National maternity and neonatal service improvement efforts in England: what has been happening/ what’s going on?

By Jo Dagustun on behalf of the AIMS Campaigns Team

In this briefing note, Jo offers an account of what has been happening following Wes Streeting’s 2024 commitment to overhaul the maternity and neonatal services in England, and what further developments we might expect over the next few months.

In summary, it is likely that the Government will still be at the stage of ‘making a plan to make a plan’ for some months to come, which on the face of it represents very poor progress indeed. We seek to explore reasons for the delay in the Government’s establishment of a new shared vision and plan for maternity and neonatal service transformation, as we share our understanding of what’s been happening since July 2024. In doing so, we recognise that readers may have concerns about the pace of activity. For our part, we will reserve judgement until we see the promised deliverables: the new Modern Service Framework including/and the proposed ‘Compendium’ for maternity service providers, both expected in 2027.

Stage 1: a focus on NHS wide issues, July 2024- July 2025

The current Government came into power in July 2024, with the NHS key to its manifesto. The initial focus for the then Secretary of State for Health, Wes Streeting, was to commission a rapid review of the NHS in England, published as the Darzi Report in September 2024. During this period, however, his concern about the state of England’s maternity services was clear. In September 2024, Wes Streeting described the crisis in the maternity services as ‘one of the biggest issues that keeps me awake at night’.

There followed a period of public consultation and policy development leading to the publication of a new Ten Year Health Plan for England in July 2025. This is the plan that introduced the idea of three shifts, presented as core to modernizing the NHS: moving care from hospitals to communities, shifting from analogue to digital, and moving from treating sickness to preventing it.

Stage 2: a shift to maternity and the Amos Investigation, June 2025 - June 2026

During this period, the Three Year Delivery Plan for Maternity and Neonatal Services - which had been launched in March 2023 - continued, and discussions began on how national maternity service improvement plans would be informed by the Ten Year Health Plan.

During the finalisation of the Ten Year Plan, in June 2025, the National Maternity and Neonatal Investigation was commissioned, chaired by Valerie Amos. It was then decided that a National Maternity and Neonatal Taskforce, with Expert Reference Groups (ERGs) supporting this, would be the infrastructure that would support the Secretary of State for Health in receiving the National Investigation report, making a new plan for the reform of the maternity services, and for overseeing its successful delivery. These groups bring together over a hundred key stakeholders. They were assembled and ready to start work in March 2026, well before the publication of the National Maternity and Neonatal Investigation report at the end of June 2026.

At the same time, the Three Year Delivery Plan for Maternity and Neonatal Services came to an end, in March 2026. AIMS notes that neither the Taskforce nor the Expert Reference Groups have received a full account of how this plan delivered against expectations - something that AIMS would have expected, as this is surely key information in advance of a new plan being established. Neither did the NHS England Board receive any such account, which AIMS considers to be a remarkable lack of oversight.

In May, Michelle Walsh MP was appointed by the Government as a National Maternity Advisor, an unpaid role with support provided by the Department of Health and Social Care.

Stage 3: activity since the publication of the Amos Report, July 2026 onwards

Adding to the many previous recommendations for service improvement, and a further local report based on Donna Ockenden’s work in Nottingham, the publication of the National Maternity and Neonatal Investigation report at the end of June 2026 was ‘the starting gun’ for the work of the Taskforce:

• the chair of National Investigation, Valerie Amos, in addressing a gathering of Taskforce and Expert Reference Group Members in early July, made clear that her set of recommendations should not be treated as a blueprint, but that it is the job of the Taskforce to develop them - alongside additional issues as they see fit - into a comprehensive national reform plan

• In contrast, the chair of the recently published Nottingham report, Donna Ockenden, made clear that she expects each of her recommendations to be treated as final and implemented as soon as possible

In response to these reports:

• the Government responded immediately to accept the recommendation from the National Investigation to create a statutory role of Maternity and Neonatal Commissioner (to be legislated for via the Health Bill) and promised a ‘national action plan to be published in December to overhaul services and drive long-term change’, alongside a number of other commitments. At the same time, NHS England issued a Ten Point Plan for providers to start working on immediately - its corporate view of the most urgent and essential actions. The Taskforce and ERGs were not involved in discussions about the contents of these early and overlapping responses.

