Source · Select Committees · Public Accounts Committee
Recommendation 20
20
Accepted
Maternity workforce struggles and poor planning contribute to rising clinical negligence claims.
Conclusion
Evidence from the Royal College of Obstetricians and Gynaecologists suggested that the maternity workforce is struggling under the pressure of delivering increasingly complex care, with more than half of births involving medical intervention, such as a caesarean section or the use of instruments such as forceps.47 Similarly, evidence from Sands and Tommy’s Joint Policy Unit raised concerns that inadequate training, poor workforce planning and failure to adhere to staffing requirements have created the conditions which result in clinical negligence claims being filed.48 NHS England told us it carefully monitored trusts with high levels of maternity related clinical negligence claims and around 30 trusts are taking part in its maternity support programme.49 However it accepted that it had struggled to reduce maternal mortality rates in recent years, pointing to increasing maternal risk factors such as obesity and age.50 NHS England told 41 The Rehabilitation Code is a voluntary framework offered by insurance companies in the context of personal injury claims: Rehabilitation Code (Code of Best Practice on Rehabilitation, Early Intervention and Medical Treatment in Personal Injury claims, 2015 42 CCC (by her mother and litigation friend MMM) (AP) (Appellant) v Sheffield Teaching Hospitals NHS Foundation Trust (Respondent) 43 Qq 46, 48 44 Qq 43, 48 45 C&AG’s Report, para 3.23 46 Q 48 47 Royal College of Obstetricians and Gynaecologists (CCN0021) 48 Sands and Tommy’s Joint Policy Unit (CCN0003) 49 Q 84 50 Q 51 15 us that it expects the final part of the Amos Review into England’s maternity and neonatal services in 2026 but this did not mean it was waiting to act in its recommendations.51 Disproportionate legal costs
Government Response Summary
The government agrees to learn lessons from failures in maternity care and address systemic failings, aiming for implementation by Winter 2026-27, including a national investigation, the National Maternity and Neonatal Planning Framework, best practice resources, and the Maternity Outcomes Signal System.
Government Response
Accepted
HM Government
Accepted
4. PAC conclusion: The Department's failure to address problems with maternity care in England has led to avoidable harm and unnecessary costs. 4a. PAC recommendation: The Department and the organisations it funds need to learn lessons from its failure to improve maternity care in England. Where problems arise the Department and the wider NHS should look for systemic failings in care and tackle these problems at their cause. 4.1 The government agrees with the Committee’s recommendation Target implementation date: Winter 2026-27 4.2 The Secretary of State announced a rapid, national, independent investigation into NHS maternity and neonatal care to help understand the systemic issues behind why so many women, babies and families experience unacceptable care. The Investigation will bring together the findings of past reviews into one clear national set of recommendations, including local investigations of maternity and neonatal services in selected trusts. 4.3 The National Maternity and Neonatal Taskforce, chaired by Secretary of State, will transform the Investigation’s recommendations into a new national action plan to drive real change. 4.4 DHSC is not waiting for the recommendations to improve services. NHS England’s Medium-Term Planning Framework sets out the requirement for all Integrated Care Boards and providers to take immediate steps to improve care, ensuring that progress is already underway ahead of the national action plan. 4.5 The introduction of best practice resources, including the maternal care bundle, new approaches to avoiding brain injury, a new maternity triage specification and roll out of the Perinatal Equity and Anti-Discrimination Programme, will help improve safety and consistency across services. NHSR’s Maternity Incentive Scheme continues to work with trusts to deliver safer maternity care and reduce cases of brain injuries or other harm. 4.6 The Maternity Outcomes Signal System, has been implemented across all trusts from November 2025, allowing near real time monitoring of key indicators and prompt timely safety reviews. 4.7 In January 2026 the Maternity and Neonatal Inequalities Data Dashboard was published, which will give leaders clearer insight into variation and emerging risks.