that the CCGs and NHS England are not willing or able to provide the level of support that this service or model of care needs to survive.

“I believe that the emphasis is now on the financial basis of the service and not on the excellent clinical outcomes that this model of care achieves for women and their babies.”

Clare Strickland, deputy director of Professional Regulation for the Nursing and Midwifery Council, said: “We are aware that concerns have been raised following the closure of One to One Midwives last year and we will take any regulatory action we consider necessary, including reviewing any additional information arising out of this investigation.”

In October, the Royal College of Midwives issued a statement in response to the announcement of an independent inquiry into One to One.

Gill Walton, chief executive of the Royal College of Midwives, said: “I hope that through this investigation lessons can be learnt so that steps can be taken to prevent something similar from happening again. We need to have robust systems in place to prevent other women, families and midwives from facing a situation like this.

“The RCM will cooperate and support the investigation in any way it can working with NHS England, NHS Improvement and the independent investigators.”

Warrington Hospital left with debts of more than £1 million 

Warrington Hospital took over the care of hundreds of pregnant women within days following the collapse of One to One last summer.

It has been left with bills of more than £1 million from the failed firm.

Most of that (more than £800,000) was for the failure of One to One to pay the bill for services carried out at the hospital.

This could be scans, or treatment a mother or child needed following or during a home birth. The other £300,000 was to cover the costs after the collapse.

Warrington Hospital (Image: .)

Simon Constable, chief executive of Warrington and Halton Teaching Hospitals NHS Trust, said: “We can confirm that the debt owed to this trust by the collapsed One to One Midwives is £877,691.

“We moved swiftly to accommodate those women who were left without midwifery support with 48 hours’ notice, some of whom gave birth with us almost immediately and we were able to support their personal birth plans as far as clinically possible.

“Feedback from women who transferred to the trust has been uniformly positive.

“We were able to employ some of the midwives who were left without jobs, and who are continuing happy and fulfilling careers with us.

“Beyond this we are unable to provide further comment as there is a formal investigation under way.”

A Warrington Hospital worker who did not wish to be named said: “Frankly, this organisation has been trading fraudulently for years – using public money to prop up lavish lifestyles.

"They continued to book women and take money from the commissioners – when they have known for a long time the business was unsustainable.”

Founder's second maternity service loses insurance 

Joanne Parkington, who set up the business and acted as director, trained as a midwife at the University of Chester.

She lives in Middlewich and is also listed as being the director of One to One Partnership Ltd, The One to One Foundation which are now in liquidation.

However, she is still company director of My Midwife and Me Ltd which was established in 2012.

This changed names from One to One (Birth Centres) Ltd in June 2016.

The professional indemnity arrangement (insurance) provided through My Midwife & Me Limited ended on June 30.

After this date no midwives can rely on this policy for their professional indemnity cover, as all midwives must be covered by an appropriate indemnity arrangement, which means staff cannot not practise as a midwife.

My Midwife & Me members were made aware that the indemnity arrangement they relied on was coming to an end in October.

Following the collapse of One to One on July 31 last year, Parkington was appointed business development specialist at Birth Like a Boss in August 2019.

The online membership programme charges women £17 a month to ‘expand’ their knowledge of births.

In her website biography, Joanne Parkington says: ‘My expertise is midwifery but also in business and I know that I have got a lot of knowledge to share.’

This was established days after her company collapsed.

Joanne’s husband Stephen Parkington is listed in documents claiming £93.98 in mileage from the company’s remaining credit for when he visited the offices to empty them of ‘clinical waste and drugs’ following the collapse.

On her LinkedIn profile under her One to One experience, she says: ‘I have developed a process driven model that provides a robust framework to deliver safe high-quality care which in turn releases clinicians to have time to develop meaningful relationships with women and their families.

‘Our service is focused on supporting organisations to adopt safe and effective practices that are sustainable and financially viable.’

Health bosses await review on the collapse of the service

The arrival of the companies like One to One changed the landscape of health services in the UK.

Women could now choose to have their babies outside of the NHS.

Services such as One to One could bid to win a contract from clinical commissioning groups.

They received the same amount of money per expectant mother as a hospital would – all paid as soon as the mum booked in.

Warrington CCG commissioned One to One to carry out midwifery services in Warrington, alongside Warrington Hospital and community midwives.

So parents could choose how they wanted to be cared for during their pregnancy.

NHS Wirral CCG was the lead commissioner for this service and therefore represents the position of all NHS commissioners contracted with One to One (North West) Limited.

A spokesperson for NHS Wirral CCG: “As soon as NHS commissioners were advised that One to One (North West) Limited had decided they were unable to continue with their contract to provide community midwifery services, and subsequently went into administration on July 31, 2019 we took action to ensure as a priority that those women registered with the service could continue to access the support they needed.

“Women affected were contacted directly by a dedicated team to make arrangements to transfer their care to an alternative provider.

“An independent review into the circumstances that led to the organisation going into administration is ongoing and we will await the outcome of that work to ensure any further actions required are implemented appropriately.”

The independent inquiry has been commissioned by NHS England and NHS Improvement North West Region.

NHS England and Joanne Parkington were approached for comment.

If you were affected by the closure of One to One Midwives, email isobel.cotogni@nqnw.co.uk