Maternity care failings ‘worse than anticipated’, national investigation warns

The chair of the National Maternity and Neonatal Investigation (NMNI) has warned that problems with services are ‘much worse than I anticipated’, in her initial reflections on care quality across England.

Baroness Valerie Amos said she also had specific concerns around the challenges that maternity and neonatal staff are facing as they deliver these services.

Her comments come alongside a newly published report setting out her early impressions gathered from engagement with families, visits to seven NHS trusts, meetings with staff and discussions with a wide range of national stakeholders.

The government appointed Baroness Amos to lead the investigation in August following feedback from bereaved families who ‘expressed a preference for someone with distance from the NHS who is able to bring a fresh pair of eyes to the role’.

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The investigation was first announced in June to look ‘urgently’ at the worst-performing services in the country, alongside the maternity system as a whole.

Baroness Amos said she had heard repeated accounts from women and families of not being listened to, poor communication, discrimination and a lack of support to make informed choices.

Staff also described significant pressures, distress caused by social media targeting, and the impact of poor-quality facilities and estates.

However, the investigation also heard about positive developments. Staff commented on the beneficial impact of specialist midwifery posts, such as bereavement pathway midwives and midwives leading on addressing inequalities, which have improved families’ experiences and raised awareness of inequalities issues among staff.

Increased accessibility and visibility of senior midwifery leaders was also identified as having improved morale, as well as contributing to early resolution of staff concerns and a more positive experience for women and their partners.

Although the investigation has not yet reached conclusions, the reflections form the basis for developing national recommendations aimed at improving the safety and quality of maternity and neonatal services.

Last month, those behind the NMNI warned that some delays to the investigation were expected, with a call for evidence pushed back from November to January 2026.

The next phase will also involve further site visits by Baroness Amos and the gathering of views from staff both inside and beyond the 12 trusts under review. This will include neonatal nurses and wider maternity staff groups.

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Baroness Amos said: ‘I know that doing so can be traumatic and stressful, but it is crucial to hear first-hand what is going on to help inform the wholescale change to maternity and neonatal services I feel is necessary.’

The investigation will publish a report in February 2026 summarising findings from the trust visits, with a final report and national recommendations due in spring 2026.

These recommendations will then be developed into a National Action Plan by the Maternity and Neonatal Taskforce, chaired by health secretary Wes Streeting.

Baroness Amos added: ‘When I was asked by the secretary of state for health and social care to chair a rapid independent investigation into maternity and neonatal services in England, I knew that it would be challenging.

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‘I also knew that, despite many previous inquiries, investigations and reviews, there were still many families who felt let down by the care they have received across the country.

‘But what I have found so far has been much worse than I anticipated and the scale of unacceptable care experienced by women and families across the country is extremely concerning.

‘The challenges that staff are facing as they deliver maternity and neonatal services to women and families also concerns me.’