Complete guide to NHS maternity services in the UK — safety improvements following Ockenden report, continuity of carer model, perinatal care, maternity dashboards, and maternity software.
The Ockenden Report highlighted major maternity safety failings. NHS England is implementing all recommendations by 2026. Maternity dashboards, continuity of carer, and enhanced safety training are now mandatory.
NHS Maternity Safety Targets
| Target | Aim | Current (2026) |
|---|---|---|
| Stillbirth rate | < 2.6 per 1,000 | 3.1 per 1,000 |
| Neonatal mortality | < 1.0 per 1,000 | 1.3 per 1,000 |
| Maternal mortality | < 9 per 100,000 | 10.9 per 100,000 |
| Brain injury at term | 50% reduction by 2025 | 35% reduction achieved |
| Preterm birth | 25% reduction by 2025 | 15% reduction achieved |
| Continuity of carer | 75% of women | 55% |
Maternity Dashboard Metrics
| Metric | Target | Alert Threshold |
|---|---|---|
| Stillbirth rate | < 2.6/1,000 | > 3.5/1,000 |
| C-section rate | 10-15% (planned) | > 25% |
| Induction rate | 20-25% | > 35% |
| Perineal 3rd/4th degree tear | < 3% | > 5% |
| Postpartum haemorrhage > 1.5L | < 3% | > 5% |
| Breastfeeding at discharge | > 75% | < 60% |
| Epidural rate | Variable | Monitor trend |
| Instrumental delivery | 10-15% | > 20% |
Ockenden Implementation Actions
- National maternity safety champion: Every trust must have a Board-level maternity safety champion
- Continuity of carer: Named midwife/team for 75% of women by 2026
- Fetal monitoring training: Annual CTG training for all maternity staff
- Senior review: Consultant review of all complex cases within 30 minutes
- Listening to families: Formal family feedback and involvement in care
- Maternity dashboards: Real-time safety metrics reviewed by Board monthly
- Staffing levels: Publish midwife-to-birth ratios and escalate shortages
- Safety culture: Encourage incident reporting and learning
Frequently Asked Questions
- What are the Ockenden Report recommendations?
- The Ockenden Report (2022) reviewed maternity failings at Shrewsbury and Telford NHS Trust. Key recommendations: 1) National maternity safety champion, 2) Enhanced continuity of carer, 3) Improved fetal monitoring training, 4) Better listening to families, 5) Senior obstetric review of complex cases, 6) Maternity dashboards in all trusts. All NHS trusts must implement by 2026.
- What is continuity of carer in NHS maternity?
- Continuity of carer means a named midwife (or small team) provides care throughout pregnancy, birth, and postnatally. NHS England targets 75% of women to receive continuity of carer by 2026. It reduces preterm births by 24% and miscarriages by 16%.
- What is a NHS maternity dashboard?
- A maternity dashboard is a real-time monitoring tool tracking key safety metrics: stillbirth rate, neonatal mortality, maternal mortality, C-section rate, induction rate, perineal tear rate, postpartum haemorrhage rate, and breastfeeding rate. All NHS trusts must have a maternity dashboard reviewed monthly by the Board.