England’s maternity services entered a new phase of scrutiny in 2026 after a series of major reviews and investigations documented serious failures in safety, communication and organisational culture. The most significant recent development was the final Ockenden review into maternity and neonatal services at Nottingham University Hospitals NHS Trust, published on 24 June 2026.
The review considered the experiences of more than 2,500 families. Its findings included missed opportunities to recognise deterioration, families feeling ignored or dismissed, and a culture in which some staff and parents did not feel able to raise concerns. The government and NHS England have since announced measures intended to strengthen escalation and accountability across maternity services.
Why the findings matter beyond one trust
The Nottingham review concerns one NHS trust, so its findings should not be presented as a statistical description of every maternity unit in the country. But it adds to a wider body of evidence showing recurring problems in some services: poor listening, weak escalation, staff culture, inconsistent clinical practice and unequal experiences of care.
In May 2026 the government also confirmed a national maternity investigation, chaired by Baroness Amos, intended to produce recommendations across England and address inequalities in maternity and neonatal care.
Martha’s Rule and escalation
One practical change announced in June is the extension of Martha’s Rule to all maternity settings in England. The principle gives patients and families a clearer route to request an urgent review when they believe deterioration is not being recognised or their concerns are not being heard.
This does not replace ordinary communication with midwives and clinicians. It is an additional escalation route designed for situations in which a patient or family remains seriously concerned.
What patients and families can reasonably do
People using maternity services should not be expected to compensate for systemic failings themselves. However, it can be useful to keep questions and concerns written down, ask clinicians to explain changes in symptoms or care plans, and seek clarification when something is not understood. Hospitals also have formal routes for raising concerns and complaints.
The central lesson from the 2026 reviews is institutional rather than individual: safe maternity care depends on clinical competence, effective staffing, a culture that listens to families and junior staff, and systems that respond quickly when concerns are raised.
A wider reform process
The national investigation, the Nottingham review and the expansion of Martha’s Rule mean maternity safety reform is still an active process rather than a completed programme. The important test will be whether recommendations translate into measurable improvements in day-to-day care, particularly for groups that have historically experienced poorer outcomes or felt less heard within the system.
Sources: Department of Health and Social Care, Ockenden review into maternity services at Nottingham University Hospitals NHS Trust, final report, 24 June 2026; Department of Health and Social Care and NHS England, Martha’s Rule extended to all maternity services, 24 June 2026.