• The Taskforce and Expert Reference Groups have continued to meet, albeit without an explicit and agreed workplan. A forward-looking workplan has not yet been shared with ERGs, despite this being promised to Taskforce members over the summer¹:

• Notwithstanding the lack of a workplan, it is clear that preparatory work is being done on a range of topics behind the scenes at the Department for Health and Social Care and NHS England, with the Taskforce and ERGs being used as ‘sounding boards’ for some of this work. For example, the Taskforce has been briefed on and had an opportunity to discuss certain aspects of current maternity and neonatal service organisation and outcomes, as well as the Modern Service Framework initiative that was one of the core recommendations of the National Maternity and Neonatal Investigation (see below).

• The Taskforce and Expert Reference Groups have received presentations from both Valerie Amos and Donna Ockenden, have had an opportunity to discuss the plan for a Maternity and Neonatal Commissioner, and have looked at the current arrangements for maternity investigations, and initiatives designed to achieve equity in maternity and neonatal outcomes.

• Taskforce and Expert Reference Group members have spent a day together to focus on the theme of ‘listening to women’ (September 2026).

AIMS notes that it seems that the initial promise of full transparency - and of Ministerial decisions being taken only after consultations with the Taskforce - is not being fully delivered in practice. This raises questions about whether, as we had been led to believe, it is the Taskforce supported by the Expert Reference Groups that will be driving the process and offering the final advice to Ministers, or whether the agenda is being set by the Department for Health and Social Care (and - whilst it continues to exist - NHS England), with Taskforce and Expert Reference Group members having little meaningful part to play.

Current activity

As far as AIMS can tell, there currently seem to be two key outputs expected from the Taskforce and the Department for Health and Social Care: the development of a Modern Service Framework and the creation of what AIMS is calling the Maternity and Neonatal ‘Compendium’, although it seems possible that these might be merged into one:

• the Modern Service Framework (MSF)² will effectively be a new ‘ten year plan’ for maternity and neonatal services. As set out in the Ten Year Health Plan for England, Modern Service Frameworks - as part of the new National Quality Strategy - are expected to identify ‘moonshot policies’. These are innovative policies that should promise a step-change in outcomes, drawing on, but not restricted to, the ‘three shifts’ set out in the 10 Year Health Plan for England. It is not clear when this Framework is due to be published. The process by which the Framework will be established is also unclear.

• alongside this, and reflecting the fact that much good policy already exists - but just isn’t being implemented reliably, for all, in all areas - the National Investigation and others have called for the improved visibility of existing national expectations of maternity and neonatal service providers, including all relevant quality standards. AIMS supports this call, which we have conceptualised this as the need for a ‘compendium’: an integrated online service handbook, setting out in one place all expectations of maternity and neonatal service providers. This would be a checklist for providers to plan and provide assurance around the local delivery of services; for service users to identify what should be on offer to them; and for regulators to be clear about what providers are accountable for delivering.This in itself would be a worthwhile step forward, although a more complicated task than we believe many imagine.

Next steps

It seems that the Taskforce and Expert Reference Groups are not yet being expected to work directly on these outputs, however, but to be involved in developing a plan for their production. This plan is a so-called action plan for further work, due to be published in December 2026. AIMS expects this to include:

- confirmation of the plan to develop a Modern Service Framework for Maternity and Neonatal Services

- confirmation of the need to build a Compendium, or service handbook, drawing on existing and newly identified service expectations/ quality standards

- an update on how the the planned Modern Service Framework and Compendium between them respond appropriately to the recommendations made in the National Investigation Report and all other previous inquiries into individual maternity services, including a commitment to publish the rationale for how each recommendation has been actioned

- a list of further key issues identified as priorities by the Taskforce or Expert Reference Groups, and how they will be included in the work plans for the development of either the Modern Service Framework or the Compendium as appropriate.

