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Feature Maternity Care

Implementing Ockenden: What next for NHS maternity services?

BMJ 2022; 377 doi: (Published 12 May 2022) Cite this as: BMJ 2022;377:o1120
  1. Emma Wilkinson, freelance journalist
  1. Sheffield
  1. emmalwilkinson{at}

Funding, recruitment, retention, and interprofessional training will all be key, says Emma Wilkinson—but there are concerns that effective current models of care will be wrongly jettisoned

Doctors have described the Ockenden review as a watershed moment for NHS maternity services, but what’s striking about its conclusions is just how many times similar recommendations have been made for the past decade or more.

The final report into maternity services at Shrewsbury and Telford Hospital Trust,1 published at the end of March after a review of the care received by almost 1500 families from 2000 to 2019, described an NHS maternity service that had failed. Those failings were repeated time and time again, with patients and staff not being listened to, investigations not done, and missed opportunities to make improvements. Underpinning it all were ongoing staff shortages and a lack of training, a culture of “them and us” between midwives and obstetricians, and concerns not being escalated or action not taken.

Donna Ockenden, the senior midwife who chaired the review, also criticised a reluctance to perform caesarean sections in the context of a national drive to promote normal births, for which organisations such as the Royal College of Midwives have since apologised.

The five year inquiry for the report may be the largest and most comprehensive such review in NHS history, but there have been others: Northwick Park in 2006, Morecambe Bay in 2015, and Cwm Taf in 2021. Investigations are ongoing into services in Nottingham and at East Kent. And as far back as 2008 in Safe Births: Everybody’s Business,2 the King’s Fund highlighted the need for effective leadership, clear communication, and adequate staffing levels for safe maternity services.

Mary Ross-Davie, the Royal College of Midwives’ director for professional midwifery, says, “It’s incredible how it’s the same …

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