We expect this action plan for further work to clearly establish the work processes and methodology envisaged, timelines for each of these workstrands, and full details of the related stakeholder engagement plans.

Broader context - the Health Bill

In parallel with this activity, it is important to remember that the Health Bill continues its passage through Parliament and will include a proposal for a Maternity Services Commissioner. It is vital that the Taskforce and Expert Reference Group members understand the implications not only of this proposal but other aspects of the bill that will impact maternity and neonatal service policy.

Next steps for AIMS

As a member of the Charities and Third Sector Expert Reference Group, AIMS Volunteers are in regular contact with a range of colleagues across the maternity services improvement sector, scrutinising the materials we are receiving, offering feedback and flagging issues of concern.

We are keen to receive the promised workplan: we will be looking at that to understand how the Taskforce and Expert Reference Groups will be meaningfully involved both in the development of the December Action Plan and beyond, together with stakeholders beyond those groups.

We are also keen to understand the process for selecting policy priorities that sit outside the National Investigation recommendations, to be included in the December Action Plan.

We look forward to commenting on the draft legislative proposals for a Maternity and Neonatal Commissioner, when these are available.

We have already begun to develop and share our own ideas for the Maternity and Neonatal Modern Service Framework.

We will participate in further Taskforce and Expert Reference Group discussions and meetings, as well as feeding into the process on our own initiative.

Final reflections

It could be argued that AIMS volunteers have been ‘insiders’ in the development of the processes set out in this note, given our long-standing membership of NHS England’s Maternity and Neonatal Stakeholder Council and now of an Expert Reference Group. Certainly, we have been busy over the last couple of years offering our input and feedback at every stage of the way.

As such, we may not have been as frustrated by the passing of time as others less involved in this work. Nevertheless, it’s certainly quite something to reflect that the Government will likely still be at the stage of ‘making a plan to make a plan’ as we break for the Christmas holidays, nearly two and a half years after they came to power.

We very much hope that the work done to date, in examining both the dysfunction in and functioning of the maternity services and the wider NHS, will serve as a solid foundation for the development of an ambitious and achievable Modern Service Framework for the maternity services, including a strong focus on human rights, implementation and governance. We argue that this must include much of the undelivered Better Births agenda, especially in terms of a much-needed shift towards integrated community-based provision and the provision of full pathway midwifery continuity of carer for all. We also very much welcome the prospect of a maternity services ‘compendium’, in which national expectations of service providers are made absolutely clear, and we look forward to supporting its development.

But many questions remain. Having been attentive to this area of public service development for 66 years, and watching the fate of multiple reports and recommendations over that time, AIMS is particularly well placed to attend to the question of whether all of this activity is really likely to lead to substantive improvement, where previous attempts have failed. Or as it was put in a recent meeting, “What’s different this time around?” Time will tell, of course. For now, in our view, there is a key difference that we think bodes well. This is the explicit commitment to do public policy differently: public policy making, involving dozens of stakeholders from across the stakeholder community, being done in public. It is this commitment that we think stands a chance of producing a more robust agenda for change, and it is on that basis that we will continue to press for transparency, openness and inclusion.

Jo Dagustun on behalf of the AIMS Campaigns Team

[October 1, 2026]

Footnotes

1 “The Secretary of State confirmed that a work plan for the Taskforce would be drawn up and shared with the Taskforce over the summer to support members’ engagement with their expert reference groups.” From the note of the July Taskforce meeting: https://assets.publishing.service.gov.uk/media/6a71fd238a340ed57ba476e0/national-maternity-and-neonatal-taskforce-july-2026-meeting-note.pdf

2 “The Secretary of State confirmed that a plan for the development of the Modern Service Framework would be considered as part of the Taskforce’s future work.” From the note of the July Taskforce meeting. https://assets.publishing.service.gov.uk/media/6a71fd238a340ed57ba476e0/national-maternity-and-neonatal-taskforce-july-2026-meeting-note.pdf